Current concepts in the aetiology, diagnosis and treatment of TMJ and muscle dysfunction.

The complexity of managing TMJ and muscle dysfunction is reflected in the variety of treatment modalities that are continually being advocated. The multidimensional nature of the problem is readily appreciated in a TMJ Oral-Facial Pain Clinic where most of the referred patients represent a broad spectrum of treatments that have failed. Where such a clinic has been present for several decades the introduction of new ideas, or the reintroduction of old forms of treatment, are readily seen as well as the quantity and quality of treatment successes and failures. A major shift in ideas concerning the natural history of TMJ/muscle dysfunction, and an explosion of treatment problems and failures related to mandibular repositioning appliances and surgery suggest the need to reconsider various approaches to the diagnosis and treatment of TMJ and muscle dysfunction. Guidelines for diagnosis and treatment of these disorders are discussed.