The stomatognathic system is characterized by various structures including skeletal components (maxillary bone, mandibular bone), dental arches, soft tissues (salivary glands, nerves and blood vessels), masticatory muscles, and the TMJ.

These structures work in harmony to perform various functions such as speaking, chewing, and swallowing. This system also includes the hyoid bone and the muscles that connect it to the manubrium of the sternum, the mandible, the scapula, the fascia within the anterior cervical region, and other structures of the neck.

The TMJ creates muscular and ligamentous connections with the cervical region, forming a complex functional unit called the ‘cranio-cervico-mandibular system’.

This is a synovial joint that comprises the condyles of the mandible, the mandibular fossa of the temporal bone, a thin articular disc, and a capsule.

The TMJ is responsible for all movements of the jaw, which take place on different orthogonal planes and on multiple axes of rotation.

These movements allow a wide range of functions such as chewing, sucking and swallowing, articulating sounds, breathing, and producing facial expressions.
The TMJ works properly when the right and left sides are synchronized in movement.

TMJ Disorders

TMJ disorders are a general term to describe various clinical problems involving rigid structures and soft tissues of the TMJ.

Symptoms may include mandibular clicking, grinding, mechanical restrictions (ability to open the mouth, mandibular deviations), headaches, neck pain, stiffness.

The origin of TMD is often multifactorial. Micro-macrotrauma, malocclusion, abnormalities of the articular disc and its surfaces, bruxism, anxiety, stress, local inflammatory conditions.

In particular, excessive mechanical loading activates the inflammatory cascade (release of free radicals, inflammatory neuropeptides, cytokines) that culminates in a degenerative state of the joint.

TMJ disorders are among the most difficult conditions to manage, and often require a multidisciplinary approach.

Some of these include osteopathic treatment, which focuses on improving ligament elasticity, restoring muscular balance, improving jaw opening and movement, and reducing pain.

Some studies have emphasized the treatment of accessory ligaments, useful when we consider the clinical anatomy and their role in the etiology of the problem.