Temporomandibular disorders: a review of current concepts in aetiology, diagnosis and management

Abstract

Temporomandibular disorders (TMD) is a collective term for a group of musculoskeletal conditions involving pain and/or dysfunction in the masticatory muscles, temporomandibular joints (TMJ) and associated structures. It is the most common type of non-odontogenic orofacial pain and patients can present with pain affecting the face/head, TMJ and/or teeth, limitations in jaw movement and sounds in the TMJ during jaw movements. Comorbid painful and non-painful conditions are also common among individuals with TMD. The diagnosis of TMD have significantly improved over time with the recent Diagnostic Criteria for TMD (DC/TMD) being reliable and valid for most common diagnoses, and an efficient way to communicate in multidisciplinary settings. This classification covers 12 most common TMD, including painful (myalgia, arthralgia and headache attributed to TMD) as well as the non-painful (disc displacements, degenerative joint disease and subluxation) TMD diagnoses. Recent studies have demonstrated that the pathophysiology of common painful TMD is biopsychosocial and multifactorial, where no one factor is responsible for its development. Importantly, research has suggested different predisposing, initiating and perpetuating factors, including both peripheral and central mechanisms. This is an active field of investigation and future studies will not only seek to clarify specific causal pathways but translate this knowledge into mechanism-directed diagnosis and treatment. In accordance with this complex aetiology, current evidence supports primarily conservative multidisciplinary treatment including self-management strategies, behavioural therapy, physical therapy and pharmacotherapy. The aim of this review is to present an overview of most recent developments in aetiology, pathophysiology, diagnosis and management of TMD.

Temporomandibular disorder symptoms in young adults: Three‐dimensional impact on oral health‐related quality of life

“…Temporomandibular disorders (TMDs) are a heterogeneous group of musculoskeletal conditions typified by pain and/or dysfunction of the stomatognathic system. 1 Based on physical examination/self-reported surveys, up to 75% of people have signs and/ or symptoms of TMDs. 2 The prevalence of TMDs ranges from 6% to 16% when determined using formalised diagnostic criteria.…”

A Randomized Controlled Trial Evaluating the Levels of the Biomarkers hs-CRP, IL-6, and IL-8 in Patients with Temporomandibular Disorder Treated with LLLT, Traditional Conservative Treatment, and a Combination of Both

“…Conservative “reversible” management of TMD remains the most common approach to the management of more than 90% of patients [ 9 ]. Conservative treatment methods for TMDs include psychological [ 10 , 11 ], splints [ 9 , 12 ], pharmacological therapies [ 13 , 14 ], physiotherapy [ 15 , 16 ], self-management [ 17 ], and low-level laser therapy (LLLT) [ 18 , 19 , 20 ]. Irreversible treatment involves orthodontics, occlusal adjustments [ 21 , 22 ], and surgery [ 14 ].…”

Evaluation of Oclusal Force Parameters by T-scan Iii With Fixed Orthodontic Treatment; a Prospective Clinical Study

“…While some studies investigating the role of TMJ disorders and occlusal factors found a positive relationship between signs and symptoms of TMJ diseases and Angle classi cation and occlusal guidance factors, no relationship was found in some studies. However, with the thought that malocclusion is the most important factor leading to TMJ disorders, irreversible occlusal adjustments are made by dentists today as in the past [13]. The aim of this study is to determine the distribution of occlusal factors and whether there are changes in the joint due to this in individuals receiving xed orthodontic treatment.…”