A dynamic model of etiology in temporomandibular disorders

Article Abstract:

Disorders of the temporomandibular joint (TMJ), the joint between the jaw bone and the skull, are characterized by pain, dysfunction of the joint, limitation of motion, and often clicking noises during movement. The causes of temporomandibular disorders (TMD) are multifactorial. A dynamic model describes TMD as an imbalance between destructive and adaptive forces. Hyperactive factors that cause dysfunction, such as the masticatory or chewing process, are normally balanced by homeostatic factors that allow the system to return to its normal condition. Five factors that can increase or decrease the ability of the masticatory system to adapt and return to normal are: trauma, health and nutrition, structural differences, coping ability, and sex (women outnumber men in seeking treatment for TMD). There are also five factors that negatively influence TMJ function: poor posture and forward thrusting of the head; poor jaw occlusion; pain and depression, which can cause muscle hyperactivity; sleep disorders; and psychological life stresses which can increase muscle tension. This model of TMD focuses on the roles of hyperfunction and adaptability. The factors affecting TMJ function should be considered when making a diagnosis and developing a treatment plan. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities

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New TMJ clinical data and the implication on diagnosis and treatment

Article Abstract:

The temporomandibular joint (TMJ), which lies between the temporal bone of the skull and the mandible of the jaw, allows the jaw to open and close. Pain in the TMJ has many causes. The TMJ is formed by a condyle, or protuberance, on the mandible which hinges and glides in and out of the fossa, or depression, in the temporal bone. Researchers questioned if this positioning plays an important role in causing TMJ pain. A review of the literature indicated that condylar displacement is a contributing factor in TMJ pain. Clinical findings of a group of 220 patients with acute temporomandibular joint disorders (TMD) and a control group are presented. Symptoms of the patient group were related to the position of the condyle in the fossa. Ten clinical factors were recorded and compared; then the factors were evaluated in relation to condylar displacement. The data suggest that posterior or backward displacement of the condyle of the jaw significantly contributes to TMJ pain. There was a high incidence of pain and noisy or clicking sound in the joints of patients with TMD; these symptoms were found only rarely in the control group. Elimination of the term 'joint' in the description of this disorder may be premature. (Consumer Summary produced by Reliance Medical Information, Inc.)

Medical examination

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Condylar and disk position and signs and symptoms of temporomandibular disorders in stress-free subjects

Article Abstract:

Subjects free from psychological stress were tested to determine whether the position of the condyle is related to signs and symptoms of temporomandibular disorders (TMDs). Results showed the role of the absence of psychological stress, and also that there is a relationship between the position of the condyle and displacement of the temporomandibular disk, but it is not predictive of TMD.

Brazil, Usage, Observations, Stress (Psychology), Magnetic resonance imaging, Clinical report

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