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Related Experiment Videos

Temporomandibular joint dysfunction: from Costen to the present

H T Perry1

  • 1Department of Orthodontics, Northwestern University Dental School, Chicago, Illinois, USA.

Annals of the Academy of Medicine, Singapore
|January 1, 1995
PubMed
Summary

Costen's original temporomandibular joint dysfunction theory is largely refuted. Modern understanding emphasizes muscle function, psychosocial factors, and parafunctional habits, requiring accurate diagnosis before treatment.

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Area of Science:

  • Dental Medicine and Otolaryngology
  • Temporomandibular Joint Disorders (TMD)

Background:

  • Review of literature on temporomandibular joint dysfunction (TMD) since James Costen's 1930s description.
  • Costen's hypothesis linked jaw and ear symptoms to missing posterior teeth and jaw overclosure, proposing "bite buildup" therapy.

Discussion:

  • Evolving concepts have largely refuted Costen's original etiological explanations for TMD.
  • Current understanding highlights the significant roles of muscle function, psychosocial factors, and individual parafunctional habits (e.g., teeth grinding) in TMD development.
  • Stress is recognized as a contributing factor to these parafunctional habits.

Key Insights:

  • TMD etiology is multifactorial, moving beyond simple occlusal disharmony.
  • Muscle activity, psychological state, and stress-related behaviors are critical considerations.

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  • Accurate diagnosis is paramount for effective TMD management.

    • Outlook:

    • Future TMD treatment protocols must integrate a comprehensive diagnostic approach.
    • Distinguishing between arthrogenous, neurogenous, and myogenous origins of TMD is crucial for tailored therapy.
    • Continued research into the interplay of biological, psychological, and social factors in TMD is warranted.