Lund Bodil, Ulmner Mattias, Bjørnland Tore, Berge Trond, Olsen-Bergem Heming, Rosèn Annika
Department of Clinical Dentistry, Faculty of Medicine, University of Bergen.
Department of Dental Medicine, Karolinska Institutet.
J Oral Sci. 2020;62(1):1-8. doi: 10.2334/josnusd.19-0128.
Temporomandibular joint (TMJ) disease classification and subsequent treatment selection are highly debated subjects within dentistry and medicine. Several suggestions for diagnostic classification and treatment algorithms have been proposed thus far without achieving a clear gold standard. A universally accepted diagnostic classification is essential for therapeutic decision-making as well as a prerequisite for prognostic evaluation and is necessary for achieving research results that are reproducible, comparable, relevant, and applicable in the clinical setting. Often, problems of the TMJ are viewed as mere symptoms or as a syndrome-like group of conditions, without clear demarcation, impeding individualized treatment planning. A Scandinavian group of experienced TMJ surgeons participated in an iterative, structured group discussion process in accordance with the Delphi method, aiming to produce recommendations for a standardized patient clinical evaluation in relation to TMJ dysfunction. Guided by this standardized evaluation, a disease-focused and simplified diagnostic classification scheme is herein suggested.
颞下颌关节（TMJ）疾病的分类及后续治疗选择是牙科学和医学领域中备受争议的课题。迄今为止，已提出了多种诊断分类和治疗算法的建议，但尚未达成明确的金标准。普遍接受的诊断分类对于治疗决策至关重要，也是预后评估的先决条件，对于获得可重复、可比、相关且适用于临床环境的研究结果是必要的。通常，TMJ问题仅被视为症状或类似综合征的一组病症，没有明确的界限，这妨碍了个性化治疗计划的制定。一组斯堪的纳维亚经验丰富的TMJ外科医生按照德尔菲法参与了一个迭代的、结构化的小组讨论过程，旨在为TMJ功能障碍的标准化患者临床评估提出建议。在此标准化评估的指导下，本文提出了一种以疾病为重点且简化的诊断分类方案。
