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Management of pain in patients with temporomandibular disorder (TMD): challenges and solutions

Authors Gil-Martínez A, Paris-Alemany A, López-de-Uralde-Villanueva I, La Touche R

Received 3 October 2017

Accepted for publication 4 January 2018

Published 16 March 2018 Volume 2018:11 Pages 571—587

DOI https://doi.org/10.2147/JPR.S127950

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Katherine Hanlon


Alfonso Gil-Martínez,1–3 Alba Paris-Alemany,1–4 Ibai López-de-Uralde-Villanueva,1–3 Roy La Touche1–4

1Department of Physiotherapy, 2Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 3Hospital La Paz Institute for Health Research, IdiPAZ, 4Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain


Abstract: Thanks to advances in neuroscience, biopsychosocial models for diagnostics and treatment (including physical, psychological, and pharmacological therapies) currently have more clinical support and scientific growth. At present, a conservative treatment approach prevails over surgery, given it is less aggressive and usually results in satisfactory clinical outcomes in mild–moderate temporomandibular disorder (TMD). The aim of this review is to evaluate the recent evidence, identify challenges, and propose solutions from a clinical point of view for patients with craniofacial pain and TMD. The treatment we propose is structured in a multimodal approach based on a biobehavioral approach that includes medical, physiotherapeutic, psychological, and dental treatments. We also propose a new biobehavioral model regarding pain perception and motor behavior for the diagnosis and treatment of patients with painful TMD.

Keywords: biobehavioral, review, temporomandibular disorders, biobehavioral orofacial pain, multimodal approach, motor behavior, disability

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