The temporomandibular joint (TMJ) forms one of the most fascinating and complex synovial systems in the body. Movements of the TMJ are regulated by an intricate neurological controlling mechanism, which is essential for the system to function normally and efficiently. Lack of such harmony may cause disruptive muscle behavior or structural damage to any of the components.
In 1934, Costen first described a syndrome that included facial and head pain and temporomandibular joint dysfunction, which was known as temporomandibular joint pain dysfunction syndrome (TMJPDS). Over the years, several diagnostic terms have been suggested by various authors for musculoskeletal disorders of the temporomandibular region, reflecting the different theories of etiology probably responsible for the various signs and symptoms presenting in the patients. The term, “Myofascial Pain Dysfunction Syndrome” was initially coined by Laskin in 1969. Even though the condition is common, it is not well understood by most dental practitioners. The reason is probably related to the diversity of views expressed and a difficulty in comprehending its natural history and symptomatology.
Consequently, many different therapies-some conservative and reversible, others irreversible, including surgery and repositioning of the mandible, have been advocated for patients with TMJ dysfunction. Due to the difficulty in determining the etiology and the possibility that the symptoms are secondary to some other disorders of TMJ or muscles of mastication, initial treatment given should be reversible.
Occlusal splint therapy is chosen for the treatment of dysfunctions in the orofacial region for several reasons. It is relatively simple, reversible, noninvasive and costs less than other treatments. Soft splints have been advocated for patients with TMD. They can be made for maxillary arches and are easily constructed and often inserted immediately at the initial examination. A high degree of patient acceptance has been reported with soft splints. The soft, resilient material may help in distributing the heavy load that occurs during parafunctional activity.
A wide variety of drug classes have been described for chronic orofacial pain, ranging from short-term treatment with Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and muscle relaxants for pain of muscular origin to long-term administration of antidepressants for less well-characterized pain.
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