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

Area of Science:

• Temporomandibular Disorders (TMD)
• Musculoskeletal (MSK) Disorders
• Clinical Taxonomy

Background:

• Muscular Temporomandibular Disorders (mTMD) have an unclear etiopathology, complicating diagnosis and treatment.
• Current mTMD classifications primarily focus on pain, neglecting broader musculoskeletal assessments.
• Aligning taxonomy with comprehensive MSK evaluations is crucial for improving diagnosis and targeted interventions.

Purpose of the Study:

• To review recent clinical research on mTMD and identify new concepts for refining the myalgia classification within the Diagnostic Classification for Temporomandibular Disorders (DC/TMD).
• To develop a reframed classification system for mTMD based on emergent research findings.

Main Methods:

• A scoping review adhering to PRISMA guidelines was conducted.
• Searches were performed across major databases (PubMed, EMBASE, CINAHL, Scopus, Web of Science, Cochrane) for studies published between 2022 and 2025.
• Two independent reviewers assessed 16 selected papers for classification systems and novel assessment concepts.

Main Results:

• Sixteen relevant papers were identified and analyzed.
• Classifications in the reviewed studies incorporated somatosensory profiles, latent phenotypes, psychosocial characteristics, and novel assessment methods.
• A pragmatic, five-category stratification for mTMD was conceptualized, offering suggestions for examination and management.

Conclusions:

• The proposed five-category stratification enhances clarity for mTMD diagnosis, treatment, and research.
• Integrating broader MSK evaluation concepts into mTMD classification offers a more comprehensive approach.
• This reframed classification supports more targeted and effective management strategies for patients with mTMD.