Temporomandibular disorders

Authors: Väino Sinisalu , Stephanie Akermann

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Temporomandibular disorders (TMD )are a heterogenous group of musculosceletal and neuromuscular conditions involving the temoromandibular joint, and the surrounding structures. The TMD are classified into myalgia, artralgia, intraarticular disorders and TMD related headache. The most common symptoms are jaw pain irradiating to the ear,,neck and temporal region,which is aggrevated by jaw movements, as well as restricted jaw movements and joint noise.

The TMD have multifactoral aetiology, their pathophysiology is not well understood. The incidence of the fi rst onset of TMD is 3-4% per annnum, while women are more likely to develop the disorder. Painful TMD have the potential to become chronic.

Conservative treatment is eff ective in most cases; psychological aspects of pain management are also important. Conservative treatment includes drugs (NSAID, central muscle relaxants), occlusal splints, rest and patient education and self care. Surgery may be used in selective cases involving structural pathology that does not respond to conservative treatment.