Skip to main content
  • 1094 Accesses

Abstract

Careful evaluation of the occlusal scheme with an accurate diagnosis and treatment plan before orthodontically modifying the occlusion is a critical step in solving patients’ TMD problems; however, it is underappreciated and underutilized. To begin, the goals of occlusal treatment must be clearly defined before starting treatment. They should not be ambiguous, and clear goals are needed for each area affected with treatment. Changing the occlusion will influence the following areas:

  • Functional occlusion

  • TMJ

  • Three-dimensional position of the mandible

  • Periodontal tissues

  • Dental and facial esthetics

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Posselt V. Physiology of occlusion and rehabilitation. 2nd ed. Oxford: Blackwell; 1968. p. 76.

    Google Scholar 

  2. Ramfjord SP, Ash MM. Occlusion. 3rd ed. Philadelphia: WB Saunders; 1983. p. 95.

    Google Scholar 

  3. Roth RH. The maintenance system and occlusal dynamics. Dent Clin North Am. 1976;20:761–88.

    CAS  PubMed  Google Scholar 

  4. Lee R. Esthetics and its relationship to function. In: Rufenacht C, editor. Fundamentals of esthetics. Chicago: Quintessence; 1992. p. 153–5.

    Google Scholar 

  5. Williamson EH, Lundquist DO. Anterior guidance: its effect on electromyographic activity of the temporal and masseter muscles. J Prosthet Dent. 1983;49:816–23.

    CAS  PubMed  Google Scholar 

  6. Lundeen HC, Gibbs CH. The function of teeth. New York: L and G Publishers LLC; 2005. p. 70.

    Google Scholar 

  7. Posselt V. Physiology of occlusion and rehabilitation. 2nd ed. Oxford: Blackwell; 1968. p. 5.

    Google Scholar 

  8. Arnett GW, Bergman RT. Facial keys to orthodontic diagnosis and treatment planning. Part I. Am J Orthod Dentofacial Orthop. 1993;103:299–312.

    CAS  PubMed  Google Scholar 

  9. Ikeda K. TMJ 1st orthodontics. Concepts, mechanics, and stability. Tokyo: TOPNOTCH KIKAKU Ltd.; 2014. p. 29–35.

    Google Scholar 

  10. Wennström JL, Lindhe J, Sinclair F, et al. Some periodontal tissue reactions to orthodontic tooth movement in monkeys. J Clin Periodontol. 1987;14:121–9.

    PubMed  Google Scholar 

  11. Andrews LF. The six keys to normal occlusion. Am J Orthod. 1972;62:296–309.

    CAS  PubMed  Google Scholar 

  12. Dawson PE. A classification system for occlusions that relates maximal intercuspation to the position and condition of the temporomandibular joints. J Prosthet Dent. 1996;75:60–6.

    CAS  PubMed  Google Scholar 

  13. Drace JE, Enzmann DR. Defining the normal temporomandibular joint: closed-, partially open-, and open-mouth MR imaging of asymptomatic subjects. Radiology. 1990;177:67–71.

    CAS  PubMed  Google Scholar 

  14. Sicher H, DuBrul EL. Sicher’s oral anatomy. 5th ed. St Louis: C.V. Mosby; 1980. p. 158.

    Google Scholar 

  15. Burnett KR, Davis CL, Read J. Dynamic display of the temporomandibular joint meniscus by using “fast-scan” MR imaging. AJR Am J Roentgenol. 1987;149:959–62.

    CAS  PubMed  Google Scholar 

  16. Hansson T, Oberg T, Carlsson GE, et al. Thickness of the soft tissue layers and the articular disk in the temporomandibular joint. Acta Odontol Scand. 1977;35:77–83.

    CAS  PubMed  Google Scholar 

  17. Isberg A. Tempoeomandibular joint dysfunction: a practitioner’s guide. Oxford: Isis Medical Media Ltd.; 2001. p. 4–6.

    Google Scholar 

  18. Kircos LT, Ortendahl DA, Mark AS, et al. Magnetic resonance imaging of the TMJ disc in asymptomatic volunteers. J Oral Maxillofac Surg. 1987;45:852–4.

    CAS  PubMed  Google Scholar 

  19. Ribeiro RF, Tallents RH, Katzberg RW, et al. The prevalence of disc displacement in symptomatic and asymptomatic volunteers aged 6 to 25 years. J Orofac Pain. 1997;11:37–47.

