The etiology of temporomandibular disorders: implications for treatment

摘要: This article begins by reviewing the history of etiologic thinking in field temporomandibular disorders (TMD). I conclude from this review that not only are old mechanistic concepts incorrect, but also 2 most popular current (biopsychosocial and multifactorial) seriously flawed. Therefore, what we really have at individual TMD patient level is nearly always an idiopathic situation--we simply do know enough, or cannot measure precisely determine why each has a TMD. In addition, understand host resistance factors ultimately one person gets sick while another does not. The issue "why" (etiology) must be differentiated "how" (pathophysiology), both semantically intellectually, to discuss all properly. However, our inability identify etiologies patients prevent us providing sensible (and often successful) treatment for these patients. Many health conditions currently treated physicians dentists with either incomplete flawed understanding their etiology, availability empirical data about outcomes permits some appropriate care given. Fortunately, large number comparative studies been done therapy, basis selecting initial therapies as well dealing failures. Even absence perfect still can provide good conservative care, should avoid aggressive irreversible treatments, especially when they based on etiology. concludes discussing basic science research activities orofacial pain. propose ongoing molecular cellular mechanisms joint disease, muscle pain, chronic pain likely avenues future progress field, specific countermeasures developed become more targeted therapies.