Ohrbach R, Dworkin S F
Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, NY, USA
Schools of Medicine and Dentistry, University of Washington, Seattle, WA, USA.
J Dent Res. 2016 Sep;95(10):1093-101. doi: 10.1177/0022034516653922. Epub 2016 Jun 16.
This review explores the principles and process associated with the diagnosis of temporomandibular disorders (TMDs). TMD diagnosis has evolved substantially over the past 25 y. Previously, diagnosis focused solely on aberrations in oral structures, largely without empirical evidence. The Research Diagnostic Criteria for TMD (RDC/TMD) were developed on core principles of 1) a dual-axis system reflecting the biopsychosocial model, 2) a clear operationalization for reliability, and 3) the allowance of multiple diagnoses. These principles were retained in the subsequent validation research of the RDC/TMD, and the current diagnostic system-the Diagnostic Criteria for TMD (DC/TMD)-has improved on those principles as well as on diagnostic validity and protocols for assessing the psychosocial domain. Further investigations into etiology and its potential contribution to taxonomy revision are described, particularly within the context of complex disease. The review concludes with an outline of major research areas already underway that will support future revisions of the DC/TMD.
本综述探讨了与颞下颌关节紊乱病（TMDs）诊断相关的原则和过程。在过去25年中，TMD诊断有了很大发展。以前，诊断仅关注口腔结构的异常，很大程度上缺乏实证依据。颞下颌关节紊乱病研究诊断标准（RDC/TMD）基于以下核心原则制定：1）反映生物心理社会模型的双轴系统；2）明确的可操作性以确保可靠性；3）允许进行多种诊断。这些原则在RDC/TMD随后的验证研究中得以保留，当前的诊断系统——颞下颌关节紊乱病诊断标准（DC/TMD）在这些原则以及诊断有效性和评估心理社会领域的方案方面都有了改进。文中还描述了对病因及其对分类学修订潜在贡献的进一步研究，特别是在复杂疾病的背景下。综述最后概述了已经在进行的主要研究领域，这些研究将支持未来对DC/TMD的修订。
