Prof. Daniele Manfredini received his DDS from the University of Pisa, Italy in 1999, a MSc in Occlusion and Craniomandibular Disorders in 2001 from the same University, and a PhD in Dentistry from the ACTA Amsterdam, The Netherlands, in 2011.
He was a clinical fellow at the Section of Prosthetic Dentistry, Department of Neuroscience, University of Pisa, Italy until 2005.
Since 2006, Prof. Manfredini has been Assistant Professor and coordinator of the research projects at the TMD Clinic, Department of Maxillofacial Surgery, University of Padova, Italy.
Currently, he holds teachings in Prosthodontics and Temporomandibular Joint Physiopathology at the School of Dentistry, University of Padova.
On January 2014, the Italian Ministry of University and Research (MIUR) appointed him as Professor by scientific production at the age of 38.
Prof. Manfredini authored more than 130 papers in the field of bruxism and temporomandibular disorders in journals indexed in the Medline database. He also edited the book “Current concepts on temporomandibular disorders” (Quintessence Publishing, 2010), including contributions from 45 world-renowned experts, and co-authored several textbooks on the same topics.
Based on publication ratings, since November 2013, the US agency Expertscape has been ranking Prof. Manfredini as world #1 expert in the field of temporomandibular joint disorders, and #3 in the field of bruxism.
Sábado, 19 Março - Auditório 1 - 9h30
«Disfunção Temporomandibular: da Oclusão à Neuropsicologia e Dor Orofacial»
Temporomandibular disorders (TMD) are now recognized as having a multifactorial etiology, with an interaction between biological, psychological, and social factors. Such a so-called biopsychosocial model has been gaining support over the past few decades, but there are still some communities of professionals who have not yet abandoned the previous occlusal paradigm. This may be due to the fact that, despite the obsolescence of the occlusal theories for TMD etiology and treatment as well as the well-known clinical observations that led to the introduction of the biopsychosocial model for TMD, there are some difficulties to “apply” the biopsychosocial model at chairside.
Indeed, on one hand, there are some paradoxical observations that seem to support a certain effectiveness of occlusally-based approaches (e.g., oral appliances), whilst on the other hand there are problems, for the average dental practitioner, to accept including a psychological evaluation as part of a routine target for TMD diagnosis and treatment. The biopsychosocial management of TMD patients in a dental office is a real challenge for the current generation of dentists and orofacial pain practitioners.
The study of the mutual interactions between bruxism, pain, and psychosocial factors has contributed a lot to develop a proposal for a unified concept of biomechanical TMD physiopathology: the overload model. According to that, the onset of TMD symptoms may be viewed as the result of an unbalance between the load exerted on the temporomandibular joints by the jaw muscles and the resistance of the structures to that load. Bruxism in the form of jaw/teeth clenching, which in turn is related to an emotional overload, is likely the most detrimental factor. Psychosocial factors may also reduce the load-bearing capacity of the masticatory system. Based on that, their role as fundamental factors to be addressed in the clinical setting is undisputed.
The evidence in support of the overload theory, the clinical suggestions for its adoption in the clinical setting as well as its shortcomings will be discussed in the core part of this lecture. Indeed, the overload model is likely the best available model of disease we have to explain the clinical observations in most TMD patients. Notwithstanding that, there are several issues that remain to be answered or that have been answered only in part, such as the chronicization of symptoms and the relation of temporomandibular disorders with other pain disorders. Strategies to get deeper into those topics will be dealt with, including concepts of differential diagnosis and suggestions for future researches on this very intriguing conditions.