Disfunções temporomandibulares: até onde o cirurgião dentista pode atuar

Abstract

The aim of this study was to conduct a literature review of temporomandibular disorders (TMD) in order to emphasize and define the role of the dentist in the therapeutic approaches employed for this disease. Aspects related to anatomy and neurophysiology of temporomadibular joints, types of patients pain, diagnostic systems and therapeutic approaches proposed for the treatment of TMD wereevaluated. Temporomandibular disorders have been broadly divided into myogenic and artrogenic. The signs and symptom associated with TMD are complaints of chronic pain in the head and orofacial structures. The DTM has a multifactorial origin and history of the patient remains the most important step in the formulation of the initial diagnostic impression. It is part of a complete medical history to identifypredisposing factors, initiators factors and perpetuating factors of the disease. The diagnostic system considered most complete and currently recommended for TMD is the DC/TMD (Diagnostic Criteria for temporomandibular disorders), comprising a multiaxial diagnostic system that includes the physical, mental and social status ofpatients. The correct diagnosis includes determining the type of patient, type of pain and classify the type of problem. After that, we define the most appropriate clinical management, initially based on the use of conservative and reversible therapy. The need for treatment is largely dependent upon the level of pain and dysfunction as well as the progression of the symptoms. When necessary, patients can be referredto a multidisciplinary team, always under the supervision of dentists.