치아 상실과 턱관절장애의 연관성: 문헌적 고찰

Abstract

Temporomandibular disorders (TMD) are multifactorial conditions involving the temporomandibular joint (TMJ), masticatory muscles, and occlusal factors. Among these, tooth loss has long been proposed as a potential etiologic factor; however, its role in TMD remains controversial. This narrative review summarizes the existing evidence regarding the association between tooth loss and TMD in terms of structural changes, clinical symptoms, and the effects of prosthetic rehabilitation. Anatomical and imaging studies suggest that posterior tooth loss may alter joint loading and contribute to condylar remodeling, although such findings are often confounded by age and other factors. Epidemiologic investigations generally reveal weak or inconsistent associations between tooth loss and TMD symptoms, and patients with a shortened dental arch do not show a higher prevalence of TMD compared with those with complete dentitions. Furthermore, prosthetic replacement of missing teeth does not consistently improve TMD symptoms or reduce disease prevalence. Overall, current evidence indicates that while tooth loss may influence masticatory function and TMJ loading, it should not be regarded as a direct causal factor for TMD. A comprehensive, multifactorial approach is therefore essential when evaluating and managing TMD in patients with missing teeth.