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Informationen aus Orthodontie & Kieferorthopädie 2012; 44(04): 277-292
DOI: 10.1055/s-0032-1331234
Übersichtsartikel
© Georg Thieme Verlag KG Stuttgart · New York

Die Rolle der Kieferorthopädie bei kraniomandibulären Dysfunktionen*

The Role of Orthodontics in Temporomandibular Disorders
A. Michelotti
1   School of Dentistry, Section of Orthodontics and Temporomandibular Disorders, University of Naples, Italy
,
G. Iodice
1   School of Dentistry, Section of Orthodontics and Temporomandibular Disorders, University of Naples, Italy
› Author Affiliations
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Publication History

Publication Date:
09 January 2013 (online)

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Zusammenfassung

Kraniomandibuläre Dysfunktionen sind die wichtigste Ursache für nicht dental verursachte Schmerzen im orofazialen Bereich, also dem Kopf, dem Gesicht und den benachbarten anatomischen Strukturen. Ätiologie und Pathophysiologie von kraniomandibulären Dysfunktionen sind bisher kaum geklärt. Man geht davon aus, dass an der Entstehung dieses Krankheitsbildes eine Vielzahl an Faktoren direkt oder indirekt beteiligt ist. Dabei wird die Okklusion häufig als einer der wichtigsten ätiologischen Faktoren angesehen. Aus epidemiologischen Studien ist bekannt, dass Symptome für kraniomandibuläre Dysfunktionen, und hier besonders die Geräusche im Kiefergelenk, häufig bei Kindern und Jugendlichen und verstärkt im Alter zwischen 15 und 45 Jahren auftreten. Ein gestiegenes ästhetisches Bewusstsein, die Entwicklung neuer ästhetischer kieferorthopädischer Verfahren und verbesserte prothetische Versorgungen haben dazu geführt, dass immer mehr Erwachsene eine kieferorthopädische Behandlung nachfragen. Durch diese Veränderung im Patientenalter ist die Wahrscheinlichkeit gestiegen, Patienten mit Symptomen kraniomandibulärer Dysfunktionen zu behandeln. Eine kieferorthopädische Behandlung dauert etwa 2 Jahre. Während oder nach dieser Zeit könnten Patienten über kraniomandibuläre Dysfunktionen klagen und die kieferorthopädischen Maßnahmen für ihr Auftreten verantwortlich machen. Diese vermutete Kausalität hatte bereits rechtliche Folgen für Zahnärzte und Kieferorthopäden. Aus diesem Grund ist das Interesse an den Beziehungen zwischen okklusalen Faktoren, kieferorthopädischer Behandlung und temporomandibulären Dysfunktionen stark gestiegen und es sind viele Untersuchungen zu dieser Thematik durchgeführt worden. Die Behauptung, eine kieferorthopädische Behandlung könne kraniomandibuläre Dysfunktionen verursachen oder heilen, sollte allerdings wissenschaftlich fundiert sein. Ziel des vorliegenden Beitrages ist es daher, eine kritische Übersicht über die möglichen Beziehungen zwischen Malokklusionen, kieferorthopädischer Therapie und kraniomandibulären Dysfunktionen zu bieten.

Abstract

Temporomandibular Disorder (TMD) is the main cause of pain of non-dental origin in the oro-facial region including head, face and related structures. The aetiology and the pathophysiology of TMD is poorly understood. It is generally accepted that the aetiology is multifactorial, involving a large number of direct and indirect causal factors. Among such factors, occlusion is frequently cited as one of the major aetiological factors causing TMD. It is well known from epidemiologic studies that TMD-related signs and symptoms, particularly temporomandibular joint (TMJ) sounds, are frequently found in children and adolescents and show increased prevalence among subjects between 15 and 45 years old. Aesthetic awareness, the development of new aesthetic orthodontic techniques and the possibility of improving prosthetic rehabilitation has increased the number of adults seeking orthodontic treatment. The shift in patient age also has increased the likelihood of patients presenting with signs and symptoms of TMD. Because orthodontic treatment lasts around 2 years, orthodontic patients may complain about TMD during or after treatment and orthodontists may be blamed for causing TMD by unsatisfied patients. This hypothesis of causality has led to legal problems for dentists and orthodontists. For these reasons, the interest in the relationship between occlusal factors, orthodontic treatment and TMD has grown and many studies have been conducted. Indeed, claims that orthodontic treatment may cause or cure TMD should be supported by good evidence. Hence, the aim of this article is to critically review evidence for a possible

association between malocclusion, orthodontic treatment and TMD.

Schlüsselwörter

Okklusion - Kieferorthopädie - kraniomandibuläre ­Dysfunktionen

Key words

occlusion - orthodontics - temporomandibular ­disorders
 

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