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Search Results (434)

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16 pages, 1993 KB  
Systematic Review
Impact of Molar Teeth Distalization by Clear Aligners on the Temporomandibular Joint: Systematic Review and Meta-Analysis
by Kacper Galant, Sylwia Dąbrowska, Natalia Turosz and Konrad Małkiewicz
J. Clin. Med. 2025, 14(16), 5836; https://doi.org/10.3390/jcm14165836 - 18 Aug 2025
Viewed by 460
Abstract
Background: This review aimed to assess the association between upper molar distalization using clear aligners (CAs) and structural changes in the temporomandibular joint (TMJ). Methods: On February 20, 2025, the following databases were searched: PubMed, Embase, BASE, Web of Science, and Scopus. Studies [...] Read more.
Background: This review aimed to assess the association between upper molar distalization using clear aligners (CAs) and structural changes in the temporomandibular joint (TMJ). Methods: On February 20, 2025, the following databases were searched: PubMed, Embase, BASE, Web of Science, and Scopus. Studies were included if they reported on orthodontic treatment with CAs involving upper molar distalization and presented TMJ parameter measurements before and after treatment. The JBI Critical Appraisal Checklist for Quasi-Experimental Studies was used to assess the risk of bias. The collected data were analyzed using the paired t-test, mean difference assessment, and Spearman correlation matrix. Results: A total of 4 articles out of 238 records retrieved were included in the review. The mean age of patients was 23.18–29.80 years, and the treatment duration was 1.90–2.21 years. The most important changes were in the posterior and superior joint spaces (PJS and SJS) (p < 0.05), with SJS increasing in two studies (0.56 and 0.7 mm) and PJS increasing in one and decreasing in another (−0.94 and 0.36 mm). Conclusions: Limited evidence suggests that molar distalization with CAs may influence TMJ dimensions to a small extent. However, the results are inconsistent and require further validation with high-quality studies to draw firm conclusions. Registration: The review was pre-registered using the OpenScience Framework (OSF) on 17 April 2025—osf.io/9xyr8. No funding or conflicts of interest were reported. Full article
(This article belongs to the Special Issue Orthodontics: State of the Art and Perspectives)
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16 pages, 519 KB  
Systematic Review
Neurological Complications Following Temporomandibular Joint Injections in Patients with Temporomandibular Disorders: A Systematic Review of Reported Adverse Events
by Maciej Chęciński, Kamila Chęcińska, Izabella Chyży, Kamila Walkowiak, Natalia Turosz, Bartosz Kosiński, Sebastian Zduński, Dariusz Chlubek and Maciej Sikora
J. Clin. Med. 2025, 14(16), 5770; https://doi.org/10.3390/jcm14165770 - 15 Aug 2025
Viewed by 426
Abstract
Background: Temporomandibular joint (TMJ) injections and arthrocentesis are commonly used minimally invasive methods for treating temporomandibular disorders (TMDs). Although considered safe, they can cause neurological complications. The aim of this systematic review was to synthesize all identified evidence for neurological adverse events following [...] Read more.
