Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- dor cíclica
- dor contínua
- ruído articular
- movimento mandibular anormal
- sensibilidade dos músculos da mastigação
Outros fatores diagnósticos
- depressão ou ansiedade
- cefaleia, dorsalgia, otalgia ou dor cervical
Fatores de risco
- sexo feminino
- comorbidades dolorosas
- idade de 20-40 anos
- depressão, ansiedade ou estresse
- genética
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- diagnóstico clínico
Investigações a serem consideradas
- RNM
- TC ou TC de feixe em cone
Algoritmo de tratamento
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
Colaboradores
Autores
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
利益声明
NA declares she has no competing interests.
鸣谢
Dr Andrew Sidebottom and Dr Nabeela Ahmed would like to gratefully acknowledge Dr Sandra McNeal, a previous contributor to this topic.
利益声明
SM declares that she has no competing interests.
同行评议者
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
利益声明
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
利益声明
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.
参考文献
关键文献
List T, Jensen RH. Temporomandibular disorders: old ideas and new concepts. Cephalalgia. 2017 Jun;37(7):692-704.全文 摘要
Durham J, Newton-John TR, Zakrzewska JM. Temporomandibular disorders. BMJ. 2015 Mar 12;350:h1154. 摘要
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.全文 摘要
Kapur N, Kamel IR, Herlich A. Oral and craniofacial pain: diagnosis, pathophysiology and treatment. Int Anesthesiol Clin. 2003;41:115-50. 摘要
Acquired temporomandibular disorders in infants, children, and adolescents. American Academy of Pediatric Dentistry. 2019 [internet publication].全文
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Rinossinusite
- Pericoronite
- Cefaleia crônica
更多 鉴别诊断指南
- 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
更多 指南患者教育信息
Disfunções temporomandibulares
更多 患者教育信息
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