Citation: Badel T, Pavičin IS, Čimić S, Zadravec D (2016) Diagnostics and Management of Temporomandibular Joint Disorder - A Reported Case with a Review of Literature. J Dent Probl Solut 3(1): 018-023. DOI: 10.17352/2394-8418.000027 Journal of Dental Problems and Solutions 018 he irst one to research this type of orofacial pain was an otorhinolaryngologist, James B. Costen, who started describing clinical cases with heterogenic otologic symptoms in 1934 and connected them to morphological features of occlusion, such as loss of posterior teeth [9,11]. he origins of the symptoms were based on only one factor – mechanical condylar displacement (Costen’s syndrome), parafunction (bruxism) as a consequence of occlusal interferences causing muscular spasm and muscular hyperactivity (neuromuscular theory) and muscular hyperactivity which causes muscle tension and spasm (muscular theory). he psychological theory considers temporomandibular disorders to be psychosomatic. he hybrid theories connect a combination of certain factors – such as stressful states and occlusal relations. Today, the etiology of temporomandibular disorders is explained by the multifactorial concept, that is, by the inluence of various factors (traumatic, anatomic, pathophysiological and psychosocial), as well as by the biopsychosocial concept (including the combination of biological and psychological factors, particularly in chronic temporomandibular pain) [5,12]. Methods A system of uniied clinical diagnostics of TMDs has been developed and in the latest revision it was called to research criteria for temporomandibular disorders (RC/TMD). TMDs do not encompass only one diagnostic category in each individual case. It is possible to establish several diagnoses in one patient because a certain diagnostic subgroup of TMDs does not rule out another one [13]. Introduction Orofacial pain (musculoskeletal, neuropathic, neurovascular) has a prevalence of up to 22-26% in general population, out of which 7-11% have chronic pain [1,2]. In clinical symptomatology which involves sounds (clicking, crepitation) in the temporomandibular joint (TMJ) and reduced mouth opening, the symptom of arthralgia (joint pain) is the most common symptom that causes patients to seek diagnosis and treatment. Prevalence of pain in the TMJ and masticatory muscles is relatively low (around 2-7%) [3-5]. Emergency cases in oral surgery are mostly consequences of odontogenic complications and sot tissue injuries (33.94% and 22.54% respectively), whereas TMJ disorders and trigeminal neuralgia account for less than 2% (1.63% and 1.34% respectively) [6-8]. his review is about the clinical presentation of musculoskeletal disorders in the orofacial area. he article will emphasize medical- dental and radiological diagnostics of TMJ disorder, presented through a three-year follow-up of a reported case. Orofacial pain and temporomandibular disorders (TMDs) Orofacial pain has a diverse pathophysiological foundation and therefore its diagnostics and treatment include several medical and dental ields. One of the most common causes of orofacial pain, that is, pain in the area of the stomatognathic system, are TMDs. TMDs are a group of painful musculoskeletal conditions of the masticatory muscles, temporomandibular joints and adjoining structures (International Association for the Study of Pain) [9,10]. Mini Review Diagnostics and Management of Temporomandibular Joint Disorder - A Reported Case with a Review of Literature Tomislav Badel 1 *, Ivana Savić Pavičin 2 , Samir Čimić 1 and Dijana Zadravec 3 1 Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia 2 Department of Dental Anthropology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia 3 Department of Diagnostic and Interventional Radiology, Clinical Hospital Center “Sestre milosrdnice”, University of Zagreb, Zagreb, Croatia Dates: Received: 28 April, 2016; Accepted: 02 June, 2016; Published: 03 June, 2016 *Corresponding author: Tomislav Badel, Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb/CROATIA, Tel: +38514802125; Fax: +38514802149; E-mail: www.peertechz.com ISSN: 2394-8418 Keywords: Temporomandibular joint; Magnetic resonance imaging; Splint; Axiography Abstract Musculoskeletal disorders of the stomatognathic system together comprise the term temporomandibular disorders (TMDs). The etiopathogenetic correlation between anterior disc displacement and osteoarthritis of the temporomandibular joint (TMJ), as the main diagnoses of arthrogenic forms of TMDs have not been fully explained. Since the early nineties of the twentieth century the diagnostics of the TMJ disorders has been improved by use of magnetic resonance imaging (MRI). The psychological factors play an important role in the expression of pain during different stages of TMD, especially in perpetuation of TMD and in the response of such patients to treatment. Axiographic recordings of the mandibular joint motion can help with the diagnosis of muscular dyscoordination, hyper and hypomobility, dynamic asymmetries of movement, avoidance mechanisms, and joint pathologies. The clinical problematic is illustrated in a case of a 36-year-old female patient who suffered from bipolar disorder for years, which started as an unrecognized postpartum depression. MRI revealed anterior disc displacement without reduction in the left and with reduction in the right joint, with an additional osteophyte with degenerative subchondral changes of the condyle in the left joint. Osteoarthritis is mostly responsible for joint pain in general population, but experience tells us that TMJ is a dominant clinical sign and symptom which is often unrecognized as a separate entity because the criteria for clinical signs of TMJ are susceptible to validity checks compared to MRI indings.