Department of Prosthodontics, Center for Oral and Jaw Functional Diagnosis, Treatment and Research, Peking University School and Hospital of Stomatology, Beijing, China.
Center for TMD & Orofacial Pain, Peking University School and Hospital of Stomatology, Beijing, China.
J Oral Rehabil. 2022 Feb;49(2):116-124. doi: 10.1111/joor.13236. Epub 2021 Aug 14.
Occlusion can be viewed as the most sensitive susceptor of the central nervous system in the oro-facial region. Its inalienable relationships to the temporomandibular joint, the muscles, the stomatognathic system and even the central nervous system are self-evident. Almost all the dental treatments inevitably change the occlusion, potentially or actually, locally or extensively, and immediately or gradually.
The objective of this study was to present a narrative literature on occlusal disharmony and chronic oro-facial pain.
Literature reviews focusing on clinical studies about the relationship between occlusal disharmony and myofascial oro-facial pain, and related preclinical studies about the animal models of, as well as the peripheral and central mechanisms underlying this condition related to, occlusal disharmony were used as starting point and guidelines to describe the topics mentioned. A search of the PubMed database was performed mainly with the following search terms: "occlusion," "occlusal interference," "occlusal disharmony," "occlusal change," "oro-facial pain" and "myofascial pain."
Relevant literature from the past 70 years until the present day was meticulously studied. The literature review together with three related characteristic clinical cases revealed an intimate association between occlusal disharmony and chronic oro-facial pain, involving pathological changes, extending from the peripheral tissues to the central nervous system. The patients suffered from psychological distress, sleep disturbance and poor life quality.
Occlusal disharmony-related oro-facial pain is a clinical problem that deserves attention, although there are no universally accepted clinical protocols. The existing literature provides some constructive suggestions, but further research is needed.
口腔颌面部的中枢神经系统最敏感的易感器官可以看作是阻塞。它与颞下颌关节、肌肉、咀嚼系统甚至中枢神经系统的不可分割的关系是不言而喻的。几乎所有的牙科治疗都不可避免地改变了咬合，无论是潜在的还是实际的，局部的还是广泛的，即刻的还是渐进的。
本研究旨在对咬合失调与慢性口腔颌面部疼痛的文献进行综述。
以咬合失调与肌筋膜口腔颌面部疼痛之间关系的临床研究，以及关于动物模型的相关临床前研究，以及与咬合失调相关的外周和中枢机制为起点和指导，综述了有关文献。主要使用以下搜索词在 PubMed 数据库中进行了搜索：“咬合”、“咬合干扰”、“咬合失调”、“咬合变化”、“口腔颌面部疼痛”和“肌筋膜疼痛”。
精心研究了过去 70 年至今的相关文献。文献综述结合三个相关的典型临床病例，揭示了咬合失调与慢性口腔颌面部疼痛之间的密切关系，涉及从外周组织到中枢神经系统的病理变化。患者遭受心理困扰、睡眠障碍和生活质量差。
尽管没有普遍接受的临床方案，但与咬合失调相关的口腔颌面部疼痛是一个值得关注的临床问题。现有文献提供了一些建设性的建议，但仍需要进一步研究。
