Megha Bahal, Vanshika Saggar, Yogesh Kumar, Chandanpreet Kaur Sachdeva, Maninderjit Singh, Muskan Chopra

ABSTRACT

Medicine is a science of uncertainty and an art of probability. A unique joint in the facial region which affects the functioning of the entire orofacial structure forms the hallmark of controversies due to its multifactorial etiology and multi dynamic diagnosis and treatment approach. Depending on the type of TMD, many treatment modalities have been proposed, ranging from conservative options to open surgical procedures. In this review, the present thinking in the etiology and classification of TMD, followed by the diagnostic approach and the current trend and controversies in management in discussed. Diagnostic criterias with differentials for any TMD ailment is explained and simple pragmatic approach to diagnose TMDs is recommended. What makes the diagnosis and classification of TMD complicated at times is that many patients present with multiple diagnoses of TMD simultaneously, and it is impossible to isolate the condition to a single particular cause. There are 12 most common diagnoses of TMD described in Axis-I of the DC/TMD, which are divided into painful conditions (myalgia, local myalgia, myofascial pain, myofascial pain with referral, arthralgia, headache attributed to TMD) and non-painful conditions (disc displacement with reduction, disc displacement with reduction with intermittent locking, disc displacement without reduction with limited opening, disc displacement without reduction without limited opening, degenerative joint disease, subluxation). Differentiating one from the other requires thorough understanding and crystal clear knowledge of the ailment and its progression. Amid controversies of various theories put forward and multidynamic treatment approach, we all believe that the valid diagnosis is the key to successful treatment on account of TMD multifactorial nature and often of patients suffering from other disorder simultaneously that can make the correct diagnosis difficult. This review serves as an insight to the diagnostic criteria and easy treatment planning for TMDs