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This narrative review examines the impact of chronic traumatic dental occlusion (TDO) on the temporomandibular joint (TMJ), masticatory system, and overall health. It synthesizes current literature on etiologic factors, functional implications, and long-term consequences of TDO, emphasizing the adaptive nature of the masticatory system. The review also discusses clinical approaches for managing TDO-related structural and occlusal changes, including restorative and minimally invasive interventions.
Chronic traumatic dental occlusion can lead to alterations in temporomandibular joint biomechanics and masticatory system performance, potentially contributing to patient-reported functional complaints.
PURPOSE Traumatic dental occlusion (TDO) is a multifactorial and dynamic clinical condition that extends beyond localised tooth wear and has been reported to be associated with alterations in temporomandibular joint biomechanics, neuromuscular function and overall masticatory system performance. While acute dental trauma often receives greater clinical attention, chronic occlusal trauma may remain underrecognised in routine practice, despite its potential to influence mandibular movement patterns, modify joint loading and contribute to patient-reported functional complaints. BASIC PROCEDURES This narrative review synthesises current concepts from the literature regarding the proposed etiologic factors, functional implications and long-term clinical consequences of traumatic dental occlusion. Particular emphasis is placed on the adaptive nature of the masticatory system and the variability of individual responses to occlusal disturbances. Contemporary digital diagnostic tools, occlusal analysis technologies and CAD/CAM-assisted restorative workflows are discussed as adjunctive modalities that may support clinical assessment and treatment planning rather than as definitive solutions. MAIN FINDINGS The review outlines commonly applied clinical approaches used in the management of TDO-related structural and occlusal changes, including tooth wear and variations in occlusal vertical dimension, with reference to provisional strategies, indirect restorations and minimally invasive interventions. PRINCIPAL CONCLUSIONS By providing an expert narrative synthesis and acknowledging ongoing controversies within occlusion and temporomandibular disorder research, this review aims to enhance clinician awareness, support cautious and patient-centred decision-making and encourage further research to clarify the clinical relevance of traumatic dental occlusion within contemporary dental practice.