Original article Influence of defective complete dentures renewal on TMD; an MRI and clinical controlled prospective study Mohamed H. Abdelnabi 1,2 and Amal A. Swelem 1,3 1 Oral and Maxillofacial Rehabilitation Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; 2 Removable Prosthodontic Department, Minia University, Minia, Egypt; 3 Removable Prosthodontic Department, Cairo University, Cairo, Egypt doi: 10.1111/ger.12102 Influence of defective complete dentures renewal on TMD; an MRI and clinical controlled prospective study Background: The influence of complete denture occlusion on temporomandibular disorder (TMD) is controversial. Some studies found that defective occlusion contributes to the development of TMD, while others found no correlation. Objective: This prospective controlled study evaluated the relationship between renewal of old defec- tive complete dentures and TMD as evidenced both by clinical examination and magnetic resonance imaging (MRI) findings. Materials and Methods: The study included 25 complete denture patients with signs and symptoms of TMD and 21 asymptomatic controls. Clicking was a common finding in all symptomatic joints. All selected participants needed complete denture renewal. MRI and clinical assessment following research diagnostic criteria for TMD guidelines (RDC/TMD) were carried out at baseline and 2 years after new complete denture insertion. Temporomandibular joint (TMJ) pain, muscle pain, clicking and movement limitation were the assessed signs and symptoms. MRIs were conducted to evaluate the TMJs for disc displacement, disc morphology and joint effusion. Results: Complete denture renewal significantly improved the signs and symptoms of TMD in symp- tomatic group (p < 0.01). Only in the symptomatic group, treatment resulted in a significant increase in joints displaying superior (normal) disc position (symptomatic p < 0.001; asymptomatic p = 0.157). New dentures did not affect disc morphology in both groups (p = 0.5 for both groups) but significantly reduced joint effusion in the symptomatic group (symptomatic p < 0.001; asymptomatic p = 0.5). Rela- tionship between clinical and MRI findings was not one to one. Conclusions: New complete dentures had a positive impact on TMD signs and symptoms, disc position and joint effusion but not on disc morphology. Keywords: complete dentures, temporomandibular disorder, magnetic resonance imaging, disc displace- ment, TMJ pain. Accepted 1 November 2013 Introduction Temporomandibular disorder in complete denture wearers has been reported in several epidemiolog- ical studies 1–5 . Complete denture wearers, as well as, individuals with other types of dentition can both be afflicted by TMD. However, severe signs and symptoms seem to be relatively less common in complete denture wearers, even in those with old dentures of poor quality. This can explain why there have been relatively few complete den- ture wearers in samples of patients with TMD 6 . The role of occlusion in TMD is controversial. Some studies found that occlusal instability was one of the potential factors contributing to the development of TMD among complete denture wearers 1,2,4,7 . TMD signs and symptoms were cor- related with the quality of the dentures and the denture wearing habits 3,4,8 . It has also been sug- gested that incorrect vertical dimension and cen- tric relation were the most frequent causes of TMD 7,9,10 . On the other hand, other studies have found no correlation between signs and symptoms of TMD and factors contributing to the quality of © 2013 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd, Gerodontology 2015; 32: 211–221 211