Cranio-cervical-mandibular disorders and oro-cervical-facial pain: a classification based on anatomical units

Objective: To develop an integrated classification of cranio-cervical-mandibular disorders (CCMD) and oro-cervical-facial pain (OCFP), based on anatomical units, to allow for a more precise and useful clinical approach. Method: A multicenter study was conducted involving 8 clinical specialists from Chilean and Italian universities, as well as 14 students serving as collaborators. The methodology involved organizing the participants into subgroups and holding periodic discussion sessions. Successive drafts were produced until a final classification was agreed upon. Once completed, each included pathology was defined. Results: The classification is organized into four hierarchical levels: (1) anatomical structure/origin (muscular, osteoarticular, nervous/neurovascular, and associated structures), (2) pathogenetic mechanism (pain/inflammation/ degeneration, dysfunction/mobility, growth/development/genetics), (3) pathophysiology, and (4) associated local or systemic pathologies. A list of specific conditions that can affect the suprascapular unit was also included. Conclusion: The proposal addresses shortcomings in previous organizations by establishing a clear, logical, and hierarchical structure. This first integrative classification favors a more precise, inferential organization of cranio-cervical disorders (CCD) and temporomandibular disorders (TMD), including OCFP. It offers an initial framework that is susceptible to future expansion and adjustments. It also represents a step towards standardizing diagnoses and optimizing treatments in this area.