A Disease-focused View on the Temporomandibular Joint Using a Delphi-guided Process

Temporomandibular joint (TMJ) disease classification and subsequent treatment selection are highly debated subjects within dentistry and medicine. Several suggestions for diagnostic classification and treatment algorithms have been proposed thus far without achieving a clear gold standard. A universally accepted diagnostic classification is essential for therapeutic decision-making as well as a prerequisite for prognostic evaluation and is necessary for achieving research results that are reproducible, comparable, relevant, and applicable in the clinical setting. Often, problems of the TMJ are viewed as mere symptoms or as a syndrome-like group of conditions, without clear demarcation, impeding individualized treatment planning. A Scandinavian group of experienced TMJ surgeons participated in an iterative, structured group discussion process in accordance with the Delphi method, aiming to produce recommendations for a standardized patient clinical evaluation in relation to TMJ dysfunction. Guided by this standardized evaluation, a disease-focused and simplified diagnostic classification scheme is herein suggested.