Abstract:"Abordaje actual de los trastornos temporomandibulares.." Dr. Antoon de Laat

Next to  odontalgia, musculoskeletal masticatory pain has the highest prevalence in the orofacial region.   Among the more ”atypical” pains in the orofacial system, temporomandibular disorders  (TMD)  present an important challenge since the diversity of etiologic factors is still not clear. Large-scale prospective studies have started  to elucidate risk factors for both chronic TMD and new-onset TMD and it is clear that systemic  factors like psychosocial  functioning  and disturbed pain modulation are as important in the etiology as local factors. Recently,  Clinical Diagnostic criteria have been formulated and validated for the major subgroups  composing TMD, allowing to discriminate masticatory muscle pain, arthralgia, several kinds of intra-articular disorders.

TMD-pain can, but does not necessarily has to be accompanied by signs of dysfunction, limitation or interference of the jaw movements. An increasing number of studies confirms that most TMD pains are managed successfully using conservative and reversible means. Reducing overload (daytime clenching of the teeth), physical therapy and splint therapy help the time need to adapt and heal. Few of these approaches, however, have been proven significantly efficacious in RCTs. Development into chronic pain is considered rare, although clear figures are lacking. These more complex  situations are  linked to more psychosocial interference, that preferably should be screened for early in the diagnostic stage.