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Br Dent J. 2007 Jan 13;202(1):E2; discussion 38-9.

TMD and occlusion part I. Damned if we do? Occlusion: the interface of dentistry and orthodontics.

Author information

  • 1Department of Orthodontics, Child Dental Health, Leeds Dental Institute, Clarendon Way, Leeds, UK.

Erratum in

  • Br Dent J. 2007 Apr 28;202(8):474.



To review how occlusion, facial growth, TM disc position and malocclusion may relate to TMD; to review clinical studies investigating TMD pre- and post-orthodontic treatment as well as other studies linking occlusal features with TMD highlighting their limitations; and to make suggestions for improved study designs in the future in order to provide an evidence-base for clinical practice.


Review article.


Electronic databases (MEDLINE and the Cochrane Database of Systematic Reviews) were used to select relevant and frequently cited studies (mean: 28 citations). Citation rate was confirmed using the Web of Science. Study designs are reviewed and weaknesses discussed.


Evidence is lacking to suggest static occlusal factors cause TMD.


Poor study designs have led to much of the controversy over whether occlusal factors (including orthodontics) 'cause' TMD. In order to provide an evidence-base for future clinical practice, suggestions to improve study designs are made.

Comment in

  • A wider spectrum. [Br Dent J. 2007]
  • Spatial matrix hypothesis. [Br Dent J. 2007]
[PubMed - indexed for MEDLINE]
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