Neuromuscular problems in the orofacial region: diagnosis-classification, signs and symptoms.

In the light of recent findings, it is clear that organic changes in the tissues of the temporomandibular joint commonly occur simultaneously with neuromuscular problems. It is suggested that the term "masticatory disorder' should be adopted in order that diagnosis will fully reflect this inter-relationship. Patients with masticatory disorders will exhibit one or more of the following signs and symptoms: (a) pain and tenderness in the region of the masticatory muscles and TMJ, (b) incoordination and sounds during condylar movement and (c) limitation of mandibular movement. Diagnosis which relies solely on subjective symptoms is incomplete and the progressive nature of the condition requires careful attention to the prognosis. A diagnostic classification of masticatory disorders is given in Table II and the characteristics of each of the conditions listed is described in greater detail in the text.