Informed consent for the prosthodontic patient with temporomandibular disorders. Report of the Committee on Temporomandibular Disorders of the American College of Prosthodontists

The effect of musculoskeletal facial pain on registration of maxillomandibular relationships and treatment planning: a synthesis of the literature

STATEMENT OF PROBLEM

A significant number of patients exist who are in need of prosthodontic rehabilitation and who at the same time report musculoskeletal pain in the facial area.

PURPOSE

This article, which is based on an assessment of both the past and the most recent basic science and clinical literature, evaluates the effect of musculoskeletal facial pain on two static (physiologic rest position and centric relation) and two dynamic (protrusive border and lateral border movements) maxillomandibular relationships.

MATERIAL AND METHODS

To find the relevant studies addressing the association between musculoskeletal facial pain and maxillomandibular relationships, a MEDLINE search was conducted, which was complemented by a hand search in selected journals.

RESULTS AND CONCLUSIONS

Musculoskeletal facial pain seems to variably affect the aforementioned positions and movements. Hence, the validity of maxillomandibular registrations in patients with existing facial pain is questioned. In those patients with facial pain who simultaneously are in need of a prosthodontic rehabilitation, clinicians should be cautious with regard to the timing of the restorative procedures.

Prosthetic rehabilitation in patients with temporomandibular disorders

Decision-making in prosthetic dentistry and in the management of patients suffering from temporomandibular disorders is strongly influenced by the clinical and educational background of the dentist. The prosthetic rehabilitation of patients affected by one of the various subsets of temporomandibular disorders is a particularly challenging task, and the literature about this topic is limited. This article reviews the current situation and gives suggestions on how the dentist should proceed in the prosthetic treatment of these patients.