Need for occlusal therapy and prosthodontic treatment in the management oftemporomandibular disorders. Part II. Tooth loss and prosthodontic treatment

The second part of this review, evaluating the Literature on the relationsh ip between dental occlusion and temporomandibular disorders (TMDs), focuses on the aetiological importance of tooth loss and the place of prosthodonti c replacement in the treatment of TMD. Loss of teeth and lack of posterior occlusal support seem to have little influence on the development of TMD, w hich calls into question the use of prosthodontic restoration as prevention or treatment for TMD. In addition, there are practically no studies assess ing the benefit of instrumental analysis in diagnosis or comparing the outc ome of prosthodontic treatment with simple reversible methods in the manage ment of TMD. There is a trend in the current literature to abandon any trea tment, including positioning appliances and prosthodontic measures, to 'rec apture the disk' in patients with disk displacements because of the favoura ble, long-term results achieved after using more simple methods. It is conc luded that prosthetic therapy in TMD patients is not appropriate for initia l TMD treatment and should only be carried out on prosthodontic indications after reversible treatment has alleviated pain and dysfunction.