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Disfunções temporomandibulares

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 20 Aug 2025
Last updated: 05 Mar 2025

Summary

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • presença de fatores de risco
  • dor cíclica
  • dor contínua
  • ruído articular
  • movimento mandibular anormal
  • sensibilidade dos músculos da mastigação
Полная информация

Другие диагностические факторы

  • depressão ou ansiedade
  • cefaleia, dorsalgia, otalgia ou dor cervical
Полная информация

Факторы риска

  • sexo feminino
  • comorbidades dolorosas
  • idade de 20-40 anos
  • depressão, ansiedade ou estresse
  • genética
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • diagnóstico clínico
Полная информация

Исследования, проведение которых нужно рассмотреть

  • RNM
  • TC ou TC de feixe em cone
Полная информация

Алгоритм лечения

Начальные

dor na articulação temporomandibular: à apresentação inicial

Острый

dor persistente após 2 semanas de repouso articular e <3 meses de duração

ПРОДОЛЖЕНИЕ

dor crônica ≥3 meses

dor refratária ou incapacidade: osteoartrite ou subtipo de disfunção interna

Составители

Авторы

Andrew Sidebottom, BDS, FDSRCS, MBChB, FRCS, FRCS (OMFS)

Consultant Oral and Maxillofacial Surgeon

Spire Nottingham Hospital

BMI Park Nottingham Hospital

Nottingham

UK

Раскрытие информации

AJS has been and continues to be reimbursed for provision of educational lectures and cadaveric training courses by the following companies: Stryker, Biomet, KLS Martin. These companies make surgical implants used during maxillofacial surgery. AJS has written patient information leaflets for EIDO on various aspects of TMJ surgery. AJS is author of a number of book chapters on management of TMD. None of the above have been influenced by the paid educational provision to the above three companies.

Nabeela Ahmed, BDS, MFDS RCS England, MBChB, FRCS (OMFS)

​Consultant OMFS

Tauranga Hospital

Bay of Plenty District Health Board

New Zealand

Раскрытие информации

NA declares she has no competing interests.

Выражение благодарностей

Dr Andrew Sidebottom and Dr Nabeela Ahmed would like to gratefully acknowledge Dr Sandra McNeal, a previous contributor to this topic.

Раскрытие информации

SM declares that she has no competing interests.

Рецензенты

Lawrence R. Lustig, MD

​BMJ Best Practice ENT expert panel member

Professor and Chair

Department of Otolaryngology

Columbia University Vagelos College of Physicians and Surgeons

New York

NY

Раскрытие информации

LRL declares that he has no competing interests.

Shanti Kaimal, BDS, MS

Clinical Associate Professor

Director, Advanced Education Program in Orofacial Pain

Division of TMD and Orofacial Pain

University of Minnesota

Minneapolis

MN

Раскрытие информации

Not disclosed.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

List T, Jensen RH. Temporomandibular disorders: old ideas and new concepts. Cephalalgia. 2017 Jun;37(7):692-704.Полный текст  Аннотация

Durham J, Newton-John TR, Zakrzewska JM. Temporomandibular disorders. BMJ. 2015 Mar 12;350:h1154. Аннотация

Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache. 2014 Winter;28(1):6-27.Полный текст  Аннотация

Dimitroulis G. Temporomandibular disorders: a clinical update. BMJ. 1998;317:190-4.Полный текст  Аннотация

Kapur N, Kamel IR, Herlich A. Oral and craniofacial pain: diagnosis, pathophysiology and treatment. Int Anesthesiol Clin. 2003;41:115-50. Аннотация

Acquired temporomandibular disorders in infants, children, and adolescents. American Academy of Pediatric Dentistry. 2019 [internet publication].Полный текст

Статьи, указанные как источники

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