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However, whether occlusion plays a crucial role in the pathogenesis of <jats:styled-content style=\"fixed-case\">TMD<\/jats:styled-content> remains controversial. Study designs utilising animal models have been used to study the effects of artificial occlusal alterations. Experimental traumatic occlusion affects blood flow in the temporomandibular joint and results in changes in the condylar cartilage, and artificial occlusal interference induces masticatory muscle nociceptive responses that are associated with peripheral sensitisation and lead to central sensitisation, which maintains masticatory muscle hyperalgesia. The possibility that occlusal interference results in <jats:styled-content style=\"fixed-case\">TMD<\/jats:styled-content> has been investigated in humans using a double\u2010blind randomised design. Subjects without a history of <jats:styled-content style=\"fixed-case\">TMD<\/jats:styled-content> show fairly good adaptation to interferences. In contrast, subjects with a history of <jats:styled-content style=\"fixed-case\">TMD<\/jats:styled-content> develop a significant increase in clinical signs and self\u2010report stronger symptoms (occlusal discomfort and chewing difficulties) in response to interferences. Meanwhile, psychological factors appear meaningful for symptomatic responses to artificial interferences in subjects with a history of <jats:styled-content style=\"fixed-case\">TMD<\/jats:styled-content>. Thus, individual differences in vulnerability to occlusal interferences do exist. Although there are advantages and disadvantages to using human and animal occlusal interference models, these approaches are indispensable for discovering the role of occlusion in <jats:styled-content style=\"fixed-case\">TMD<\/jats:styled-content> pathogenesis.<\/jats:p>","DOI":"10.1111\/joor.12034","type":"journal-article","created":{"date-parts":[[2013,1,29]],"date-time":"2013-01-29T12:33:52Z","timestamp":1359462832000},"page":"279-295","source":"Crossref","is-referenced-by-count":40,"title":["The difficult relationship between occlusal interferences and temporomandibular disorder \u2013 insights from animal and human experimental studies"],"prefix":"10.1111","volume":"40","author":[{"given":"Q.","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Prosthodontics Peking University School and Hospital of Stomatology Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics Peking University School and Hospital of Stomatology Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics Peking University School and Hospital of Stomatology Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,1,29]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"60","volume-title":"Manual of temporomandibular disorders","author":"Wright EF","year":"2005"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016359709115422"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1755-7682-1-23"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-5406(05)81517-3"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1990.0049"},{"key":"e_1_2_5_7_1","first-page":"143","article-title":"Prevalence of signs and symptoms of temporomandibular disorders in an urban and rural German population: results of a population\u2010based Study of Health in Pomerania","volume":"35","author":"Gesch D","year":"2004","journal-title":"Quintessence Int"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345930720110901"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1990.0059"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2842.2004.01432.x"},{"key":"e_1_2_5_11_1","first-page":"93","article-title":"Evidence\u2010based TMD guidelines","volume":"11","author":"McNeill C","year":"1997","journal-title":"J Orofac Pain"},{"key":"e_1_2_5_12_1","first-page":"129","volume-title":"Orofacial pain: guidelines for assessment, diagnosis and management","author":"Leeuw R","year":"2008"},{"key":"e_1_2_5_13_1","first-page":"170","article-title":"Electromyographic analysis of muscular and temporomandibular joint disturbances due to imbalances in occlusion","volume":"26","author":"Jarabak JR","year":"1956","journal-title":"Angle Orthod"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1961.0002"},{"key":"e_1_2_5_15_1","first-page":"67","article-title":"Distortion of maximal elevator activity by unilateral premature tooth contact","volume":"88","author":"Bakke M","year":"1980","journal-title":"Scand J Dent Res"},{"key":"e_1_2_5_16_1","first-page":"133","article-title":"The efficacy of appliance therapy in patients with temporomandibular disorders of mainly myogenous origin. 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