Temporomandibular disorders. Part 6: related irreversible restorative interventions

Abstract

Considering the complex biopsychosocial nature of temporomandibular disorders (TMD), irreversible interventions of any kind should be used with extreme caution. Frequently they are reserved for those patients who have not achieved adequate control with reversible measures and in whom a significant improvement is anticipated. Irreversible restorative interventions range from the simple adjustment of a single restoration or tooth up to an occlusal equilibration, and may use a subtractive, additive or combined approach. This article, the last in a series of six, reviews the available evidence in the use of irreversible restorative interventions in the management of TMD, demonstrates some of the commonly used techniques and provides some guidance for the general dental practitioner (GDP) considering this approach. CPD/Clinical Relevance: The GDP needs to be aware of when to, and more importantly when not to, consider making irreversible changes to a patient's dentition with the aim of managing their TMD.