Temporomandibular disorders. Part 1: anatomy and examination/diagnosis

Temporomandibular disorders (TMD) are a heterogeneous group of diagnoses that affect the temporomandibular joint (TMJ) and surrounding tissues. A number of methods for evaluating and managing TMD have been suggested within the physical therapy profession but these sources are not peer-reviewed and lack updates from scientific literature. The dental profession has provided peer-reviewed sources that aren’t adequately thorough in regards to the neuromusculoskeletal techniques utilized by physical therapists. The subsequent void creates the need for a thorough, research informed, and peer-reviewed source regarding TMD evaluation and management for physical therapists. This paper is the first part in a two-part series that seeks to fill the current void by providing a brief but comprehensive outline for clinicians seeking to provide services for patients with TMD. Part one focuses on anatomy and pathology, arthro- and osteokinematics, epidemiology, history taking, and physical examination as they are related to TMD. An appreciation of the anatomical and mechanical features associated with the TMJ can serve as a foundation for understanding a patient’s clinical presentation. Performance of a thorough patient history and clinical examination can lead the clinician toward an improved diagnostic process.