Neurophysiological conception of pain in craniomandibular disfunction

Abstract

INTRODUCTION: Ethiopathogenesis of dysfunction and pain in temporomandibular joints has been the subject of passionate discussions between supporters of purely mechanical conception and the ones who are supporters of psyhosomatic conception. The aim of the study: Relying on neurophysiological data, the authors are trying to reveal the main role of reticular mesencephalical formation in mechanisms which provoke craniomandibular dysfunctions and confront the influence of emotional factors from neocortex and painful stimuli from oral structures. DISCUSSION: From dynamical point of view, not only the morphological aspects of teeth and arcades, but also sensitive-sensorial mechanisms connected to masticatory muscles, periodontal structures and oral structures, should be considered. The ideal bite and perfect morphology of tooth arcades are not enough for reconstitution of correct occlusion, if there are no neuromuscular system, temporomandibular joint, and especially central nervous system. CONCLUSION: The presence of pain is just one of the craniomandibular dysfunction symptoms, but if it is added to the other clinical signs and emotional or affect--provoking factor, it will provoke dysfunctional syndrome.