Temporomandibular Disorder: New Directions in Research and Patient Care

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Background

Temporomandibular disorders (TMDs) are a heterogeneous group of conditions affecting the muscles of mastication and related tissues of the temporomandibular joint (TMJ). Other pain disorders and health conditions are among the known risk factors for TMD onset. Estimates vary, but between 25-50% of acute episodes may evolve into persistent pain that becomes chronic, often for decades. Treatments for these conditions lack good scientific evidence and are siloed mainly in the dental community.

TMDs are complex diseases. Basic research on TMDs requires a broad systems biology approach to unravel the underlying mechanisms of health and disease; far more progress has been made to date regarding the pain disorders affecting the masticatory muscles and TMJ areas, whereas progress in understanding the pathophysiology of TMJ tissue has been very slow.  In order to improve our understanding of underlying TMD etiology and pathophysiology and improve diagnosis, prognosis, and treatments for patients, scientific discovery for comprehensive clinical care requires new models that integrate expertise from multiple domains such as craniofacial biology, epidemiology, neuroscience, and behavioral medicine.

The Goal of this Research Topic is to reimagine the disparate and siloed approaches to basic, translational, and clinical research that have plagued the field of TMDs and accelerate the inclusion of medical and dental research expertise in the quest for improved, patient-centered, interprofessional care for TMD patients. This goal has most recently been explored in a National Academies of Science, Engineering and Medicine Consensus Study Report titled “Temporomandibular Disorders: Priorities for Research and Care” (March 2020).

A collection of original basic and clinical research articles, as well as critical integrative reviews, focused on studies that demonstrate a systems biology approach or the integration of multidisciplinary science expertise or that may lead to such approaches will achieve outcomes pertinent to the Goals of this Research Topic.

Two broad research themes define the Scope of this Research Topic. Overall, multidisciplinary writing teams including partners with contemporary skills in bioinformatics are necessary in order to appreciate the complex interactions of multiple body systems in determining the health and disease characteristics of the masticatory system.

The first theme is the application of a systems biology approach to basic TMD research. As mentioned previously, TMDs are complex conditions that require a systems approach to determine the interactions occurring at many levels from the molecular and cellular to the biobehavioral and even to the population – in other words, a biopsychosocial model of health and disease is essential. The discovery of biomarkers, genetic influences, neuroendocrine and neuroimmune interactions, and the role of inflammation are important critical research themes that are of special interest for this Research Topic. Structural biology, regenerative medicine, and tissue engineering approaches are of major interest. The interdependence of systems biology and behavior are also of major interest.

The second theme is the integration and assimilation of medical and dental sciences expertise in basic and clinical research in a patient-centered, whole-body approach to scientific discovery and care for TMD patients. Multifaceted writing teams, including expertise in neurology, immunology, endocrinology, rheumatology, physical therapy, musculoskeletal diseases, and biobehavioral science are encouraged to submit manuscripts. A broad range of biologic, pharmacologic, behavioral, and physical treatment approaches that have substantial backing from recent discoveries by the international TMD research community also are encouraged.

Keywords: Temporomandibular, Systems Biology, Interprofessional Care, Multidisciplinary, Pain, Comorbidities

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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