Temporomandibular Joint Disorders: Diagnosis and Management

Temporomandibular joint disorders (TMD) constitute a heterogeneous group of conditions affecting the masticatory muscles, the temporomandibular joint (TMJ) and associated structures. Symptoms range from pain, joint sounds and restricted motion to complex degenerative changes. Aetiology is multifactorial, incorporating biomechanical overload, occlusal factors, psychosocial stressors and parafunctional habits. Diagnosis relies on a structured clinical examination, supplemented by imaging modalities such as magnetic resonance imaging and cone-beam computed tomography in selected cases. Management spans conservative measures—education, physiotherapy, splint therapy and pharmacotherapy—to minimally invasive interventions and, when indicated, surgical reconstruction or prosthetic replacement. Emerging technologies aim to restore physiological biomechanics and enhance long-term outcomes.

Research from Nature Portfolio

Recent studies have applied functionally graded materials to improve implant kinematics and reduce joint reaction forces. A novel approach 3D printed artificial cartilage with gradations from hard to soft material, demonstrating improved mandibular movement by up to 20–88%, reduced joint reaction forces by 8–10% under physiological loading, and more natural translation during incisal clenching and group biting. These findings point to next-generation prostheses that more closely mimic native biomechanics and may extend implant longevity.

Temporomandibular Joint Disorders: Diagnosis and Management publication trend

The graph below shows the total number of articles in temporomandibular joint disorders: diagnosis and management across all publications each year (not limited to Nature Index journals).

Technical terms

Occlusal splint: Custom-fitted acrylic device worn over teeth to redistribute occlusal forces and reduce muscle hyperactivity.

Bruxism: Involuntary clenching or grinding of teeth, often linked to stress and a contributory factor in TMD.

Myofascial pain: Pain arising from trigger points in masticatory muscles, a common subtype of TMD.

Arthrocentesis: Minimally invasive lavage of the joint space to remove inflammatory mediators and improve mobility.

Functionally graded material (FGM): Composite designed with a gradual variation in composition to mimic natural tissue transitions in implants.

Disc displacement with reduction: Intra-articular disorder in which the articular disc dislocates upon mouth opening and returns on closing, often accompanied by clicking.

References

1. Temporomandibular Disorders: Current Concepts and Controversies in Diagnosis and Management. Diagnostics (2021).
2. Multi-material 3D printing of functionally graded soft-hard interfaces for enhancing mandibular kinematics of temporomandibular joint replacement prostheses. Communications Materials (2024).
3. Reported concepts for the treatment modalities and pain management of temporomandibular disorders. The Journal of Headache and Pain (2015).
4. Occlusal stabilization splint for patients with temporomandibular disorders: Meta-analysis of short and long term effects. PLOS ONE (2017).
5. Temporomandibular Disorders and Bruxism Outbreak as a Possible Factor of Orofacial Pain Worsening during the COVID-19 Pandemic—Concomitant Research in Two Countries. Journal of Clinical Medicine (2020).
6. Temporomandibular joint disc displacement with reduction: a review of mechanisms and clinical presentation. Journal of Applied Oral Science (2019).