Reported concepts for the treatment modalities and pain management of temporomandibular disorders

Abstract

BackgroundPain related to temporomandibular disorders (TMD) is a common problem in modern societies. The aim of the article is to present the concepts of TMD pain clinical management.MethodsA survey was performed using the PubMed, SCOPUS and CINAHL databases for documents published between 1994 and 2014. The following search keywords were selected using MeSH terms of the National Library of Medicine in combination: TMD pain, TMD, TMJ, TMJ disorders, occlusal splint, TMD physiotherapy, TMJ rheumatoid disorders and TMJ surgery. Original articles and review papers which presented the clinical relevance and practical validity regarding the possibility of application in TMD management have been included. Authors have excluded articles without outstanding practical aspect and evidence-based background. A first selection was carried out by reviewing titles and abstracts of all articles found according to the criteria. After that the full texts of potentially suitable articles were assessed. In line with these criteria, among 11467 results the writers have included 66 papers.ResultsThe most commonly reported conservative treatments are massage therapy and individually fabricated occlusal splints. In addition to massage, other popular methods include manual therapy and taping, warming/cooling of aching joints, and light and laser therapy. Drugs are also commonly used. In the most severe cases of the temporomandibular joint degeneration, surgical restoration of the joint is sometimes applied.ConclusionsThe authors concluded that conservative treatment including counselling, exercises, occlusal splint therapy, massage, manual therapy and others should be considered as a first choice therapy for TMD pain because of their low risk of side effects. In the case of severe acute pain or chronic pain resulting from serious disorders, inflammation and/or degeneration pharmacotherapy, minimally invasive and invasive procedures should be considered.

Assessment of the Short-Term Effectiveness of Kinesiotaping and Trigger Points Release Used in Functional Disorders of the Masticatory Muscles

“…Physiotherapy is of particular importance in the treatment of pain syndrome in the course of temporomandibular joint functional disorders. Positive therapeutic effects are obtained using botuline, laser therapy, heat therapy, light therapy, electrotherapy, electromagnetic field, manual therapy, proprioceptive neuromuscular motion paving, kinesiotherapy, relaxation techniques, autogenic training, and biofeedback to change of parafunctional behaviors [13, 14]. …”

Pain Mechanisms and Centralized Pain in Temporomandibular Disorders

“…A recent review of 66 TMD treatment papers published between 1994 and 2014 concluded that conservative treatments-including counseling, occlusal splint therapy, physiotherapeutic techniques (e.g., massage), and drug therapy-are most often undertaken (Wieckiewicz 2015). When the results are broken down by disease entity, no clear pattern of specific treatments targeted to specific pathologies emerges.…”

Does Practice Type Determine the Complexity of Patients Encountered for Orthognathic Surgery?

“…18 Patients with TMD pose a serious problem because they are often on long-term pain medications and muscle relaxants, leading to difficulty with postoperative pain control. 19 Patients with cleft and post-traumatic deformity tend to be difficult cases because of their complex anatomy and the difficulty of operating on a previously operated area.…”