Bruxism and occlusion as risk factors for TMD - Assessment of the specific impact of occlusal habits and occlusal factors on the prevalence, incidence and progression of pain-related temporomandibular disorders (TMD) -

• Applicant: Privatdozent Dr. Daniel Ralph Reißmann
• Subject Area: Dentistry, Oral Surgery
• Term: from 2012 to 2014
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 232689885

Temporomandibular disorders (TMD) are a heterogeneous group of conditions affecting the temporomandibular joints, the masticatory muscles and adjacent structures. TMD are the second most common disorders of the muscular-skeletal system after chronic back pain. Among treatment-seeking patients, TMD leads to a substantial level of suffering, mainly caused by pain. About 10% of the adult general population demands treatment due to TMD. There is a controversial discussion regarding etiology and risk factors for TMD, and corresponding knowledge is quite limited. While importance of psychosocial factors is well established, statements regarding the impact of occlusal habits (bruxism) and occlusal factors are inconsistent. The aim of the proposed research project is the assessment of the specific impact of occlusal habits and occlusal factors on the prevalence, incidence and progression of pain-associated TMD.The research project consists of two parts: In the cross-sectional part, already existing data of a case-control-study (RDC-TMD Validation Project) will be evaluated in a secondary data analysis. The second part comprises longitudinal data collection and analysis (RDC-TMD Follow-up-Project). Both projects are multi-center studies and financed by grants from the NIDCR. The head study center is at the University of Minnesota (Minneapolis, USA). Recruitment of participants (N=705) was performed in three centers, and follow-ups (up to five years) will be performed in the same centers. Comprehensive clinical and psychosocial data potentially associated with TMD exist for all patients. 3-dimensional magnetic resonance images and cone beam computed tomography images were created for temporomandibular joints of all participants. Data designated to be collected in the follow-ups are identical to the data of the cross-sectional part. Those date have never been collected in such comprehensiveness. The use of these data is an opportunity once in a live time to investigate the impact of bruxism and occlusion on TMD.Odds ratios for the association of bruxism and occlusal factors with the outcome will be calculated using logistic regression analyses. Since development of TMD is complex and there is no simple risk-outcome relationship but an interaction between several factors, additional structural equation modeling-based path analyses will be performed. Such models have never been developed for TMD and are a novelty in dentistry. Analyses will be performed separately for prevalence, incidence and progression.The identification of modifiable risk factors for pain-associated TMD may result by eliminating those factors in the prevention of a substantial public-health problem.

• DFG Programme: Research Fellowships
• International Connection: USA
• Host: Dr. Mike John