A Disfunção Temporomandibular

Abstract

A disfunção temporomandibular (DTM) é uma condição clínica cada vez mais prevalente na sociedade atual e com grande impacto na vida dos doentes. Caracteriza-se por uma série de problemas clínicos que envolvem os músculos da mastigação, a articulação temporomandibular e as estruturas associadas. É considerada uma entidade multifatorial com uma forte componente psicossocial. O presente trabalho teve como objetivos sumariar as principais problemáticas que envolvem a esfera do doente que sofre desta patologia. Desta forma, os temas abordados foram: anatomia e funcionamento da articulação temporomandibular, epidemiologia, fatores de risco, clínica, meios de diagnóstico, principais diagnósticos diferenciais e por fim as várias abordagens terapêuticas. Foram analisados vários fatores de risco que contribuem para o desenvolvimento desta situação clínica, destacando-se a influência negativa de estados de ansiedade, stress e depressão, sob o sistema estomatognático. Por outro lado, o papel da oclusão tem vindo a ser desvalorizado. Os sinais e sintomas mais prevalentes são a dor na região pré-auricular ou nos músculos da mastigação, assim como diminuição da amplitude mandibular e os sons articulares. Conclui-se que o diagnóstico correto requer uma história clínica detalhada que inclui antecedentes dentários, médicos e psicossociais, aliada a um exame físico detalhado. O recurso à imagiologia tem um papel secundário, sendo útil para suplementar informação obtida pelo exame físico e esclarecer dúvidas de diagnóstico. Por último, conclui-se que a abordagem terapêutica deve beneficiar de um envolvimento multidisciplinar de diversas especialidades médicas e deve-se iniciar com o tratamento menos invasivo, ficando as manobras cirúrgicas invasivas reservadas para patologias intra-articulares que não respondem a terapêutica conservativa. joint dysfunction (TMD) is a clinical condition increasingly prevalent in today’s society, with a great impact in the patients’ life. It is characterized by a set of clinical conditions that involve the muscles of mastication, the temporomandibular joint and surrounding structures. It is considered a multifactorial disease with a strong psychosocial component. The goal of this assignment is to summarize the main problems that affect a patient with this condition. Therefore, the themes approached were: anatomy and function of the temporomandibular joint, epidemiology, risk factors, clinical evolution, methods for diagnosis, main differential diagnosis and finally, therapeutic approaches. Many risk factors that contribute to the development of this clinical condition were analysed, and it was found that anxiety, stress and depression are negatively linked to the stomatognathic system. On another note, the role of occlusion has been undervalued. The most significant signals and symptoms are pain in the pre-auricular area or in the muscles of mastication, as well as decreasing range of mandibular motion and joint sounds. It was concluded that the correct diagnosis requires a detailed history that should include dental, medical and psychosocial history as well as an exhaustive clinical examination. Diagnostic imaging has a secondary role, although it’s useful for complementing the information obtained by the physical exam, and may clarify some diagnosis doubts. Lastly, it was concluded that the therapeutic approach should benefit a joint dysfunction (TMD) is a clinical condition increasingly prevalent in today’s society, with a great impact in the patients’ life. It is characterized by a set of clinical conditions that involve the muscles of mastication, the temporomandibular joint and surrounding structures. It is considered a multifactorial disease with a strong psychosocial component. The goal of this assignment is to summarize the main problems that affect a patient with this condition. Therefore, the themes approached were: anatomy and function of the temporomandibular joint, epidemiology, risk factors, clinical evolution, methods for diagnosis, main differential diagnosis and finally, therapeutic approaches. Many risk factors that contribute to the development of this clinical condition were analysed, and it was found that anxiety, stress and depression are negatively linked to the stomatognathic system. On another note, the role of occlusion has been undervalued. The most significant signals and symptoms are pain in the pre-auricular area or in the muscles of mastication, as well as decreasing range of mandibular motion and joint sounds. It was concluded that the correct diagnosis requires a detailed history that should include dental, medical and psychosocial history as well as an exhaustive clinical examination. Diagnostic imaging has a secondary role, although it’s useful for complementing the information obtained by the physical exam, and may clarify some diagnosis doubts. Lastly, it