Temporomandibular Disorders and Oral Rehabilitation

Dear Colleagues,

Temporomandibular joint dysfunction (TMD) is an umbrella term characterized by orofacial pain involving structures such as the temporomandibular joints (TMJs), mastication muscles and/or related anatomical regions. According to data provided by the American Academy of Orofacial Pain (AAOP), 75% of the population of the United States has or presents signs and/or symptoms of TMD. The literature on the epidemiology of TMD also highlights the different prevalences of these disorders in relation to sex, with strong female representation (female/male relationship about 4:1) and more frequent onset of the pathology between the ages of 25 and 40 (compared to 2–4% among the elderly). The greater susceptibility of women to TMD has been associated with factors such as greater sensitivity to emotional stress, greater body care, and greater request for professional services and/or treatment. However, the evidence of a higher prevalence of TMDs in women during the period of fertility has led scholars to speculate on the possibility of hormonal involvement, in particular estrogen. The etiological cause of TMD still remains unclear; however, recent studies showed that psychosocial factors should be considered cofactors in the etiology of TMD. Biological interactions, psychosocial status, and environmental factors are complex causes, and moreover, the scientific literature does not provide evidence of malocclusion and TMD relations, but it was recently shown that there is dysregulation in the autonomic nervous system (ANS) in patients with TMD. TMD patients, in fact, show consistent functional/structural changes in the thalamus and the primary somatosensory cortex. In addition, these subjects show a greater frequency of psychiatric disorders (anxiety, depression, alexithymia, catastrophizing). Sometimes, central sensitization stems from a peripheral injury and/or dysfunction; frequently, this is the cause of chronic TMD, in which muscle, dental occlusion, or temporomandibular joint (TMJ) dysfunction can be considered peripheral triggers. In recent research, many types of therapies investigate potential treatments for TMD. A large number of studies show that certain drugs, sometimes associated with bite or oral devices, can be used in TMD treatment. Gnathology treatments, in particular for conditions without muscular tension, are often useful strategized therapies. Moreover, nowadays, therapies using natural factors are becoming increasingly popular. Lastly, as explained above, psychological support could be an optimal treatment in subjects with chronic TMD.

This Special Issue will collate original research that investigates and compares different therapeutic strategies in patients with TMD. Review articles discussing the current state of the art are also welcomed.

Prof. Dr. Annalisa Monaco
Guest Editor

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• orofacial pain
• TMD
• oral devices
• electromyography and kinesiography
• TENS