Historical evolution of temporomandibular disorders: from Costen’s syndrome to current diagnostic criterio
DOI:
https://doi.org/10.47606/ACVEN/MV0364Keywords:
temporomandibular joint disorders, history of dentistry, terminology as topic, diagnosis, therapeutics.Abstract
Introduction: temporomandibular disorders (TMD) are the main cause of non-odontogenic orofacial pain and have repeatedly changed in name and explanation. Objective: to describe the historical evolution of knowledge on TMD regarding concept and terminology, diagnosis and treatment. Materials and methods: narrative review with an explicit search in PubMed/MEDLINE, Europe PMC, OpenAlex and SciELO (October 2026), without date limits and complemented by a manual search; from 73 unique records, 47 documents with historical information on terminology, etiology, diagnosis or treatment were analyzed. Results: after the first surgeries of the nineteenth century, Costen (1934) attributed ear symptoms to the temporomandibular joint. His occlusal theory was replaced by the pain-dysfunction models of Schwartz (1955) and Laskin (1969) and by the biopsychosocial model. The term «temporomandibular disorders» was recommended in 1983, and diagnosis evolved from the Helkimo and Fonseca indices to the RDC/TMD (1992) and DC/TMD (2014) criteria. Treatment shifted from surgery and occlusal adjustment to a conservative and reversible approach; the failures of some joint prostheses showed the need to monitor implantable devices. Since 2015, the International Classification of Orofacial Pain, advanced imaging and personalized surgery have been incorporated. Conclusions: TMD evolved from being understood as a mechanical problem attributed to occlusion to being considered multifactorial musculoskeletal disorders. This evolution supports the use of standardized diagnostic criteria, evidence-based treatment and an updated dental education.
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