Neuromuscular Dentistry - a Better Solution for Temporomandibular Disorders

Introduction: Dentistry is evolving to encompass the stomatognathic system, which includes the muscles and temporomandibular joints, apart from the mouth and teeth. This system plays a vital role in achieving a good occlusion. Many disease processes manifest with similar and overlapping symptoms owing to extensive anatomic, physiologic, and biomechanical interactions. Successful treatment of these individuals relies on accurate diagnoses. Neuromuscular dentistry (NMD) is the new approach to the diagnosis and treatment of temporomandibular disorders (TMD). Objectives: To review the newer perspectives/concepts in the diagnosis and clinical management of TMD. Methodology: This review looks at recent evidence by conducting a systematic review of literature. The search was conducted in the PubMed and Cochrane library databases from 2000-2016. A total of 625 references were selected, and after applying selection criteria, 35 articles were included in the review. The selected articles focused on various approaches to the diagnosis and management of TMD. Results: After reviewing, it was observed that conventional radiography is ineffective in TMD diagnosis. The present diagnostic gold standard is magnetic resonance imaging (MRI). Electromyography (EMG), echo sonography (ESG), and transcutaneous electrical nerve stimulation (TENS) can serve as an adjunct research tool but not as a diagnostic tool. The therapeutic effects of the same are controversial. There is limited evidence on therapeutic effects of self-care, surgical intervention, and physical and behavioural therapy. Non-invasive therapy has shown potential, especially occlusal and mandibular position readjustment which maintained neuromuscular harmony. Conclusion: TMD's are complex, biopsychological, chronic illnesses with a high therapy response rate. However, a lack of patient-based outcome measures limit the evidence, and there is a need for standardised, reproducible and high evidence-based diagnostic and treatment measures in the management of these disorders. NMD is a good base on which the understanding and management of TMD continues to be developed. Keywords: neuromuscular occlusion, temperomandibular disorders, diagnosis, tretament tools