TMJ Disorder Timeline

In all of our research, writing, answering patient questions, and talking with experts, we’ve wondered – what is the history of TMJ disorder? Other than a few pieces here and there, I’ve actually never seen a comprehensive timeline of what has happened to cause TMJ disorder to be the way it is today. So, we’re pleased to finally publish this timeline…. it took weeks of research and a lot of digging (and in some cases, there is no information for specific times), but we think it is quite interesting.

In one way, we’ve come so far…. but in others, we have made no progress. Only in continuing to advocate for yourselves, make your voices heard, and talk about your TMJD will this ever change. We can get into the rut of feeling like our voice is too small to make a difference… but that couldn’t be further from the truth. Think about what could be accomplished if even 1% of the 35 million TMJD sufferers stood up and demanded answers.

Evolution of TMJ Disorder

3000BC — Pain and dislocation in the jaw described and treated.

1855 ——   Charles Goodyear provides dentists with a material that  could be molded for many different oral applications.

1859 ——   American Dental Association is established

1862 ——    Thomas Gunning, a practicing surgeon uses vulcanite to  make a custom fitting splint to treat himself for a broken
jaw. His vulcanite splint is very similar to the appliances used today to treat TMD.

1887——     British surgeon Annandale publishes an article describing two cases of discoplasty for the management of disc displacement in the TMJ, and receives credit for
the first surgical repositioning of an articular disc.

1901 ——    Arolyi introduces an occlusal splint for the treatment of bruxism

Early 1900’s —- Pringle recognized as one of the first surgeons to perform a menisectomy.

1909 ——   First published case of a discectomy reported in German  literature by Lanz.

1913 ——    Arthroplasty first used for the treatment of ankylosis.

1920’s —     The connection between what we now refer to as TMD
and ear dysfunction researched by Drs. David
Goodfriend and James Costen.

1926 —— Formation of the Gnathological Society. With the
formation of this society the role of occlusion gain in
popularity and dentists become more interested in
complex occlusal techniques.

1934 —— TMD, known as Costens Syndrome after Dr. James
Costen clarifies many aspects of the syndrome with a
predominant emphasis on dental malocclusion. Costen,
in a publication claims that pain in and around the jaw
and “related ear symptoms” improve with alteration of
the bite.

1937 ——Dr. Louis Schultz publishes a paper in The Journal of the
American Medical Association on the treatment of pain
and subluxation of the TMJ. In his paper he describes
how common TMJ syndrome is and that the traditional
treatments of rest, appliances in the mouth, physical
therapy and surgery were only partially successful.
Schultz disapproved of the traditional method of retracting
the wandering condyle with a steel headband or wiring the
jaw shut for months. His invention was to scar the tmj
tissues by injections of an over the counter bulk laxative.

1950’s — Schwartz questions the association between occlusion
and TMD.
Treatment of TMD shifts to surgical.

1963 —— Charnley warns against the use of teflon in joints because
of the intense foreign-body reactions. He describes
unfavorable results of injecting teflon into his own thigh.

1966 —— Krough-Poulsen create a list to screen the symptoms of
craniomandibular disorders. Because malocclusion is
thought to be the underlying cause, treatment of TMD
shifts from medicine to dentistry.

1967 —— Dupont sends Homsy warning about complications
caused by implanted teflon.

1968 ——- Proplast is developed by Charles Homsy as a surgical
material

1969 —— Laskin describes a subgroup category within TMD called
myofascial pain dysfunction syndrome…or MPD

1970 —— Homsy publishes first article evaluating the
biocompatibility of different materials in their selection for
surgical implantation.

1970’s —-Bernard Jankelson introduces neuromuscular
application in dentistry.

Surgical intervention for the TMJ gains momentum, and
new procedures develop with a focus on the articular
disc of the tmj as a root of the disorder.

Homsy starts Vitek.

1975 —— American Academy of Craniomandibular Disorder
founded.

Onishi adapts and miniaturizes the orthopaedic
arthroscope for use in TMJ.

1976 —— Proplast is patented.
Medical device Amendment creates a scheme linking the
degree of risk inherent in any new medical device and the
amount of control the FDA could exert over its approval
process.

1978 —— Farrar and MccCary challenge the neuromuscular
concepts and focus on internal derangements as the
primary cause TMD signs and symptoms.

Earliest known recipient of vitek proplast-teflon implant.

1982 —— Vitek creates 2 types of proplast: Proplast 1, composed of
teflon and graphite, and Proplast 11, its aluminum-oxide
analogue.

ADA holds conference on the examination, diagnosis and
management of TMD

1983 —— Vitek notifies the FDA of plans to market it’s
interpositional implant (IPI) for disk replacement after
discectomy.

1984 —— Kent, concerned about safety of vitek implants warns
Homsy of “calamity of unbelievable proportions.”

1985 —— First problems with proplast reported.

1986 —— TMJA founded

1987 —— First Lawsuit against vitek.

1988 —— FDA conducts first inspection of viteks plant

1989 —— 9 patients show deterioration’s, foreign-body giant cell
reaction in all joints

FDA cites Vitek for not reporting patient complaints.

1990 ——- Vitek files for bankruptcy.  FDA rescinds 510K approval
for Viteks implants

1991 —— FDA orders Vitek to remove it’s implant from the market
and issues a medical alert to patients.

1992 —— Homsy moves to Switzerland
Congressional hearing on TMJ implants

Wolford developed the philosophy and technique for placing fat grafts around TMJ total joint prostheses to prevent heterotopic bone formation, decrease fibrosis, improve pain levels, and increase jaw function.

1993 —— Class action lawsuit filed on both Vitek and Dow Corning
silastic tmj implants

1994 —— NIH holds workshop on TMD and related pain conditions.

1996 —— NIH health technology assessment conference held to
provide physicians and the general public with
responsible assessment of management approaches to
TMD

2005 —— The Cochrane Oral Health Group reveals common
treatments for TMJ pain have not yet been proven to be
effective despite their popularity. “No strong evidence of
benefit from occlusal adjustment for problems
associated with the TMJ joint.” “Insufficient evidence to
either support or refute the use of occlusal splints for
treating patients  with tooth grinding or clenching during
sleep.” “Insufficient evidence either for or against the use
of stabilization therapy for the treatment of
temporomandibular pain dysfunction syndrome.”

2005 —— NIDCR launches important study of temporomandibular
joint and muscle disorders (OPPERA Study)

2006 —— Researchers at the University of North Carolina at Chapel
Hill discover that commonly occurring variations of a
gene trigger a domino effect in chronic pain disorders.
The finding could potentially lead to more effective
treatments of TMJD.

2007 —— Study published in the Journal of Neurochemistry
identifies a key interaction between head and neck nerve
cell proteins that may help shed light on migraines and
TMD.

2008 —— Emory University begins a study on a comparison of
arthrocentsis, arthroscopy and arthroplasty in the
treatment of TMD

2009 —— National Institute of Dental and Craniofacial Research
(NIDCR) conducts a TMJ awareness campaign “Less is
often best in treating TMJ”

Cochrane Collaboration completes a study of the use of
botulism toxin type A in masseter muscle hypertrophy.
Reviewers conclude that there were not enough quality
studies to properly evaluate the toxin’s effectiveness nor
its potential harms.

2010 —— The American Association for Dental Research revises
their policy statement on TMJD. This policy reflects the
NIH “Less is best”

First results from OPPERA study unveiled.
TMJ Hope founded

2011 ——- FDA orders TMJ implant postmarket surveilance