Diagnosis and Treatment of Internal Derangements of the Temporomandibular Joint

Abstract

Based on the findings from the various examination procedures, it is possible to diagnose an internal derangement. The basic finding is the determination that the patient’s pain and/or dysfunctions are a result of a joint disorder. The only pathognomonic sign is reciprocal clicking when the clicks do not occur at the same mandibular position. The diagnosis is based on the combined evidence from the examination procedure, with that obtained from the history and physical examination being the most important. It must be realized that internal derangements may occur together with muscle hyperactivity disorders. One must be careful to determine the degree to which each diagnosis contributes to the patient’s problem and not simply assume that because an internal derangement is present, it is the cause of all observed signs and symptoms. The following are the diagnostic categories and their criteria.