Peck C, Goulet J-P, Lobbezoo F Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders. J Oral Rehabil. 2014; 41:2-23
Soames RW. Skeletal system. In: Gray H, Williams P, Bannister L (eds). New York: Churchill Livingstone;
Alomar X, Medrano J, Cabratosa J Anatomy of the temporomandibular joint. Semin Ultrasound CT. 2007; 28:170-83
Shaffer S, Brismée J-M, Sizer P, Courtney C. Temporomandibular disorders. Part 1: anatomy and examination/diagnosis. J Man Manip Ther. 2014; 22:2-12
Dworkin S. The OPPERA study: act one. J Pain. 2011; 12:T1-T3
Maixner W, Diatchenko L, Dubner R Orofacial pain prospective evaluation and risk assessment study – the OPPERA study. J Pain. 2011; 12:T4-T11.e2
Slade G, Bair E, Greenspan J Signs and symptoms of first-onset tmd and sociodemographic predictors of its development: the OPPERA prospective cohort study. J Pain. 2013; 14:T20-T32.e3
Aggarwal V, McBeth J, Zakrzewska J, Lunt M, Macfarlane G. The epidemiology of chronic syndromes that are frequently unexplained: do they have common associated factors?. Int J Epidemiol. 2006; 35:468-76
Hoffmann R, Kotchen JM, Kotchen T Temporomandibular disorders and associated clinical comorbidities. Clin J Pain. 2011; 27:268-74
Phillips C. The cost and burden of chronic pain. Rev Pain. 2009; 3:2-5
Cousins M, Brennan F, Carr D. Pain relief: a universal human right. Pain. 2004; 112:1-4
Suvinen T, Reade P, Kemppainen P Review of aetiological concepts of temporomandibular pain disorders: towards a biopsychosocial model for integration of physical disorder factors with psychological and psychosocial illness impact factors. Eur J Pain. 2005; 9:613-633
Engel G. The need for a new medical model: a challenge for biomedicine. Science. 1977; 196:129-136
McNeill C. Management of temporomandibular disorders: concepts and controversies. J Prosthet Dent. 1997; 77:510-522
Fillingim R, Ohrbach R, Greenspan J Psychological factors associated with development of TMD: the OPPERA prospective cohort study. J Pain. 2013; 14:T75-T90 https://doi.org/10.1016/j.jpain.2013.06.009
Slade G, Fillingim R, Sanders A Summary of findings from the OPPERA prospective cohort study of incidence of first-onset temporomandibular disorder: implications and future directions. J Pain. 2013; 14:T116-T24
Sanders A, Slade G, Bair E General health status and incidence of first-onset temporomandibular disorder: the OPPERA prospective cohort study. J Pain. 2013; 14:T51-T62
Svensson P, Jadidi F, Arima T Relationships between craniofacial pain and bruxism. J Oral Rehabil. 2008; 35:524-547
Van Der Meulen M, Lobbezoo F Self-reported oral parafunctions and pain intensity in temporomandibular disorder patients. J Orofac Pain. 2006; 20:31-35
Manfredini D, Lombardo L, Siciliani G. Temporomandibular disorders and dental occlusion. A systematic review of association studies: end of an era?. J Oral Rehabil. 2017; 44:908-23
Bell Y, Jämsä T, Korri S Effect of artificial occlusal interferences depends on previous experience of temporomandibular disorders. Acta Odontol Scand. 2002; 60:219-222
Pullinger A, Seligman D. Trauma history in diagnostic groups of temporomandibular disorders. Oral Surg Oral Med Oral Pathol. 1991; 71:529-534 https://doi.org/10.1016/0030-4220(91)90355-g
Dworkin S, Leresche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992; 6:301-305
Ghurye S, McMillan R. Pain-related temporomandibular disorder–current perspectives and evidence-based management. Dent Update. 2015; 42:533-546 https://doi.org/10.12968/denu.2015.42.6.533
Kroenke K, Spitzer RL, Williams JB, Löwe B. An ultra-brief screening scale for anxiety and depression: the PHQ–4. Psychosomatics. 2009; 50:613-621 https://doi.org/10.1176/appi.psy.50.6.613
Doufas AG. Pain and sleep.: Elsevier; 2017
Smith M, Haythornthwaite J. How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature. Sleep Med Rev. 2004; 8:119-132 https://doi.org/10.1016/s1087-0792(03)00044-3
