Temporomandibular joint pain-dysfunction syndrome and bruxism: etiopathogenesis and treatment from a psychosomatic integrative viewpoint.

It is common opinion that temporomandibular joint pain-dysfunction (TMJPD) syndrome and bruxism have a major psychosomatic component. In this paper, we try to review these entities in an integrated manner, taking into account both medical and psychological aspects. Two etiological models have been developed: the structural model emphasizes the role played by malocclusion or alterations of the maxillomandibular relationship, while the functional model underscores the role of stress, emotional tension, and personality characteristics. In TMJPD and bruxist patients a careful physical and psychological examination has to be performed. The classical dental treatment is based on equilibration procedures, prostheses and drugs. Treatment strategy can also be based on psychotherapeutic and relaxation treatments; in this respect, the use of EMG biofeedback training has been subjected to intense study.