Diagnosis of mandibular joint dysfunction

Abstract

The material used in this investigation has consisted mainly of 186 cases examined and treated by me. The case histories and the results of clinical and roentgenographic examinations are recorded on a standard form, and an analysis of the findings indicates that female patients, particularly in the 20- to 30-year age group, predominate. In the majority of cases pain is the symptom which prompts the patient to seek treatment, and pain is most frequently experienced in the region of the joint itself. Malocclusion in one form or another was found in approximately one-half of the patients, but only a small proportion of these had overclosure. Although malocclusion was present in these cases, it was frequently considered a contributory rather than a primary etiological factor. Neuromuscular tension and trauma were frequently responsible for mandibular joint dysfunction. Rheumatoid arthritis, varying from mild atypical forms to the progressive crippling form, probably attacks the mandibular joint more often than is generally supposed, although there are usually accompanying etiological factors which render the joint more susceptible to rheumatic involvement. Etiological factors are placed as far as possible into primary and contributory categories. In most cases methods of treatment to be employed depend upon the factors considered responsible for symptoms. The differential diagnosis of mandibular joint dysfunction is made easier by the use of a standard form for recording case histories and clinical findings. Certain conditions which may present difficulties in differential diagnosis are discussed.