Direct TMJ injuries

Normal anatomy and function of temporomandibular joint (TMJ) may be altered by direct traumatic injuries of joint tissues or of adjacent bones such as the lower jaw. Both cases are known as "direct trauma" to differentiate them from "indirect trauma" acting on the TMJ without contact, such as the TMJ whiplash. Nature and direction of traumatic forces, type of acute lesions (i.e. fractures and/or contusions), accuracy of diagnosis and correctness of therapeutic approach will influence the onset of different temporomandibular disorders (TMD), ranging from muscle disorders or disc displacement with reduction to severe ankylosis. The dentist acting as expert witness has to assess trauma-related TMD symptoms: a correct evaluation must be based on a complete articular and muscular assessment, must take into account for the existing literature, and must follow a correct step-by-step sequence. This approach allows to discriminate between trauma-related and non-related lesions, through the identification of pre-existing pathologies or risk factors. The final report will provide the medical legal basis of a complete evaluation.