Current Management of Temporomandibular Joint (TMJ) Disease

Temporomandibular joint (TMJ) disorder (TMD) is a collection of medical and dental conditions affecting the joint and muscles of mastication, as well as contiguous tissue components. This leads to pain and altered oral function and can lead to a poor quality of life. The majority of the population can be affected to some degree. Management of TMD is often simple in the first instance, but may involve complex decision making. This article summarizes the current investigative and treatment options available. Magnetic Resonance Imaging is the recommended radiological investigation of choice for soft tissue assessment whilst TMJ arthroscopy supersedes most other invasive treatments available in relation management of symptoms and more accurate diagnosis. Should arthroscopy fail to achieve satisfactory resolution of symptoms a standardised treatment pathway based on arthroscopic findings involves appropriate assessment, possible open surgery or even TMJ replacement. This latter procedure is governed by NICE guidelines and delivers an excellent short and medium term outcome up to 20 years.