    CAS  PubMed  Google Scholar 

  20. Tasaki MM, Westesson PL, Isberg AM, et al. Classification and prevalence of temporomandibular joint disk displacement in patients and symptom-free volunteers. Am J Orthod Dentofacial Orthop. 1996;109:249–62.

    CAS  PubMed  Google Scholar 

  21. Nebbe B, Major PW. Prevalence of TMJ disc displacement in a pre-orthodontic adolescent sample. Angle Orthod. 2000;70:454–63.

    CAS  PubMed  Google Scholar 

  22. Ikeda K, Kawamura A, Ikeda R. Prevalence of disc displacement of various severities among young preorthodontic population: a magnetic resonance imaging study. J Prosthodont. 2014;23:397–401.

    PubMed  Google Scholar 

  23. Kirkhus E, Arvidsson LZ, Smith HJ, et al. Disk abnormality coexists with any degree of synovial and osseous abnormality in the temporomandibular joints of children with juvenile idiopathic arthritis. Pediatr Radiol. 2016;46:331–41.

    PubMed  Google Scholar 

  24. Ikeda K, Kawamura A. Disc displacement and changes in condylar position. Dentomaxillofac Radiol. 2013;42:84227642.

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Legrell PE, Isberg A. Mandibular length and midline asymmetry after experimentally induced temporomandibular joint disk displacement in rabbits. Am J Orthod Dentofacial Orthop. 1999;115:247–53.

    CAS  PubMed  Google Scholar 

  26. Berteretche MV, Foucart JM, Meunier A, et al. Histologic changes associated with experimental partial anterior disc displacement in the rabbit temporomandibular joint. J Orofac Pain. 2001;15:306–19.

    CAS  PubMed  Google Scholar 

  27. Bryndahl F, Eriksson L, Legrell PE, et al. Bilateral TMJ disk displacement induces mandibular retrognathia. J Dent Res. 2006;85:1118–23.

    CAS  PubMed  Google Scholar 

  28. Nebbe B, Major PW, Prasad N. Female adolescent facial pattern associated with TMJ disk displacement and reduction in disk length: part I. Am J Orthod Dentofacial Orthop. 1999;116:168–76.

    CAS  PubMed  Google Scholar 

  29. Nebbe B, Major PW, Prasad NG. Male adolescent facial pattern associated with TMJ disk displacement and reduction in disk length: part II. Am J Orthod Dentofacial Orthop. 1999;116:301–7.

    CAS  PubMed  Google Scholar 

  30. Flores-Mir C, Nebbe B, Heo G, et al. Longitudinal study of temporomandibular joint disc status and craniofacial growth. Am J Orthod Dentofacial Orthop. 2006;130:324–30.

    PubMed  Google Scholar 

  31. Scapino RP, Mills DK. Disc displacement internal derangements. In: McNeill C, editor. Science and practice of occlusion. Chicago: Quintessence; 1997. p. 220–34.

    Google Scholar 

  32. Oberg T, Carlsson GE, Fajers CM. The temporomandibular joint. A morphologic study on a human autopsy material. Acta Odontol Scand. 1971;29:349–84.

    CAS  PubMed  Google Scholar 

  33. Weinberg LA. Role of condylar position in TMJ dysfunction-pain syndrome. J Prosthet Dent. 1979;41:636–43.

    CAS  PubMed  Google Scholar 

  34. Pullinger AG. The significance of condyle position in normal and abnormal temporomandibular joint function. In: Clark GT, Solberg WK, editors. Perspectives in temporomandibular disorders. Chicago: Quintessence; 1987. p. 89–103.

    Google Scholar 

  35. Hatcher DC, Blom RJ, Baker CG. Temporomandibular joint spatial relationships: osseous and soft tissues. J Prosthet Dent. 1986;56:344–53.

    CAS  PubMed  Google Scholar 

  36. Honda K, Arai Y, Kashima M, et al. Evaluation of the usefulness of the limited cone-beam CT (3DX) in the assessment of the thickness of the roof of the glenoid fossa of the temporomandibular joint. Dentomaxillofac Radiol. 2004;33:391–5.

