ReviewJournal of oral rehabilitation2026
Understanding Diagnostic Failure in Temporomandibular Disorders: A Narrative Synthesis of Evidence and Five-Domain Framework for Iatrogenic Mismanagement.
Review in Journal of oral rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
8 authors.
Funding
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Abstract
backgroundDiagnostic errors in temporomandibular disorders (TMDs) contribute to unnecessary procedures and avoidable patient mismanagement despite advances in pain science, diagnostic classification systems, and evidence-based care.
objectiveTo conduct a narrative review and present a dynamic, five-domain framework explaining how diagnostic uncertainty interacts with educational, cognitive, systemic, and ethical factors to produce iatrogenic overtreatment.
methodsSearches of PubMed, Scopus, Web of Science, and Google Scholar (inception to April 2026) identified literature on TMD diagnosis, clinical reasoning, dental education, health system organization, and bioethics. Concepts were synthesized into interacting thematic domains.
resultsFive dynamic, interacting domains were identified: (1) Educational Deficits, (2) Structural Reductionism, (3) Occlusal Overinterpretation, (4) System Fragmentation, and (5) Ethical Dissonance. The model demonstrates how educational gaps foster reductionist diagnostic paradigms, which are amplified by health-system silos and defensive clinical practices, increasing the likelihood of non-indicated, irreversible interventions.
conclusionsThe Five-Domain Framework offers a systemic model for understanding diagnostic breakdown in TMD management, providing a structured foundation for educational reform, integrated care pathways, and future empirical research.
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