[Craniomandibular disorders management (1) Treatment planning]

Various treatment modalities have been reported in the management of the craniomandibular disorders in the half century after Costen reported his hypothesis on the temporomandibular disorders. Recent advances in the basic sciences such as anatomy, histology, pathology, physiology and clinical trials have brought us to this new era. We have been trying to establish our diagnosis and treatment modalities in the management of the craniomandibular disorders over the past fifteen years. In this series of articles we will describe our present concept. We will first discuss diagnosis and treatment planning. After the diagnosis and initial treatment planning craniomandibular management is usually divided into two phases. Phase I is the treatment of the stomatognathic system especially the temporomandibular joint. Behavioral modification and physical therapy and splint therapy are the most common forms of treatment. Sometimes, surgical treatment is required. Phase II is the compensatory phase of the occlusion consisting of occlusal equilibration, occlusal restorations, orthodontic treatment and gnathic surgery if needed. Another phase we like to add is maintenance. In this phase, home therapy, corrective follow-up and long term observation should be emphasized. The motivation of the patient throughout the management of the craniomandibular disorder (phase I, phase II and the maintenance phase) is essential to reach to a successful result.