Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- dor cíclica
- dor contínua
- ruído articular
- movimento mandibular anormal
- sensibilidade dos músculos da mastigação
Other diagnostic factors
- depressão ou ansiedade
- cefaleia, dorsalgia, otalgia ou dor cervical
Risk factors
- sexo feminino
- comorbidades dolorosas
- idade de 20-40 anos
- depressão, ansiedade ou estresse
- genética
Diagnostic investigations
1st investigations to order
- diagnóstico clínico
Investigations to consider
- RNM
- TC ou TC de feixe em cone
Treatment algorithm
dor na articulação temporomandibular: à apresentação inicial
dor persistente após 2 semanas de repouso articular e <3 meses de duração
dor crônica ≥3 meses
dor refratária ou incapacidade: osteoartrite ou subtipo de disfunção interna
Contributors
Authors
Andrew Sidebottom, BDS, FDSRCS, MBChB, FRCS, FRCS (OMFS)
Consultant Oral and Maxillofacial Surgeon
Spire Nottingham Hospital
BMI Park Nottingham Hospital
Nottingham
UK
Disclosures
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
Disclosures
NA declares she has no competing interests.
Acknowledgements
Dr Andrew Sidebottom and Dr Nabeela Ahmed would like to gratefully acknowledge Dr Sandra McNeal, a previous contributor to this topic.
Disclosures
SM declares that she has no competing interests.
Peer reviewers
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
Disclosures
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
Disclosures
Not disclosed.
References
Key articles
List T, Jensen RH. Temporomandibular disorders: old ideas and new concepts. Cephalalgia. 2017 Jun;37(7):692-704.Full text Abstract
Durham J, Newton-John TR, Zakrzewska JM. Temporomandibular disorders. BMJ. 2015 Mar 12;350:h1154. Abstract
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.Full text Abstract
Dimitroulis G. Temporomandibular disorders: a clinical update. BMJ. 1998;317:190-4.Full text Abstract
Kapur N, Kamel IR, Herlich A. Oral and craniofacial pain: diagnosis, pathophysiology and treatment. Int Anesthesiol Clin. 2003;41:115-50. Abstract
Acquired temporomandibular disorders in infants, children, and adolescents. American Academy of Pediatric Dentistry. 2019 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Rinossinusite
- Pericoronite
- Cefaleia crônica
More DifferentialsGuidelines
- Acquired temporomandibular disorders in infants, children, and adolescents
- Recommendations for examination, diagnosis, management of patients with temporomandibular disorders and orofacial pain by the general dental practitioner
More GuidelinesPatient information
Disfunções temporomandibulares
More Patient information
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