Etiopathogenesis of parafunctional habits of the stomatognathic system

Minerva Stomatol. 2003 Jul-Aug;52(7-8):339-45, 345-9.
[Article in English, Italian]

Abstract

A broad consensus does exist among main authors on the importance of parafunctional habits in the etiopathogenesis of temporomandibular disorders (TMD). Mechanisms through which an intense parafunctional activity determined a pathological effect on the temporomandibular joints (TMJs) and their related structures have still not been definitively clarified; nevertheless, before investigating those mechanisms, it's useful to study predisposing, triggering and/or worsening factors of parafunctions themselves. At present the theory, once widely accepted, according to which occlusal interferences can trigger a muscular hyperactivity through the activation of periodontal receptors, has lost a lot of credit. Recently, the hypothesis that bruxism and other parafunctions have a central etiology has become more and more accepted. In such a context, the role of the psychic component assumes a strong relevance, particularly for its relation with the limbic system, which is the part of the central nervous system (CNS) that regulates emotions. Such a hypothesis is confirmed by clinical practice, but it doesn't explain why some patients have reported a worsening of parafunctional activities after occlusal adjustment. The aim of this study is to investigate this issue through a critical review of the literature, indicating how the 2 theories might be complementary for the development and worsening of a parafunctional habit. From this review, despite the number of clinical opinions, there emerges a lack of methodologically appropriate associative works and controlled clinical trials which consent to clarify the effective importance of psychic and/or occlusal factors in the etiopathogenesis of parafunctional habits.

Publication types

  • Review

MeSH terms

  • Adult
  • Anxiety / complications
  • Bruxism / complications*
  • Bruxism / physiopathology
  • Bruxism / psychology
  • Bruxism / therapy
  • Child, Preschool
  • Electrophysiology
  • Female
  • Humans
  • Limbic System / physiopathology
  • Male
  • Masticatory Muscles / innervation
  • Masticatory Muscles / physiopathology
  • Models, Biological
  • Models, Psychological
  • Nail Biting / adverse effects*
  • Nail Biting / psychology
  • Occlusal Adjustment
  • Pain Threshold
  • Stress, Psychological / complications
  • Temporomandibular Joint Disorders / etiology*
  • Temporomandibular Joint Disorders / physiopathology