Temporomandibular trauma and reflections on personal evaluation

Area of Science:

• Oral and Maxillofacial Surgery
• Medico-legal Science
• Dental Traumatology

Background:

• The International Consortium Network/Orofacial Pain Special Interest Group provides guidelines for temporomandibular disorder (TMD) diagnosis.
• Current personal damage assessment frameworks in Europe and America require comprehensive analysis regarding orofacial trauma and sequelae.
• Medico-legal evaluations of orofacial trauma necessitate standardized criteria for injury and sequela assessment.

Purpose of the Study:

• To comprehensively analyze injury and sequela frames within European and American approaches to personal damage related to orofacial trauma.
• To evaluate the application of temporomandibular joint (TMJ) diagnostic criteria in medico-legal evaluations of orofacial trauma.
• To propose revisions for personal damage reference tables to incorporate TMD diagnosis and its impact.

Main Methods:

• A quasiexperimental pilot study utilizing an interrupted time series design.
• Analysis of Portuguese orofacial trauma cases from a medico-legal evaluation database.
• Clinical data recorded based on five TMJ diagnostic criteria (jaw opening, pain, anatomical deficit, functional deficit, clinical sounds, occlusal deficit) across three severity degrees.

Main Results:

• Injury frame evaluation was consistently recorded in the first-degree stage across all criteria.
• Pain, as a sequela, was present in 45% of the sample (20% spontaneous, 25% stimulated).
• Temporomandibular trauma damage evaluation highlights the importance of accurate injury diagnosis and sequela framework.

Conclusions:

• Orofacial trauma analysis should prioritize the inclusion or exclusion of a TMD diagnosis.
• Current reference tables for personal damage require revision to include TMD and its specific categorization and impact.
• Standardized inclusion of TMD in medico-legal evaluations will enhance accuracy in assessing orofacial trauma damages.