was concluded that the therapeutic approach should benefit a joint dysfunction (TMD) is a clinical condition increasingly prevalent in today’s society, with a great impact in the patients’ life. It is characterized by a set of clinical conditions that involve the muscles of mastication, the temporomandibular joint and surrounding structures. It is considered a multifactorial disease with a strong psychosocial component. The goal of this assignment is to summarize the main problems that affect a patient with this condition. Therefore, the themes approached were: anatomy and function of the temporomandibular joint, epidemiology, risk factors, clinical evolution, methods for diagnosis, main differential diagnosis and finally, therapeutic approaches. Many risk factors that contribute to the development of this clinical condition were analysed, and it was found that anxiety, stress and depression are negatively linked to the stomatognathic system. On another note, the role of occlusion has been undervalued. The most significant signals and symptoms are pain in the pre-auricular area or in the muscles of mastication, as well as decreasing range of mandibular motion and joint sounds. It was concluded that the correct diagnosis requires a detailed history that should include dental, medical and psychosocial history as well as an exhaustive clinical examination. Diagnostic imaging has a secondary role, although it’s useful for complementing the information obtained by the physical exam, and may clarify some diagnosis doubts. Lastly, it was concluded that the therapeutic approach should benefit ajoint dysfunction (TMD) is a clinical condition increasingly prevalent in today’s society, with a great impact in the patients’ life. It is characterized by a set of clinical conditions that involve the muscles of mastication, the temporomandibular joint and surrounding structures. It is considered a multifactorial disease with a strong psychosocial component. The goal of this assignment is to summarize the main problems that affect a patient with this condition. Therefore, the themes approached were: anatomy and function of the temporomandibular joint, epidemiology, risk factors, clinical evolution, methods for diagnosis, main differential diagnosis and finally, therapeutic approaches. Many risk factors that contribute to the development of this clinical condition were analysed, and it was found that anxiety, stress and depression are negatively linked to the stomatognathic system. On another note, the role of occlusion has been undervalued. The most significant signals and symptoms are pain in the pre-auricular area or in the muscles of mastication, as well as decreasing range of mandibular motion and joint sounds. It was concluded that the correct diagnosis requires a detailed history that should include dental, medical and psychosocial history as well as an exhaustive clinical examination. Diagnostic imaging has a secondary role, although it’s useful for complementing the information obtained by the physical exam, and may clarify some diagnosis doubts. Lastly, it was concluded that the therapeutic approach should benefit a joint dysfunction (TMD) is a clinical condition increasingly prevalent in today’s society, with a great impact in the patients’ life. It is characterized by a set of clinical conditions that involve the muscles of mastication, the temporomandibular joint and surrounding structures. It is considered a multifactorial disease with a strong psychosocial component. The goal of this assignment is to summarize the main problems that affect a patient with this condition. Therefore, the themes approached were: anatomy and function of the temporomandibular joint, epidemiology, risk factors, clinical evolution, methods for diagnosis, main differential diagnosis and finally, therapeutic approaches. Many risk factors that contribute to the development of this clinical condition were analysed, and it was found that anxiety, stress and depression are negatively linked to the stomatognathic system. On another note, the role of occlusion has been undervalued. The most significant signals and symptoms are pain in the pre-auricular area or in the muscles of mastication, as well as decreasing range of mandibular motion and joint sounds. It was concluded that the correct diagnosis requires a detailed history that should include dental, medical and psychosocial history as well as an exhaustive clinical examination. Diagnostic imaging has a secondary role, although it’s useful for complementing the information obtained by the physical exam, and may clarify some diagnosis doubts. Lastly, it was concluded that the therapeutic approach should benefit a multidisciplinary effort of different medical specialties, and start with a less invasive treatment, leaving invasive surgery procedures for intra-articular pathologies that don’t respond to conservative therapy.