J.Jpn.Soc.TMJ16(1):21.

2004

21

Risk series factors for chronic TMD pain

from a

I
orofacial influences pain disorders. Other authors suggest that central pain and instead struc-

: Results

of longitudinal Department Division Minnesota

studies of Diagnostic and Surgical Sciences, of

are a consequence factors

of persistent

cite local biological tural joint

such as disc displacement, oral habits, and

of TMJ and Orofacial School of Dentistry

Pain, University

degeneration, from occlusal that

proprioceptive factors. are

imbalances Many widely them. based

dysharmony

as etiologic

Temporomandibular population time, and However, with most about

disorders

James R. Fricton are common in the general fluctuate to the severe over dis-

treatments

are based on these two theories scientific therapy, knowledge occlusal

used with limited Surgery, physical

to support are

cases mild in nature, a disability TMJD

treatments

do not constitute 20% of early

patient.

on peripheral

etiologies therapies

while biofeedback, address central

medicaetiologies. during

develop

tions, and psychological Research the past conducted

orders associated those order, patients require

with chronic pain. that are most severely

This group constitutes affected by the disthe

at the University factors and

of Minnesota

15 years have identified natural history suggests

that may and may outcome of

the most health

care, and, thus, warrant etiology practice

not influence TMD.

treatment

lion's share ment. scientific

of research

effort in studying in clinical the

and treatand the

This research

that factors

involved

in pre-

There

is controversy

disposition

and onset of TMD are more peripheral involved in development

in nature

literature orofacial

on whether

etiology

of chronic in the

while factors

of chronic TMD pain presents

dysfunctional peripheral

pain is generated

from factors

are more centrally these results

generated.

This presentation

nervous system versus factors nervous system.

that are generated has sug-

and discusses etiology

their implication

in understanding central and

from the central

Some research

the biobehavioral peripheral TMD pain.

of TMD progression,

gested that specific central modulating processes reflected in factors such as depression, stress, sleep disorders, and fibromyalgia play a significant role in perpetuation of

mechanisms

of pain amplification treatment strategies

and modulafor chronic

tion, and multi-dimensional

21