TMJ CLICK

GSID GUIDELINES – TMJ CLICK

(Edited by Daniele Manfredini, 2017)Logo GSID modificato 2

1. It is commonly caused by the presence of an anteriorized TMJ disc, which in a not negligible percentage of cases (up to one-third according to some studies) is nonetheless sound-free (Manfredini & Guarda-Nardini, Int J Oral Maxillofac Surg 2008) https://www.ncbi.nlm.nih.gov/pubmed/18486451

2. Natural course of TMJ click is benign. The fact that all joints with TMJ click inevitably progress toward a closed lock is a false myth. Closed lock is most likely due to antalgic muscle contracture…IT CLICKS AND SO WHAT? (Kononen et al., Lancet 1996) https://www.ncbi.nlm.nih.gov/pubmed/8602059

3. An anteriorized disc positions is (logically) accompanied by a loss of the ideal morphology as well as the micro- and macro-tissue structure…thus making it complex even a surgical repositioning, not to say any dentally-related recapturing strategies…please remember that knee meniscus (if it causes problems) is removed, not repositioned! (Goncalves et al., Oral Maxillofac Surg Clin North Am 2015) https://www.ncbi.nlm.nih.gov/pubmed/25483446

4. TMJ click has nothing to do with dental occlusion! (Manfredini et al., Angle Orthod 2014) https://www.ncbi.nlm.nih.gov/pubmed/23957663

5. Any claims on the need to reposition mandibles for medical purposes do not follow the basic ethical code to respect the “medical necessity” of an intervention (Greene & Obrez, Oral Surg Oral Med Oral Pathol Oral Radiol 2015) https://www.ncbi.nlm.nih.gov/pubmed/25864818

6. Such guidelines have ethical and legal implications that cannot be neglected, and they are the international STANDARD! Please remember: the buredn of proof is on those who propose the contrary…possibly stopping to ask clinical researchers (and I would like to highlight the word “clinical”, being sick and tired of any pathetic claims that clinical evidence is different from literature evidence…) explanations on what they do “in their hands”. (Manfredini et al., J Oral Rehabil 2011)  https://www.ncbi.nlm.nih.gov/pubmed/20726941

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