Table of Contents
Journal of Oral Diseases
Volume 2015, Article ID 302646, 11 pages
Review Article

Malocclusion Characteristics as Risk Factors for Temporomandibular Disorders: Lessons Learned from a Meta-Analysis

1College of Dental Medicine, Columbia University, 622 W. 168th Street, Suite PH17-306, New York, NY 10032, USA
2Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, Mesa, AZ 85206, USA
3Graduate School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
4Department of Pediatric Dentistry, Boston University, Henry M. Goldman School of Dental Medicine, 100 E. Newton Street, Boston, MA 02118, USA

Received 13 June 2015; Accepted 27 July 2015

Academic Editor: Giulio Gasparini

Copyright © 2015 Claudia L. Cruz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The objective of this meta-analysis was to evaluate the association of various malocclusion characteristics with temporomandibular disorders (TMDs). Two reviewers identified articles through database searches of MEDLINE (Ovid) and LILACS and hand searches of major orthodontic journals and selected references. Random-effects models were used to calculate weighted pooled odds ratio (OR) estimates of malocclusion exposures. Six articles qualified for inclusion in the final quantitative analysis. Our study found that static occlusal factors had no significant association with TMD. Of the dynamic occlusal factors assessed, only the absence of canine guidance, laterotrusive interferences, and retruded contact position to maximal intercuspation slide length ≥2 mm demonstrated significant ORs. These results should be viewed with caution, as reporting biases were difficult to assess, and heterogeneity estimates may have been underestimated due to the limited number of studies within each comparison. TMD is a term that encompasses a broad group of dysfunctions, and meta-analyses should only synthesize studies with similar diagnostic criteria. At the present, there is a paucity of studies available that could be properly synthesized to answer the research question posed. Individual studies have too much variability among their methods, and researchers need to clearly define and state their TMD factor definition.