Temporomandibular Joint Disorders in Patients with Different Tooth Wear Degrees

Objectives: This study aimed to verify a possible association between different degrees of tooth wear (TW) and the occurrence of disc displacement with or without reduction, as well as the presence of osteoarthritis in temporomandibular disorders (TMD) patients.
Methods: One hundred forty-one patients (31.8±13.7 years, 85.1% females) with TMJ pain or discomfort, were recruited. All participants had the maxillary and mandibular arches molded, and tooth wear was evaluated in dental casts. TW degree was scored as follow: 0, no TW; 1, slight wear on the top of the cusps/incisal tips; 2, noticeable wear in the form of flattening with respect to the normal contour of the cusps/incisal tips; 3, marked flattening of the cusps/incisal tips; 4, total loss of cusps/incisal tips contour and moderate dentin exposure; and 5, severe TW with marked dentin exposure. Then, all volunteers were referred to perform bilateral magnetic resonance images, in order to identify the articular disc position and the osseous changes of the TMJ. The collected data were analyzed by ANOVA, followed by the Tukey-Kramer test as post-hoc, considering a significance level of 5%.
Results: Of the 3,948 teeth eligible for evaluation, 3,779 teeth were considered to classify wear degree. Score 1 was the most prevalent diagnosis, followed by ‘no TW’ and score 2. TMJ evaluation demonstrated that disc displacement with reduction was the most prevalent diagnosis (53.9%), and the articular disc position was not associated with TW degree (P >.05). Osteoarthritis was identified in 190 TMJs, and the osseous change on the right TMJ was not associated with TW degree, while the presence of osteoarthritis in the left TMJ was associated with TW (P =.003).
Conclusions: Thus, it could be concluded that TW degree does not play a role in articular disc position, but might influence the osseous changes of the TMJ.