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Abstract:
When evaluating the current status of a patient with diseases of the TMJ, certain guidelines must be followed. It is of the utmost importance to take into consideration the total picture. This must include the history, physical examination, x-rays, films, and any other pertinent information. As stated previously, the TMJ is demonstrated with a great deal of clarity by modern tomographic x-ray techniques. This, however, provides only part of the total evidence. It is indeed unfortunate that some medical and dental consultants for insurance companies and other health groups base their criteria for eligibility on the evidence provided only by the x-ray films, without taking into consideration other important data. Another source of error is the fact that the total duration of the patient's symptoms is not given enough consideration. This is shown in patients with a history lasting many months or years, associated with definite x-ray changes, who are misdiagnosed as having myofascial pain dysfunction syndrome. The fact that this is an acute process of short duration involving primarily muscles of mastication and other related soft tissues is overlooked. When presented with a patient with a long history of TMJ discomfort, it is essential to consider an intrinsic organic process of the joint. It should be stressed that osteoarthritis or degenerative joint disease is a condition frequently found in the TMJ when examined with modern tomographic techniques. It occurs in individuals of all ages. Osteoarthritis of the TMJ is basically a medical or orthopedic condition similar to that found in other joints of the body affected by this primary joint disease. For this reason, osteoarthritis cannot be considered purely a dental condition when it occurs in the TMJ. However, because of the close proximity, both anatomically and physiologically, to the teeth and related structures, these conditions are frequently labeled as dental.(ABSTRACT TRUNCATED AT 400 WORDS)