Anatomic and clinical evaluation of the relationship between the temporomandibular joint and occlusion.

An anatomic and clinical investigation of condylar remodeling; the position of the condyle in centric occlusion; and the relationships of these two factors to each other and to the features of the dentition are reported. Two groups of 100 adult crania were examined. The first group had complete or partially edentulous arches. In the second group, the dentition was complete and there were various degrees of abrasion. In addition, clinical and tomographic data were obtained from 70 patients with temporomandibular joint pain-dysfunction syndrome. Occlusion was also studied by intraoral registration of the gothic arch and by mounting the casts on an articulator in 40 patients. Comparison of the data made it clear that occlusal conditions determine the course of condylar remodeling and lead to marked changes in shape of the joints. Occlusal disorders are also responsible for condylar displacement (noted in 51.4 per cent of patients), which, in turn, may be the cause of typical reshaping of the joint. These findings cast doubt on the proposition that the gnathologic determinants (particularly centric relation) are never changed in the course of time.