Skip to main content
Top
Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 3/2017

01-05-2017 | Original Article

Dental Angle class asymmetry and temporomandibular disorders

Authors: Daniele Manfredini, Luca Lombardo, Giuseppe Siciliani

Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Issue 3/2017

Login to get access

Abstract

Objectives

The aim of this study was to determine whether there is an association between the presence of asymmetric molar or canine Angle classes on the two sides and the presence of temporomandibular joint dysfunction (TMD).

Materials and methods

Participants to the study were divided into two groups: TMD group (90 patients) or a control group (58 patients). In the TMD group, clinical assessment for TMD was performed according to the Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) guidelines by the same two trained examiners. In both groups, all subjects underwent an assessment of dental occlusion, focusing on the assessment of bilateral canine and molar Angle class relationship. The study protocol was reviewed and approved by the Institutional Review Board of the University of Padova, and each participant gave written consent to take part in the investigation.

Results

TMJ pain was diagnosed in 58, disk displacement in 96, arthrosis in 17, and muscle pain in 46 individuals. Molar Angle class was symmetrical in 86 individuals and asymmetrical in 62 subjects. Molar Angle class was not correlated with any of the TMD diagnoses. Canine Angle class was correlated with TMJ arthrosis. Correlation values with the other TMD diagnoses were low and were not significant.