Buenaver L, Quartana P, Grace E Evidence for indirect effects of pain catastrophizing on clinical pain among myofascial temporomandibular disorder participants: the mediating role of sleep disturbance. Pain. 2012; 153:1159-1166 https://doi.org/10.1016/j.pain.2012.01.023
Essick GK, Raphael KG, Sanders AE, Lavigne G. Orofacial pain and temporomandibular disorders in relation to sleep-disordered breathing and sleep bruxism.: Elsevier; 2017
Schiffman E, Ohrbach R, Truelove E Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache. 2014; 28:6-27
Gonzalez Y, Schiffman E, Gordon S Development of a brief and effective temporomandibular disorder pain screening questionnaire. J Am Dent Assoc. 2011; 142:1183-1191 https://doi.org/10.14219/jada.archive.2011.0088
Epstein JB, Caldwell J, Black G. The utility of panoramic imaging of the temporomandibular joint in patients with temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92:236-239 https://doi.org/10.1067/moe.2001.114158
Petersson A. What you can and cannot see in TMJ imaging – an overview related to the RDC/TMD diagnostic system. J Oral Rehabil. 2010; 37:771-778 https://doi.org/10.1111/j.1365-2842.2010.02108.x
Temporomandibular Disorders. Part 1: Anatomy, Aetiology, Diagnosis and Classification Funmi Oluwajana Pete Clarke Emma Foster-Thomas Martin James Charles Crawford Dental Update 2024 49:4, 707-709.
Authors
FunmiOluwajana
Specialty Registrar in Restorative Dentistry, University Dental Hospital of Manchester; Clinical Fellow, Health Education England Northwest
Temporomandibular disorders (TMD) are the most common causes of chronic pain in the orofacial region. The aetiology of TMD is complex owing to its multifactorial biopsychosocial nature. TMD shares many commonalities, and can be associated with, other chronic pain conditions. The physical and psychological impact of chronic pain on the individual can be far-reaching and should not be underestimated. This article, the first of a six-part series, aims to provide the reader with a background to TMDs as well as an overview of the clinical examination and diagnostic process for patients presenting with TMD-related pain.
CPD/Clinical Relevance: Clinicians should be aware of the signs and symptoms of TMD with which their patients might present and understand the complex nature of chronic pain conditions.
Article
Temporomandibular disorders (TMD) can be defined as a heterogeneous group of musculoskeletal disorders involving the temporomandibular joint (TMJ), masticatory muscles, and associated structures, characterized by pain and functional limitations in the orofacial region.1,2 It is a complex condition, influenced and affected by a variety of factors, with a wide spectrum of possible disorders and diagnoses.
This six-part series aims to explore the various aspects of TMD beginning with the patient presentation and diagnostic process, through the various forms and methods of management, non-surgical, pharmacological and surgical, that may be employed in isolation or in conjunction with one another. The aims of this paper are to discuss the anatomy of the TMJ and the epidemiology of the disorders, to describe the clinical features that a patient may present with, and to guide the practitioner through the diagnostic process.
The temporomandibular joint is an atypical synovial joint that permits a hinging movement and a gliding motion of the surfaces.3 The left and right condyles articulate with the temporal bone but are unable to move independently of each other.3 The TMJ shares some commonalities with other synovial joints such as a disc, fibrous capsule, fluid, synovial membrane and ligaments. However, the features that make the TMJ unique are its articular surface covered by fibrocartilage rather than hyaline cartilage.4
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
