Abstract
Background
The roles of occlusion in various aspects of clinical dentistry have been the subjects of long-standing debates. The purposes of this study were to examine the fundamental engineering-based relationships between occlusion, a clinical principle of occlusion, the forces experienced by the temporomandibular joint and temporomandibular joint disorders.
Methods
The governing equations of static equilibrium, based on Newton’s laws, were applied to the mandible to compute the forces on the temporomandibular joint and to relate those forces to the alignment of occlusal forces with the long axes of teeth, the principle of occlusion in question. Calculations were performed for 48 combinations of 4 teeth (maxillary and mandibular incisors and molars) with 3 angulations of each and 4 prescribed sets of muscle forces.
Results
The analyses indicate that (1) anatomic dimensions are inherent variables in the equations of equilibrium and (2) the 48 combinations of teeth and muscle forces yielded forces on the joint with an approximately 23:1 range in magnitudes and directions that spanned the entire 360°.
Conclusions
Because mandibular dimensions in the equations of equilibrium translate directly into factors of occlusion (e.g., cusp angulation, vertical dimension of occlusion, occlusal plane height and anterior–posterior occlusal contact location) it is concluded that occlusion is a determinant of joint force and hence, it is fundamentally involved in temporomandibular joint disorders. Flawed contemporary principles of occlusion have made it impossible to prove or disprove a link between occlusion and temporomandibular joint disorders.
Similar content being viewed by others
References
Alanen P. Occlusion and temporomandibular disorders (TMD): still unsolved question? J Dent Res. 2002;81:518–9.
Rinchuse DJ, Kandasamy S. Evidence-based versus experience-based views on occlusion and TMD. Am J Orthod Dentofacial Orthop. 2005;127:249–54.
Dawson PE. Evidence-based versus experience-based views on occlusion and TMD. Am J Orthod Dentofacial Orthop. 2005;128:150–1; author reply 151–2.
Luther F. TMD and occlusion part I. Damned if we do? Occlusion: the interface of dentistry and orthodontics. Br Dent J. 2007;202:E2; discussion 38–9.
Turp JC, Greene CS, Strub JR. Dental occlusion: a critical reflection on past, present and future concepts. J Oral Rehabil. 2008;35:446–53.
Kirveskari P, Jamsa T. Health risk from occlusal interferences in females. Eur J Orthod. 2009;31:490–5.
Rinchuse DJ, Kandasamy S. Myths of orthodontic gnathology. Am J Orthod Dentofacial Orthop. 2009;136:322–30.
Carlsson GE. Some dogmas related to prosthodontics, temporomandibular disorders and occlusion. Acta Odontol Scand. 2010;68:313–22.
Manfredini D, Peretta R, Guarda-Nardini L, Ferronato G. Predictive value of combined clinically diagnosed bruxism and occlusal features for TMJ pain. Cranio. 2010;28:105–13.
Marklund S, Wanman A. Risk factors associated with incidence and persistence of signs and symptoms of temporomandibular disorders. Acta Odontol Scand. 2010;68:289–99.
Greene CS. Relationship between occlusion and temporomandibular disorders: implications for the orthodontist. Am J Orthod Dentofacial Orthop. 2011;139:11, 13, 15.
Miller DB. Diagnosis and treatment of temporomandibular disorders: emergence of a new care guidelines statement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111:133; author reply 136–7.
Okeson JP. A response to the AADR’s “Managing the care of patients with temporomandibular disorders: a new guideline for care”. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111:134–5.
Antosz M. Occlusion and TMDs. Am J Orthod Dentofacial Orthop. 2011;140:139; author reply 139–40.
Slavicek R. Relationship between occlusion and temporomandibular disorders: implications for the gnathologist. Am J Orthod Dentofacial Orthop. 2011;139:10–6.
Gray R, Al-Ani Z. Risk management in clinical practice. Part 8. Temporomandibular disorders. Br Dent J. 2010;209:433–49.
Michelotti A, Iodice G. The role of orthodontics in temporomandibular disorders. J Oral Rehabil. 2010;37:411–29.
Manfredini D, Bucci MB, Montagna F, Guarda-Nardini L. Temporomandibular disorders assessment: medicolegal considerations in the evidence-based era. J Oral Rehabil. 2011;38:101–19.
