ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Orthodontics and Temporomandibular Disorder: A Meta-Analysis
Clinical Question Do teenagers who have had orthodontic treatment have higher chance of having TMD compared to those who haven’t had orthodontic treatment?
Clinical Bottom Line There isn’t sufficient evidence to support that orthodontic treatment is an etiology of TMD. (See Comments on the CAT below)
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) 12045761Kim/ 2002Patient who have TMDMeta-Analysis
Key resultsThere has been a long dispute over whether orthodontic treatments can cause TMD, no study indicates that the orthodontic treatment can be an etiology of TMD.
Evidence Search Orthodontic treatments AND Temporomandibular joint dysfunction
Comments on
The Evidence
The article is talking about whether orthodontic treatment causes TMD. This is a meta-analysis type of study, and it was not a review of randomized nor double blinded studies. Some of the studies had no controls, and some had epidemiologic control groups. Some were cross sectional studies therefore no cause and effect relationship can be drawn, and some of them were longitudinal studies that lost a lot of data during follow ups. However, carefully designed studies were found. Due to severe heterogenicity, true meta-analysis couldn’t be performed. TMD can have multi-origins, and TMD studies have limitations; clusions cannot be drawn. The data in this meta-analysis do not indicate that traditional orthodontic treatment increases the prevalence of TMD. Therefore, it is hard to study and make a conclusion about TMD.
Applicability Applicable to patients seeking orthodontic treatment where there may be concerns about TMJ problems.
Specialty/Discipline (General Dentistry) (Orthodontics) (Pediatric Dentistry)
Keywords TMD, orthodontic treatment, temporomandibular joint, pain
ID# 869
Date of submission: 04/28/2011spacer
E-mail choj@livemail.uthscsa.edu
Author Joowon Cho
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Peter T. Gakunga, BDS, MS, PhD
Faculty mentor/Co-author e-mail GAKUNGA@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
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Enas Bsoul (San Antonio, Texas) on 07/09/2012
A more recent meta-analysis study published by Al-Riyami et al., in 2009, concluded that patients undergoing Orthognathic surgical intervention for treating TMD as well as for correcting their dentofacial deformities appear more likely to see improvement in their signs and symptoms than deterioration.
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