Resolving the problems and controversies surrounding temporo-mandibular mechanics

• The functional anatomy of the temporo-mandibular joint is reviewed.
• The controversies surrounding the mode of action of this joint are described.
• Some shortcomings in standard biomechanical theory and the lever model are outlined.

The temporo-mandibular joint causes more problems than any other in the body and is the least understood with the high incidence of associated symptomatology remaining a major cause for concern. This lack of knowledge is partly due to the difficulties in acquiring information as it is not easy to access and practical and ethical constraints have ensured the almost complete absence of reliable in vivo data on joint loading and muscle forces. Whilst the issue of joint compression was debated throughout much of the twentieth-century, it is now considered that short-comings in the underlying biomechanical theory and analysis have contributed to this uncertainty and stifled progress, and that a reassessment of mandibular motion from a different perspective could resolve this.

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