Canine Guidance and Temporomandibular Disorders: A Systematic Review of Existing Evidence
Oleksii Borzakovskyi, Dr. Marco Rossit, Dr. Ovidiu Ionut Saracutu, Prof. Marco Ferrari, Prof. Daniele Manfredini
Department of Medical Biotechnologies, School of Dentistry, University of Siena, 53100, Siena, Italy
Objectives
For many years, old gnathological dogmas supported the belief that canine guidance (CG) should prevent individuals from developing temporomandibular disorders (TMD). This systematic review aims to analyze all the scientific literature on the topic to find if there is a clear relationship between canine guidance and temporomandibular disorders and highlight any other possible clinical implications for the presence or absence of CG.
Materials and Methods
In August 2023, a comprehensive systematic literature search was executed across the PubMed and Scopus databases. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the search utilized the keywords "Canine guidance" and "Temporomandibular disorders". Only articles in English with accessible abstracts were included. Two authors independently screened studies based on title and abstract, resulting in 25 full-text retrievals. Following the removal of duplicates and irrelevant citations, a consensus led to the exclusion of 22 articles, leaving three manuscripts for detailed analysis. To summarize data, a PICO-structured reading model was adopted
Results
All three studies focused on adult populations, enrolling a total of 606 patients. Of these, two studies (66.6%) compared the presence of canine guidance in healthy individuals against those with TMD, while one study (33.3%) compared canine guidance in patients exhibiting varying temporomandibular joint statuses, as observed through MRI scans. None of the studies established a statistically significant relationship between the presence or absence of canine guidance and TMD.
Conclusions
While many clinicians commonly assume a correlation between CG and TMD, our systematic review reveals a notable gap. Despite this assumption, high-quality scientific literature on this topic is still lacking. Our research process led us to only three relevant manuscripts that failed to establish a clear link between the presence or absence of CG and TMDs. This finding underlines the need for cautious interpretation of assumptions and emphasizes the urgency for more meticulous research.