7_th ICCO Study Club Meeting

Description

Topic: Occlusion and Temporomandibular Disorders

Abstract The relationship between occlusion and temporomandibular disorders (TMD) represents one of the major controversies reported in the scientific literature. Nevertheless, sound evidence from large population-based surveys indicates weak and inconsistent associations, supporting that the role of occlusion in the etiology of TMD should not be overstated. Also, despite the type of device, traditional orthodontic treatment seems to play a neutral role regarding the onset of TMD. In particular, this therapeutic approach has been reported not to prevent or to increase the risk of TMD development. Orthodontists should be aware of the multifactorial etiology of TMD and should be instructed regarding the available tools to manage patients before, during, and after any orthodontic intervention. 
Indeed, in our everyday clinical practice, it is not uncommon to find patients who report with a history of orofacial pain. Therefore, a routine TMD-related examination before the commencement of orthodontic therapy appears to be crucial. It is mandatory to start by taking a thorough history and a comprehensive TMD examination to assess pain intensity, interference in function due to pain, and distress. Generally, it is not recommended to initiate an orthodontic treatment until the pain is managed. Furthermore, whenever TMD signs and symptoms appear during an orthodontic treatment, it is suggested to stop the active treatment and to manage the pain by using the entirety of available methods. Orthodontic treatment can be continued as previously planned or, if necessary, modified according to the patient's conditions when the patient is pain-free.

Objectives Potential risk factors, including the role of occlusion and orthodontics, will be analyzed with a focus on the biopsychosocial model. The classification according to the diagnostic criteria for TMD (DC/TMD) and to the International Classification of Orofacial Pain (ICOP) will be explained. The flow chart for the clinical examination of the patient to assess TMD signs and symptoms will be provided. Finally, the management of patients presenting TMD signs and symptoms prior or during orthodontic treatment will be analyzed by presenting corresponding clinical cases.

Speaker

Prof. Dr. Ambrosina Michelotti

• Graduation in Dentistry (Doctor of Dental Surgery) in 1984;
• Honorary Degree in Dentistry at the University of Malmo (Sweden) in 2018: Specialist in Orthodontics;
• Full professor of Orthodontics and Clinical Gnathology;
• Director of the post-graduate School in Orthodontics and responsible of the Master course on “Orofacial Pain and Temporomandibular Disorders” at the University of Naples Federico II;
• Author or co-author of more than 170 papers published in Italian and international journals, co-author of several book chapters;
• President of the European Academy of Craniomandibular Disorders (2010); President of the Neuroscience Group of IADR (2011); President of the SIDA (Società Italiana Disfunzioni e Algie Temporomandibolari) 2012–2013); President of the RDC/TMD Consortium at the International Association of Dental Research (2013–2014); President-elect of the European Society of Oral Physiology (2024).
• Editor-in-Chief of the Orthodontic and Craniofacial Research journal; Associate Editor of the European Journal of Oral Science; Associate Editor of the Journal of Oral Rehabilitation; Member of the Editorial Board of the European Journal of Orthodontics and referee of several national and international journals.