University of Oulu

Elisa Tervahauta, Linnea Närhi, Pertti Pirttiniemi, Kirsi Sipilä, Ritva Näpänkangas, Mimmi Tolvanen, Ville Vuollo & Anna-Sofia Silvola (2022) Prevalence of sagittal molar and canine relationships, asymmetries and midline shift in relation to temporomandibular disorders (TMD) in a Finnish adult population, Acta Odontologica Scandinavica, 80:6, 470-480, DOI: 10.1080/00016357.2022.2036364

Prevalence of sagittal molar and canine relationships, asymmetries and midline shift in relation to temporomandibular disorders (TMD) in a Finnish adult population

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Author: Tervahauta, Elisa1,2; Närhi, Linnea1,2; Pirttiniemi, Pertti1,2;
Organizations: 1Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
2Medical Research Center, Oulu UniversityHospital and University of Oulu, Oulu, Finland
3Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Finla
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 2 MB)
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Language: English
Published: Informa, 2022
Publish Date: 2023-06-05


Objective: To examine the prevalence of sagittal relationships, asymmetries and midline shift, and their associations with temporomandibular disorders (TMD) in the Northern Finland Birth Cohort 1966 (NFBC1966).

Materials and methods: 1845 subjects participated in a clinical examination at the age of 46. Occlusal measurements were performed using 3D models. Symptoms of TMD were screened using validated questions, and signs and diagnoses of TMD were assessed using a modified protocol of the Diagnostic Criteria for TMD (DC/TMD) and questionnaires. Associations between variables of occlusion and TMD were evaluated with χ2-test and Fisher's exact test and using logistic regression analyses, adjusted for self-reported general health, mental health, bruxism, and rheumatoid arthritis.

Results: The most common sagittal relationships were Class I and normal canine relationship. Half-cusp Class II and post-normal canine relationship were more frequent in females, and Class III and pre-normal canine relationship in males. Deviations from normal cuspid or molar relationships showed a weak but statistically significant association with TMD, especially in females. Half-cusp Class II and Class II relationships were more frequent in relation to joint-related TMD signs and diagnoses while missing canines were associated with pain-related TMD diagnoses.

Conclusions: The present study findings gave some indications that canine relationships are associated with pain-related TMD, whereas Angle II sagittal occlusal relations may associate with joint-related TMD. Occlusal characteristics should therefore be taken into account as one possible associating factor in subjects with TMD.

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Series: Acta odontologica Scandinavica
ISSN: 0001-6357
ISSN-E: 1502-3850
ISSN-L: 0001-6357
Volume: 80
Issue: 6
Pages: 470 - 480
DOI: 10.1080/00016357.2022.2036364
Type of Publication: A1 Journal article – refereed
Field of Science: 313 Dentistry
Funding: NFBC1966 received financial support from the University of Oulu [grantnumber 24000692], Oulu University Hospital [grant number 24301140],and ERDF European Regional Development Fund [grant number 539/2010 A31592].
Dataset Reference: NFBC data is available from the University of Oulu, Infrastructure for Population Studies. Permission to use the data can be applied for research purposes via electronic material request portal. The use of datafollows the EU general data protection regulation (679/2016) and Finnish Data Protection Act. The use of personal data is based on cohort participant’s written informed consent at his/her latest follow-up study, which may cause limitations to its use. Please, contact NFBC projectcentre ( and visit the cohort website ( for more information.
Copyright information: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Acta Odontologica Scandinavica Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, orbuilt upon in any way.