Although temporomandibular disorders (TMD) are now recognized as having a multifactorial etiology, with an interaction between biological, psychological, and social factors, there are still some communities of professionals who have not yet abandoned the previous occlusal paradigm, which is often defended more on the ground of tradition and fanatism than with solid arguments. That is in part understandable, based on paradox effectiveness of oral appliances on one hand, the effects of which seem to be occlusally-mediated, and the difficulties, for the average dental practitioner, to accept including a psychological evaluation as part of a routine target for TMD diagnosis and treatment on the other hand. Notwithstanding that, it is undoubtful that so-called gnathologic dogmas rely on assumptions that are not biologically and anatomically plausible, and that they should be definitively dismantled.

The study of the mutual interactions between bruxism, pain, and psychosocial factors has contributed a lot to develop a proposal for a unified concept of TMD physiopathology: the overload model. According to that, the onset of TMD symptoms may be viewed as the result of an unbalance between the load exerted on the temporomandibular joints by the jaw muscles and the resistance of the structures to that load. Bruxism in the form of jaw/teeth clenching, which in turn is related to an emotional overload, is likely the most detrimental factor, and psychosocial factors may also reduce the load-bearing capacity of the masticatory system. 

The evidence in support of the overload theory and the clinical suggestions for its adoption in the clinical setting will be discussed and put into practice during the full day course, to help practitioners providing care to their patients within an evidence-based paradigm. 

Course Program

Morning Session 9-12.30

• My journey from general dentistry and orthodontics to orofacial pain practice
• Temporomandibular Disorders guidelines
• Fundamentals of TMD management: from conservative approaches to TMJ arthrocentesis

Afternoon Session (Hands-On – patients) 14-17.30

• Clinical Assessment
• How to read imaging of the temporomandibular joint
• Cognitive-behavioural strategies
• Impressions for oral appliances
• Focus on TMJ arthrocentesis