This review aims at presenting a current view on the physiopathologic mechanisms
associated with temporomandibular disorders (TMDs). While joint pain is characterized
by a well-defined inflammatory process mediated by tumor necrosis factor-α and
interleukin, chronic muscle pain presents with enigmatic physiopathologic mechanisms,
being considered a functional pain syndrome similar to fibromyalgia, irritable bowel
syndrome, interstitial cystitis and chronic fatigue syndrome. Central sensitization
is the common factor unifying these conditions, and may be influenced by the
autonomic nervous system and genetic polymorphisms. Thus, TMDs symptoms should be
understood as a complex response which might get worse or improve depending on an
individual's adaptation.
The effects of treating Class II malocclusion adult patients, by means of using Mandibular Protraction Appliance (MPA) combined with a fixed appliance were mostly observed in the mandibular arch, and consisted of buccal inclination, protrusion and intrusion of incisors, and mesialization and extrusion of the molars.
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