Conclusions

It can be suggested that an association between dental Angle class asymmetry and TMDs does not exist and that the role of dental asymmetries as a factor correlated with the presence of TMD signs and symptoms is minimal.
Literature
1.
go back to reference Bishara SE, Burkey PS, Kharouf JG (1994) Dental and facial asymmetries: a review. Angle Orthod 64(2):89–98PubMed Bishara SE, Burkey PS, Kharouf JG (1994) Dental and facial asymmetries: a review. Angle Orthod 64(2):89–98PubMed
2.
go back to reference Chang FH, Chen KC, Shiau YY (1997) The importance of determination of jaw position in orthodontic diagnosis and treatment planning for adult patients. Dent Clin North Am 41(1):49–66PubMed Chang FH, Chen KC, Shiau YY (1997) The importance of determination of jaw position in orthodontic diagnosis and treatment planning for adult patients. Dent Clin North Am 41(1):49–66PubMed
3.
go back to reference Costen JB (1934) A syndrome of ear and sinus symptoms dependent upon disturbed function of the temporomandibular joint. Ann Otol Rhinol Laryngol 43:1–15CrossRef Costen JB (1934) A syndrome of ear and sinus symptoms dependent upon disturbed function of the temporomandibular joint. Ann Otol Rhinol Laryngol 43:1–15CrossRef
4.
go back to reference D’Ippolito S, Ursini R, Giuliante L, Deli R (2014) Correlations between mandibular asymmetries and temporomandibular disorders (TMD). Int Orthod. 12:222–238PubMed D’Ippolito S, Ursini R, Giuliante L, Deli R (2014) Correlations between mandibular asymmetries and temporomandibular disorders (TMD). Int Orthod. 12:222–238PubMed
5.
go back to reference Fushima K, Inui M, Sato S (1999) Dental asymmetry in temporomandibular disorders. J Oral Rehabil 26:752–756CrossRefPubMed Fushima K, Inui M, Sato S (1999) Dental asymmetry in temporomandibular disorders. J Oral Rehabil 26:752–756CrossRefPubMed
6.
go back to reference Greene CS, Obrez A (2015) Treating temporomandibular disorders with permanent mandibular repositioning: is it medically necessary? Oral Surg Oral Med Oral Pathol Oral Radiol. 119:489–498CrossRefPubMed Greene CS, Obrez A (2015) Treating temporomandibular disorders with permanent mandibular repositioning: is it medically necessary? Oral Surg Oral Med Oral Pathol Oral Radiol. 119:489–498CrossRefPubMed
7.
go back to reference Ireland AJ, Cunningham SJ, Petrie A, Cobourne MT, Acharya P, Sandy JR, Hunt NP (2014) An index of orthognathic functional treatment need (IOFTN). J Orthod. 41:77–83CrossRefPubMedPubMedCentral Ireland AJ, Cunningham SJ, Petrie A, Cobourne MT, Acharya P, Sandy JR, Hunt NP (2014) An index of orthognathic functional treatment need (IOFTN). J Orthod. 41:77–83CrossRefPubMedPubMedCentral
8.
go back to reference Ishizaki K, Suzuki K, Mito T, Tanak EM, Sato S (2010) Morphologic, functional, and occlusal characterization of mandibular lateral displacement malocclusion. Am J Orthod Denotfac Orthop 137:454.e1-e9 Ishizaki K, Suzuki K, Mito T, Tanak EM, Sato S (2010) Morphologic, functional, and occlusal characterization of mandibular lateral displacement malocclusion. Am J Orthod Denotfac Orthop 137:454.e1-e9
9.
go back to reference Kahn J, Tallents RH, Katzberg RW, Ross ME, Murphy WC (1999) Prevalence of dental occlusal variables and intraarticular temporomandibular disorders: molar relationship, lateral guidance, and nonworking side contacts. J Prosthet Dent 82:410–415CrossRefPubMed Kahn J, Tallents RH, Katzberg RW, Ross ME, Murphy WC (1999) Prevalence of dental occlusal variables and intraarticular temporomandibular disorders: molar relationship, lateral guidance, and nonworking side contacts. J Prosthet Dent 82:410–415CrossRefPubMed
10.
go back to reference Klasser GD, Greene CS (2009) The changing field of temporomandibular disorders: what dentists need to know. J Can Dent Assoc 75:49–53PubMed Klasser GD, Greene CS (2009) The changing field of temporomandibular disorders: what dentists need to know. J Can Dent Assoc 75:49–53PubMed
11.
go back to reference Landi N, Manfredini D, Tognini F, Romagnoli M, Bosco M (2004) Quantification of the relative risk of multiple occlusal variables for muscle disorders of the stomatognathic system. J Prosthet Dent 92(2):190–195CrossRefPubMed Landi N, Manfredini D, Tognini F, Romagnoli M, Bosco M (2004) Quantification of the relative risk of multiple occlusal variables for muscle disorders of the stomatognathic system. J Prosthet Dent 92(2):190–195CrossRefPubMed
12.
go back to reference Manfredini D, Ahlberg J, Winocur E, Guarda-Nardini L, Lobbezoo F (2011) Correlation of RDC/TMD axis I diagnoses and axis II pain-related disability. A multicenter study. Clin Oral Investig 15:749–756CrossRefPubMed Manfredini D, Ahlberg J, Winocur E, Guarda-Nardini L, Lobbezoo F (2011) Correlation of RDC/TMD axis I diagnoses and axis II pain-related disability. A multicenter study. Clin Oral Investig 15:749–756CrossRefPubMed
13.
go back to reference Manfredini D, Bucci MB, Montagna F, Guarda-Nardini L (2011) Temporomandibular disorders assessment: medicolegal considerations in the evidence-based era. J Oral Rehabil 38:101–119CrossRefPubMed Manfredini D, Bucci MB, Montagna F, Guarda-Nardini L (2011) Temporomandibular disorders assessment: medicolegal considerations in the evidence-based era. J Oral Rehabil 38:101–119CrossRefPubMed
14.
go back to reference Manfredini D, Lobbezoo F (2010) Relationship between bruxism and temporomandibular disorders: a systematic review of literature from 1998 to 2008. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010(109):e26–e50CrossRef Manfredini D, Lobbezoo F (2010) Relationship between bruxism and temporomandibular disorders: a systematic review of literature from 1998 to 2008. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010(109):e26–e50CrossRef
15.
go back to reference Manfredini D, Peretta R, Guarda-Nardini L, Ferronato G (2010) Predictive value of combined clinically diagnosed bruxism and occlusal features for TMJ pain. Cranio. 28:105–113CrossRefPubMed Manfredini D, Peretta R, Guarda-Nardini L, Ferronato G (2010) Predictive value of combined clinically diagnosed bruxism and occlusal features for TMJ pain. Cranio. 28:105–113CrossRefPubMed
16.
go back to reference Manfredini D, Perinetti G, Guarda-Nardini L (2014) Dental malocclusion is not related to temporomandibular joint clicking: a logistic regression analysis in a patient population. Angle Orthod 84:310–315CrossRefPubMed Manfredini D, Perinetti G, Guarda-Nardini L (2014) Dental malocclusion is not related to temporomandibular joint clicking: a logistic regression analysis in a patient population. Angle Orthod 84:310–315CrossRefPubMed
