Diagnosis and management of temporomandibular joint dysfunction syndrome

Abstract

This report describes the clinical experience gained from the management of 55 patients with temporomandibular joint dysfunction syndrome, and characterized by the principal symptoms of preauricular pain accompanied by limited mandibular movements. Eighty per cent of the patients were women. Dental history indicated that their tooth loss and replacement experience and the incidence of clenching and bruxism were similar to those of a group of control patients. However, clicking in the joint was approximately twice as frequent as in the control group. No correlation was made between the incidence of temporomandibular joint symptoms and the presence of systemic disease in these groups. Half of the patients exhibited some evidence of emotional tension; of these, 15 individuals had emotional problems which were considered to be sufficiently serious to interfere with their usual daily life. Clinical examination revealed principally the presence of limited mandibular movements and tenderness of the muscles of mastication. Occlusal analysis indicated that 21 of the 55 patients required occlusal adjustment. Treatment consisted of (1) relieving painful symptoms by means of therapeutic exercises and other auxiliary methods, and (2) eliminating etiologic factors such as occlusal disharmony or emotional problems. Half of the patients were successfully treated without any occlusal adjustment. The results of this conservative approach are considered to be effective in the management of most patients with this problem.