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Title No Evidence to Support Orthodontics As An Effective Treatment For Temporomandibular Disorders
Clinical Question In a patient with temporomandibular disorder (TMD), how effective is orthodontic treatment compared with placebo therapy in reducing symptoms after one year?
Clinical Bottom Line At this time, orthodontic treatment has not been shown to be effective in decreasing TMD symptoms.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20614447Luther/2010Adults (≥18yrs) with 2 or more TMD symptomsSystematic Review
Key resultsOf the 284 records identified, only four articles included data useable for a meta-analysis. Of these four articles none met the inclusion criteria, so none were used. The four articles either did not provide a control group or did not use orthodontic therapy. In one noteworthy article, disc position was not altered by orthodontic therapy; however change in TMD symptoms was not reported.
Evidence Search “Orthodontics”[Mesh] AND “Temporomandibular Joint Disorders”[Mesh]
Comments on
The Evidence
The Luther article followed the Cochrane systematic review guidelines, and therefore applied stringent criteria in the inclusion of meaningful data. As none of the available studies met these inclusion criteria, no conclusions could be reached.
Applicability Orthodontic treatment has not been shown to decrease symptoms of TMD. Therefore, orthodontic treatment should not be recommended as a treatment plan for the purpose of alleviating TMD symptoms in a clinical setting. Patient’s TMD symptoms might decrease, stay the same, or get worse as a result of orthodontic treatment. Additional research and novel orthodontic therapies should continue to be assessed.
Specialty/Discipline (General Dentistry) (Orthodontics)
Keywords Orthodontic therapy, TMD, TMJ
ID# 2180
Date of submission: 04/09/2012spacer
E-mail glick@uthscsa.edu
Author Aaron Glick
Co-author(s) e-mail
Faculty mentor/Co-author Edward F. Wright, DDS, MS
Faculty mentor/Co-author e-mail wrighte2@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Anthony Mendez, Lauren Bierschwale (San Antonio, TX) on 11/30/2017
A PubMed search performed November 2017 found two more recent systematic reviews which support the conclusion that there continues to be no correlation between orthodontic treatment and temporomandibular joint disorders (TMJ). Fernandez-Gonzalez, 2015 (PMID 26155354) and Dym 2011 (PMID 22117948) conclude that orthodontic treatment has not been shown to be effective in regard to either the indication of, or decreasing symptoms of ,temporomandibular joint disorder.

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