Review article
Temporomandibular disorders – problems in diagnostics
Melita Valentić-Peruzović
; School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Abstract
Temporomandibular disorders (TMD) is a group of conditions affecting the temporomandibular joint, masticatory muscles and the adjacent structures, and most clinicians and researchers believe that it is multifactorial etiology. There are multiple risk factors associated with TMD. The etiology of TMD has not been yet completely understood. Likewise with other chronic musculoskeletal pain disorders, TMD seems to be best explained from a biopsychosocial perspective, in which it is viewed as a psychophysiological disorder involving changes in endogenous regulatory pain pathways, resulting in maladaptive emotional, physiological and neuroendocrine responses to physical and psychological stressors. In adolescents with TMD, psychosocial factors such as increased levels of stress, somatic complaints, and emotional problems seem to play a more prominent role than dental factors. Multiple pains in the body and fatigue are significantly more common with TMD group than with the controls. Several studies have categorized TMD into subgroups.
So far, studies which examined psychological differences between subgroups generally pointed to the fact that patients with myogenic diagnoses had more pain and distress than those with joint-related diagnoses. It seems that muscular pain may overshadow joint pain. However, subjects in the myogenous group more often reported parafunction, depression, and worrying. Recent studies suggest that subjects with muscular diagnoses have more severe pain and psychological distress than those with joint diagnoses.
Further studies are needed to clarify the temporal sequence of risk factors, as well as the mechanisms accounting for the association between TMD pain and gender.
Keywords
temporomandibular disorders (TMD); temporomandibular joint disorders; masticatory muscles disorders; signs and symptoms; diagnostics of TMD; treatment modalities
Hrčak ID:
51461
URI
Publication date:
12.4.2010.
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