The association between orthodontic treatment and temporomandibular disorders diagnosis and disease characteristics

Miriam Shalish, Avi Leibovich, Avraham Zakuto, Hulio Slutzky, Stella Chaushu, Galit Almoznino*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review


    Background: The association between orthodontic treatment and temporomandibular disorders (TMD) has been contentious in the literature. Objectives: To analyse the associations between orthodontic treatment and TMD diagnosis and diseases characteristics. Methods: This case–control study included 291 individuals, 192 TMDs and 99 controls. All patients underwent assessment based on a questionnaire and a clinical examination according to Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Differences in orthodontic treatment between TMDs and controls, as well as across different TMD diagnoses within the TMD group were analysed. Patients who underwent orthodontic treatment were compared to those who did not, regarding their trauma history, bruxism, aggressive teeth brushing, level of oral hygiene, pain scores, muscle tenderness scores and subjective sleep quality. Results: Of the 291 participants, 119 (40.9%) underwent orthodontic treatment and 172 (59.1%) had no orthodontics experience. Orthodontic treatment included: mandibular orthodontic treatment (102 subjects) and maxillary orthodontic treatment (113 subjects) of those 47 used a headgear. Following multivariate analysis among TMDs, orthodontic treatment was associated with a good level of oral hygiene versus poor (Odds ratio [OR]: 5.17 [1.04–25.59]), lower number of tender muscles [OR = 0.84 (0.74–0.96)] and lower (better) Pittsburgh Sleep Quality Index (PSQI) scores (OR = 0.86 [0.76–0.97]). None of the studied parameters maintained a statistically significant association with orthodontic treatment in the multivariate analysis among the entire study population. Conclusions: Utilising a holistic approach, this study supports the main hypothesis that orthodontic treatment is not associated with TMD diagnosis and disease characteristics.

    Original languageAmerican English
    JournalJournal of Oral Rehabilitation
    Early online date6 Dec 2023
    StatePublished - Mar 2024

    Bibliographical note

    Publisher Copyright:
    © 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.


    • muscle tenderness scores
    • orthodontic treatment
    • pain
    • sleep
    • temporomandibular disorders (TMD)
    • trauma


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