    CAS  PubMed  Google Scholar 

  37. Kobayashi K, Shimoda S, Nakagawa Y, et al. Accuracy in measurement of distance using limited cone-beam computerized tomography. Int J Oral Maxillofac Implants. 2004;19:228–31.

    PubMed  Google Scholar 

  38. Ikeda K, Kawamura A. Assessment of optimal condylar position with limited cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2009;135:495–501.

    PubMed  Google Scholar 

  39. Ikeda K, Kawamura A, Ikeda R. Assessment of optimal condylar position in the coronal and axial planes with limited cone-beam computed tomography. J Prosthodont. 2011;20:432–8.

    PubMed  Google Scholar 

  40. Schellhas KP, Pollei SR, Wilkes CH. Pediatric internal derangements of the temporomandibular joint: effect on facial development. Am J Orthod Dentofacial Orthop. 1993;104:51–9.

    CAS  PubMed  Google Scholar 

  41. Rasmussen OC. Description of population and progress of symptoms in a longitudinal study of temporomandibular arthropathy. Scand J Dent Res. 1981;89:196–203.

    CAS  PubMed  Google Scholar 

  42. Hatcher DC, McEvoy SP, Mah RT, et al. Distribution of local and general stresses in the stomatognathic system. In: McNeill C, editor. Science and practice of occlusion. Carol Stream: Quintessence; 1997. p. 263.

    Google Scholar 

  43. Ikeda K. A reference line on temporomandibular joint MRI. J Prosthodont. 2013;22:603–7.

    PubMed  Google Scholar 

  44. Farrar WB. Diagnosis and treatment of anterior dislocation of the articular disc. N Y J Dent. 1971;41:348–51.

    CAS  PubMed  Google Scholar 

  45. Westesson PL, Katzberg RW, Tallents RH, et al. Temporomandibular joint: comparison of MR images with cryosectional anatomy. Radiology. 1987;164:59–64.

    CAS  PubMed  Google Scholar 

  46. Katzberg RW, Bessette RW, Tallents RH, et al. Normal and abnormal temporomandibular joint: MR imaging with surface coil. Radiology. 1986;158:183–9.

    CAS  PubMed  Google Scholar 

  47. Schellhas KP, Wilkes CH, Omlie MR, et al. Temporomandibular joint imaging. Practical application of available technology. Arch Otolaryngol Head Neck Surg. 1987;113:744–8.

    CAS  PubMed  Google Scholar 

  48. Segami N, Miyamaru M, Nishimura M, et al. Does joint effusion on T2 magnetic resonance images reflect synovitis? Part 2. Comparison of concentration levels of proinflammatory cytokines and total protein in synovial fluid of the temporomandibular joint with internal derangements and osteoarthrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94:515–21.

    PubMed  Google Scholar 

  49. Slavicek R. Clinical and instrumental functional analysis for diagnosis and treatment planning. Part 5. Axiography. J Clin Orthod. 1988;22:656–67.

    CAS  PubMed  Google Scholar 

  50. Wood DP, Elliott RW. Reproducibility of the centric relation bite registration technique. Angle Orthod. 1994;64:211–20.

    CAS  PubMed  Google Scholar 

  51. Cordray FE. Three-dimensional analysis of models articulated in the seated condylar position from a deprogrammed asymptomatic population: a prospective study. Part 1. Am J Orthod Dentofacial Orthop. 2006;129:619–30.

    PubMed  Google Scholar 

  52. Dyer EH. Importance of a stable maxillomandibular relation. J Prosthet Dent. 1973;30:241–51.

    CAS  PubMed  Google Scholar 

  53. Ramfjord SP, Ash MM. Reflections on the Michigan occlusal splint. J Oral Rehabil. 1994;21:491–500.

    CAS  PubMed  Google Scholar 

  54. Clark GT. Three principle of treatment for managing temporomandibular disorders. In: Clark GT, Solberg WK, editors. Perspectives in temporomandibular disorders. Chicago: Quintessence; 1987. p. 131.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kazumi Ikeda .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Cite this chapter

Ikeda, K. (2019). Occlusal Diagnosis and Treatment of TMD. In: Connelly, S.T., Tartaglia, G.M., Silva, R.G. (eds) Contemporary Management of Temporomandibular Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-99912-8_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-99912-8_4

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-99911-1

  • Online ISBN: 978-3-319-99912-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics