Classifications of temporomandibular disorders and patients' examination protocols - comparative analysis by the convenience of their daily use in clinical practice.

OBJECTIVE

Introduction

The problem of temporomandibular disorders (TMD) is relevant in today's world and is considered one of the most common pathologies causing nonodontogenic pain syndromes of maxillofacial region. The morbidity of temporomandibular disorders is 27 to 76% among patients who seek dental care. There is now a significant number of classifications of TMD, however, clinically convenient, morphologically and pathogenetically substantiated classification of temporomandibular joint's (TMJ) conditions has not yet been developed. Therefore, the patient's examination protocols differ substantially. The aim: To analyze and assess the quality of classifications and examination protocols for the patients with suspected TMD.

PATIENTS AND

METHODS

Materials and methods: A comparative analysis of 5 TMD classifications and 3 protocols for the examination of patients with suspected TMDs were performed.

RESULTS

Review: A comparative analysis of following TMD classifications was conducted: American Academy of Orofacial Pain, Research Diagnostic Criteria for TMD, by B.W.Neville, D.D.Damm, C.M.Allen, J.E.Bouquot, by Christian Köneke, international classification of diseases ICD-10. The analysis of the following protocols for the examination of patients with suspected TMDs was conducted: M. Helkimo index, Hamburg protocol, M. Kleinrok protocol.

CONCLUSION

Conclusions

Difficulties in interpreting diagnoses by dentists are caused by ambiguities in classifications, a considerable number of clinical entities and their construction principles. Organ principle of structure has proved to be the most convenient for clinical application. The evaluation protocols are cumbersome and duplicate each other. Owing to the lack of a common opinion about the origin and development of TMD, use of the evaluation protocols is based on the experience of dental practitioners.