17.
go back to reference Manfredini D, Perinetti G, Stellini E, Di Leonardo B, Guarda-Nardini L (2015) Prevalence of static and dynamic dental malocclusion features in subgroups of temporomandibular disorder patients: Implications for the epidemiology of the TMD-occlusion association. Quintessence Int 46:341–349PubMed Manfredini D, Perinetti G, Stellini E, Di Leonardo B, Guarda-Nardini L (2015) Prevalence of static and dynamic dental malocclusion features in subgroups of temporomandibular disorder patients: Implications for the epidemiology of the TMD-occlusion association. Quintessence Int 46:341–349PubMed
18.
go back to reference Manfredini D, Stellini E, Gracco A, Lombardo L, Nardini LG, Siciliani G (2015) Orthodontics is temporomandibular disorders-neutral. Angle orthod (Epub ahead of print) Manfredini D, Stellini E, Gracco A, Lombardo L, Nardini LG, Siciliani G (2015) Orthodontics is temporomandibular disorders-neutral. Angle orthod (Epub ahead of print)
19.
go back to reference Manfredini D, Visscher C, Guarda-Nardini L, Lobbezoo F (2012) Occlusal factors are not related with self-reported bruxism. J Orofac Pain. 26:163–167PubMed Manfredini D, Visscher C, Guarda-Nardini L, Lobbezoo F (2012) Occlusal factors are not related with self-reported bruxism. J Orofac Pain. 26:163–167PubMed
20.
go back to reference McNemar Q (1962) Psychological statistics. Wiley, New York McNemar Q (1962) Psychological statistics. Wiley, New York
21.
go back to reference Okeson JP (2015) Management of temporomandibular disorders and occlusion, 7th edn. CV Mosby, St. Louis Okeson JP (2015) Management of temporomandibular disorders and occlusion, 7th edn. CV Mosby, St. Louis
22.
go back to reference Pinho T, Pacheco JJ, Salazar F (2014) Treatment of an asymmetric malocclusion: a case report. Aust Orthod J. 30:72–80PubMed Pinho T, Pacheco JJ, Salazar F (2014) Treatment of an asymmetric malocclusion: a case report. Aust Orthod J. 30:72–80PubMed
23.
go back to reference Pullinger A (2013) Establishing better biological models to understand occlusion. I: TM joint anatomic relationships. J Oral Rehabil 40:296–318CrossRefPubMed Pullinger A (2013) Establishing better biological models to understand occlusion. I: TM joint anatomic relationships. J Oral Rehabil 40:296–318CrossRefPubMed
24.
go back to reference Pullinger AG, Seligman DA (2000) Quantification and validation of predictive values of occlusal variables in temporomandibular disorders using a multifactorial analysis. J Prosthet Dent 83:66–75CrossRefPubMed Pullinger AG, Seligman DA (2000) Quantification and validation of predictive values of occlusal variables in temporomandibular disorders using a multifactorial analysis. J Prosthet Dent 83:66–75CrossRefPubMed
25.
go back to reference Reid KI, Greene CS (2013) Diagnosis and treatment of temporomandibular disorders: an ethical analysis of current practices. J Oral Rehabil 40:546–561CrossRefPubMed Reid KI, Greene CS (2013) Diagnosis and treatment of temporomandibular disorders: an ethical analysis of current practices. J Oral Rehabil 40:546–561CrossRefPubMed
26.
go back to reference Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP et al (2014) International RDC/TMD Consortium Network, International association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Facial Pain Headache. 28:6–27CrossRefPubMedPubMedCentral Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP et al (2014) International RDC/TMD Consortium Network, International association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Facial Pain Headache. 28:6–27CrossRefPubMedPubMedCentral
27.
go back to reference Shroff B, Siegel SM (1998) Treatment of patients with asymmetries using asymmetric mechanics. Semin Orthod. 4:165–179CrossRefPubMed Shroff B, Siegel SM (1998) Treatment of patients with asymmetries using asymmetric mechanics. Semin Orthod. 4:165–179CrossRefPubMed
28.
go back to reference Slavicek R (2011) Relationship between occlusion and temporomandibular disorders: implications for the gnathologist. Am J Orthod Dentofac Orthop.139(1):10, 12, 14 passim Slavicek R (2011) Relationship between occlusion and temporomandibular disorders: implications for the gnathologist. Am J Orthod Dentofac Orthop.139(1):10, 12, 14 passim
29.
go back to reference Suvinen ti, kemppainen P, Könönen M, Dworkin SF (2005) Review of aetiological concepts of temporomandibular pain disorders: towards a biopsychosocial model for integration of physical disorder factors with psychological and psychosocial illness impact factors. Eur J Pain 9:613–33 Suvinen ti, kemppainen P, Könönen M, Dworkin SF (2005) Review of aetiological concepts of temporomandibular pain disorders: towards a biopsychosocial model for integration of physical disorder factors with psychological and psychosocial illness impact factors. Eur J Pain 9:613–33
30.
go back to reference Türp JC, Greene CS, Strub JR (2008) Dental occlusion: a critical reflection on past, present and future concepts. J Oral Rehabil 35:446–453CrossRefPubMed Türp JC, Greene CS, Strub JR (2008) Dental occlusion: a critical reflection on past, present and future concepts. J Oral Rehabil 35:446–453CrossRefPubMed
31.
go back to reference Türp JC, Schindler H (2012) The dental occlusion as a suspected cause for TMDs: epidemiological and etiological considerations. J Oral Rehabil 39:502–512CrossRefPubMed Türp JC, Schindler H (2012) The dental occlusion as a suspected cause for TMDs: epidemiological and etiological considerations. J Oral Rehabil 39:502–512CrossRefPubMed
32.
go back to reference Van Steenbergen E, Nanda R (1995) Biomechanics of orthodontic correction of dental asymmetries. Am J Orthod Dentofac Orthop 107(6):618–24 Van Steenbergen E, Nanda R (1995) Biomechanics of orthodontic correction of dental asymmetries. Am J Orthod Dentofac Orthop 107(6):618–24
Metadata
Title
Dental Angle class asymmetry and temporomandibular disorders
Authors
Daniele Manfredini
Luca Lombardo
Giuseppe Siciliani
Publication date
01-05-2017
Publisher
Springer Medizin
Published in
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Issue 3/2017
Print ISSN: 1434-5293
Electronic ISSN: 1615-6714
DOI
https://doi.org/10.1007/s00056-016-0079-4

Other articles of this Issue 3/2017

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 3/2017 Go to the issue