Management of temporomandibular joint conditions

The management of temporomandibular joint conditions has changed dramatically since the 1970s, as the knowledge of the physiology, pathology, and evidence base has developed for the temporomandibular joint. One of the main barriers for this progression was the lack of consensus for specific definitions of different diagnoses associated with TMD conditions. The most recent DC/TMD guidelines have refined the different diagnoses so that clinicians can apply these criteria during the examination, diagnosis and management of TMD patients. Most early management strategies for articular disc displacements were aimed at surgically repositioning the articular disc or utilizing an oral appliance to advance the mandible to a point where the condyle was repositioned on the articular disc. These early management approaches often failed to produce the reduction of the pain and dysfunction that both the health care provider and the patient desired. Slowly, management strategies have evolved into less invasive, more patient centered, and more multidisciplinary as the multifactorial nature of temporomandibular joint conditions became evident. This article reviews the specific DC/TMD diagnoses and the evidence base for the utilization of different management strategies.