ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Placing a Restoration or Prostheses That Introduces an Occlusal Interference Does Not Necessarily Cause TMD Symptoms
Clinical Question Will placing a restoration or prosthesis that introduces an occlusal interference always cause TMD symptoms?
Clinical Bottom Line In patients with myofascial pain, placing a restoration or prosthesis that introduces an occlusal interference will not necessarily induce 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) 26485380Cioffi/20157 females with masticatory myofascial painRandomized Controlled Trial
Key resultsVisual Analog Scale (VAS) measuring TMD-related symptoms (muscle pain, headache, and elevated stress) showed no significant difference between groups; one group received a new occlusal interference (experimental group) and the other group did not, but were under the impression they received a new occlusal interference (control group) (P>.05).
Evidence Search (occlusal[All Fields] AND interference[All Fields]) AND "Temporomandibular Joint Dysfunction Syndrome"[Mesh]
Comments on
The Evidence
Validity: In this crossover, randomized controlled trial, participants were similar at the start of the study. Measurements were recorded under several conditions (interference-free, dummy-interference, and active interference) by placing gold foil on an occlusal or vestibular surface. All seven female participants completed the study with adequate follow-up. Recall bias was unlikely, because there was no competing interests. Perspective: The study was well constructed in regards to treatment of the participants and the efficacy of gathering the data. The participants were only female, which the literature suggests more commonly develop TMD; therefore, based upon the study's findings, this limited population was probably appropriate. However, due to the brief nature of the study and small sample size, long-term effects of occlusal interferences relative to TMD symptoms could not be drawn; however, conducting a lengthier study with a larger sample size would, in turn, have other ethical drawbacks.
Applicability When a patient develops TMD symptoms following the placement of a restoration, many potential causes (including occlusal interferences) should be considered.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Prosthodontics) (Restorative Dentistry)
Keywords TMD, headache, occlusion, muscle pain
ID# 3031
Date of submission: 04/26/2016spacer
E-mail tranl4@livemail.uthscsa.edu
Author Lisa Tran
Co-author(s)
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?)
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None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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