Deas DE, Mealey BL. Is there an association between occlusion and periodontal destruction?: only in limited circumstances does occlusal force contribute to periodontal disease progression. J Am Dent Assoc. 2006;137:1381, 1383, 1385 passim.
Harrel SK, Nunn ME, Hallmon WW. Is there an association between occlusion and periodontal destruction?: yes—occlusal forces can contribute to periodontal destruction. J Am Dent Assoc. 2006;137:1380, 1382, 1384 passim.
Bhola M, Cabanilla L, Kolhatkar S. Dental occlusion and periodontal disease: what is the real relationship? J Calif Dent Assoc. 2008;36:924–30.
Kundapur PP, Bhat KM, Bhat GS. Association of trauma from occlusion with localized gingival recession in mandibular anterior teeth. Dent Res J (Isfahan). 2009;6:71–4.
Taylor TD, Wiens J, Carr A. Evidence-based considerations for removable prosthodontic and dental implant occlusion: a literature review. J Prosthet Dent. 2005;94:555–60.
Carlsson GE. Critical review of some dogmas in prosthodontics. J Prosthodont Res. 2009;53:3–10.
Reyes E, Hildebolt C, Langenwalter E, Miley D. Abfractions and attachment loss in teeth with premature contacts in centric relation: clinical observations. J Periodontol. 2009;80:1955–62.
Francisconi LF, Graeff MS, Martins Lde M, Franco EB, Mondelli RF, Francisconi PA, et al. The effects of occlusal loading on the margins of cervical restorations. J Am Dent Assoc. 2009;140:1275–82.
Hirata Y, Yamamoto T, Kawagoe T, Sasaguri K, Sato S. Relationship between occlusal contact pattern and non-carious cervical lesions among male adults. Int J Stomatol Occl Med. 2010;3:10–4.
Pikdoken L, Akca E, Gurbuzer B, Aydil B, Tasdelen B. Cervical wear and occlusal wear from a periodontal perspective. J Oral Rehabil. 2011;38:95–100.
Katona TR. The effects of cusp and jaw morphology on the forces on teeth and the temporomandibular joint. J Oral Rehabil. 1989;16:211–9.
Katona TR. An engineering analysis of dental occlusion principles. Am J Orthod Dentofacial Orthop. 2009;135:696 e691–8; discussion 696–7.
Dawson PE. Functional occlusion: from TMJ to smile design. St. Louis: Mosby; 2007.
Okeson JP. Management of temporomandibular disorders and occlusion. St. Louis: Mosby; 2007.
Beer FP, Johnston ER, Mazurek DF, Eisenberg ER. Vector mechanics for engineers: statics. New York: McGraw Hill; 2010.
Ash MM. Wheeler’s dental anatomy, physiology and occlusion. Philadelphia: W.B. Saunders; 1993.
Helms RB, Katona TR, Eckert GJ. Do occlusal contact detection products alter the occlusion? J Oral Rehabil. 2012;39:357–63.
Katona TR. A mathematical analysis of the role of friction in occlusal trauma. J Prosthet Dent. 2001;86:636–43.
Katona TR. A qualitative engineering analysis of occlusion effects on mandibular fracture repair mechanics. J Dent Biomech. 2011:752741.
Kawagoe T, Onodera K, Tokiwa O, Sasaguri K, Akimoto S, Sato S. Relationship between sleeping occlusal contact patterns and temporomandibular disorders in the adult Japanese population. Int J Stomatol Occl Med. 2010;2:11–5.
Greven M. TMD, bruxism, and occlusion. Am J Orthod Dentofacial Orthop. 2011;139:424; author reply 424–5.
Robin O. Tooth clenching as a risk factor for temporomandibular disorders: a synthesis of recent publications. Int J Stomatol Occl Med. 2012;5:1–9.
Katona TR, Goodacre CJ, Brown DT, Roberts WE. Force-moment systems on single maxillary anterior implants: effects of incisal guidance, fixture orientation, and loss of bone support. Int J Oral Maxillofac Implants. 1993;8:512–22.
Conflicts of interest
There are no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Katona, T. Engineering analyses of the link between occlusion and temporomandibular joint disorders. J. Stomat. Occ. Med. 6, 16–21 (2013). https://doi.org/10.1007/s12548-012-0068-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12548-012-0068-1