Classifying muscle dysfunction in temporomandibular disorders: Review and novel proposed classification.

BACKGROUND

Muscular Temporomandibular Disorders (mTMD) are musculoskeletal (MSK) disorders that have an unclear etiopathology, making clinical diagnosis and classification important for targeted treatment. Current taxonomies focus on pain reproduction, whereas MSK evaluation encompasses other clinical assessments. The ability to align taxonomy to MSK evaluation would improve diagnosis and targeted treatment.

OBJECTIVE

Review the recent clinical research for mTMD and identify emergent constructs to reframe the current taxonomy for myalgia classification of the Diagnostic Classification for Temporomandibular Disorders (DC/TMD). This mapped information formed the basis of the presented reframed classification for mTMD.

METHODS

A scoping review, following PRISMA guidelines searched PubMed, EMBASE, CINAHL, Scopus, Web of Science and Cochrane for studies (2022-2025) involving humans with mTMD. Studies were assessed by two independent reviewers for use of any classification system, including additional assessments that introduce novel concepts to classify mTMD.

RESULTS

16 papers were selected from the search criteria. They evaluated and classified their cohorts according to somatosensory profiles, latent phenotypes, psychosocial characteristics or by novel assessment. The evidence was used to conceptualise a pragmatic five-category stratification for mTMD, with accompanying examination and management suggestions to enhance clarity in diagnosis, treatment and research.