Predictive Value of Combined Clinically Diagnosed Bruxism and Occlusal Features For TMJ Pain

Abstract

Several works showed a decreased role for occlusion in the etiology of temporomandibular disorders (TMD). Nonetheless, it may be hypothesized that occlusion acts as a modulator through which bruxism activities may cause damage to the stomatognathic structures. To test this hypothesis, a logistic regression model was created with the inclusion of clinically diagnosed bruxism and eight occlusal features as potential predictors for temporomandibular joint (TMJ) pain in a sample of 276 consecutive TMD patients. The final logit showed that the percentage of the total log likelihood for TMJ pain explained by the significant factors was small and amounted to 13.2%, with unacceptable levels of sensitivity (16.4%). The parameters overbite ≥ 4 mm combined with clinically diagnosed bruxism [OR (odds ratio) 4.62], overjet ≥ 5 mm (OR 2.83), and asymmetrical molar relationship combined with clinically diagnosed bruxism (OR 2.77) were those with the highest odds for disease, even though none of those values was significant with respect to confidence intervals. Thus, the hypothesis under evaluation has to be rejected. It is possible that future studies with a higher discriminatory power for the different bruxism activities might be indicated to get deeper into the analysis of the potential mechanisms through which occlusion may play a role, even if small, in the etiology of the different TMD.

Additional information

Notes on contributors

Daniele Manfredini

Dr. Daniele Manfredini received his D.D.S. degree from the University of Pisa, Italy in 1999. He has been a research assistant in the Department of Neuroscience, University of Pisa and has authored more then 50 scientific papers published in peer-reviewed journals. Currently, Dr. Manfredini is a visiting professor at the TMD Clinic, Department of Maxillofacial Surgery, University of Padova, Italy.

Redento Peretta

Dr. Redento Peretta received his M.D. degree from the University of Padova, Italy in 1981. He has earned specialty degrees in dentistry and orthodontics, as well as a Ph.D. in human morphology. Currently, Dr. Peretta is a visiting professor at the Department of Maxillofacial Surgery, University of Padova, Italy.

Luca Guarda-Nardini

Dr. Luca Guarda-Nardini received his M.D. degree from the University of Padova, Italy in 1985. He has earned specialty degrees in ear-nosethroat pathologies, dentistry, and maxillofacial surgery. Currently, Dr. Guarda-Nardini is a visiting professor at the Department of Maxillofacial Surgery and is chairman of the TMD clinic, University of Padova, Italy.

Giuseppe Ferronato

Dr. Giuseppe Ferronato received his M.D. degree from the University of Padova, Italy in 1975. He has earned a D.D.S. degree and specialty degrees in maxillofacial surgery and plastic surgery. Dr. Ferronato is currently a full professor and director of the Department of Maxillofacial Surgery at the University of Padova, Italy.