Background: Temporomandibular joint (TMJ) injections and arthrocentesis are commonly used minimally invasive methods for treating temporomandibular disorders (TMDs). Although considered safe, they can cause neurological complications. The aim of this systematic review was to synthesize all identified evidence for neurological adverse events following intra-articular TMJ interventions. Methods: This review was based on a systematic search with BASE, DOAJ, PubMed, SciELO, and Semantic Scholar on 28 May 2025. It included primary studies involving patients diagnosed with TMDs who underwent intra-articular injections into the TMJ or were treated with arthrocentesis, and in whom neurological adverse effects associated with the intra-articular intervention were reported. Studies reporting non-specific symptoms or unrelated systemic conditions were excluded. The risk of bias was assessed using the Joanna Briggs Institute’s critical appraisal tools. Results were presented in summary tables. Results: The search yielded five eligible studies comprising 319 patients, of whom 320 neurological adverse events were reported. Included studies comprised a randomized controlled trial, two retrospective studies, and two case reports. Four studies had a low risk of bias, and one had a moderate risk of bias according to the Joanna Briggs Institute appraisal tools. The proportion of patients affected ranged from 14% to 65% depending on the study design and intervention type. The most common adverse event was transient facial nerve (cranial nerve VII) paralysis, mainly involving the temporal and zygomatic branches. Less commonly reported complications involved the trigeminal nerve branches (V1, V3). There is also a single case of epidural hematoma with palsy of the oculomotor nerve (III). Most symptoms resolved spontaneously within a few hours to a few days. The use of local anesthesia and large volumes of irrigation (60 mL) during arthrocentesis increases the risk of complications. Attempts to explain the mechanisms of complications include local anesthetic diffusion, compression neuropraxia due to lavage fluid leakage, and corticosteroid neurotoxicity. One of the limitations of the study is the scarcity of data. Conclusions: Although most adverse events are mild and reversible, these findings highlight that precise, real-time guided injection and careful control of lavage volumes can minimize extra-articular spread of anesthetics or fluids, thereby reducing the likelihood of neurological complications. This study received no funding. PROSPERO ID number: CRD420251088170. Full article
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14 pages, 255 KB  
Article
Association Between Occlusal Interferences, Temporomandibular Joint Dysfunction, and Bruxism in Romanian Adults
by Ioana Elena Lile, Tareq Hajaj, George Dumitru Constantin, Serban Talpos Niculescu, Diana Marian, Otilia Stana, Cristian Zaharia and Ioana Veja
J. Clin. Med. 2025, 14(16), 5612; https://doi.org/10.3390/jcm14165612 - 8 Aug 2025
Viewed by 428
Abstract
Background: Bruxism is a common parafunctional activity involving repetitive jaw muscle movements during wakefulness (awake bruxism) or sleep (sleep bruxism). While its multifactorial etiology is widely accepted, the roles of occlusal interferences, temporomandibular joint (TMJ) dysfunction, stress, and sleep-related breathing disturbances remain under [...] Read more.
Background: Bruxism is a common parafunctional activity involving repetitive jaw muscle movements during wakefulness (awake bruxism) or sleep (sleep bruxism). While its multifactorial etiology is widely accepted, the roles of occlusal interferences, temporomandibular joint (TMJ) dysfunction, stress, and sleep-related breathing disturbances remain under investigation. Objectives: This cross-sectional study evaluated associations between bruxism and occlusal discrepancies, TMJ symptoms, stress, and sleep-related variables (snoring and obstructive sleep apnea, OSA) in Romanian adults. Methods: Ninety-eight adults (mean age: 30.4 ± 8.9 years) completed a structured questionnaire reviewed for content validity and pilot-tested for clarity but not formally validated. Participants were categorized into bruxism (n = 51) and control (n = 47) groups. Variables assessed included bruxism type, TMJ symptoms, occlusal interferences, stress, snoring, OSA, and parafunctional habits. Bivariate and multivariate logistic regression analyses were conducted. Results: Sleep bruxism was predominant (88%), with 59% classified as sleep-only bruxers. Occlusal discrepancies (46% vs. 14%, p < 0.001), TMJ symptoms (joint pain: 38% vs. 8%; fatigue: 44% vs. 10%), and habitual snoring (60% vs. 22%, p < 0.001) were significantly more common among bruxers. No significant difference was observed in OSA prevalence. Independent predictors of bruxism included occlusal interferences (adjusted OR = 4.7, p = 0.009), TMJ symptoms (adjusted OR = 6.5, p = 0.002), and habitual snoring (adjusted OR = 4.1, p = 0.016). Conclusions: Bruxism was significantly associated with occlusal interferences, TMJ dysfunction, and habitual snoring, supporting the need for multifactorial assessment and integrated clinical management. Limitations: This study relied on self-reported bruxism classification and a non-validated questionnaire instrument, which may limit generalizability and diagnostic accuracy. Full article
22 pages, 2677 KB  
Article
Prevalence of Temporomandibular Disorder Symptoms Among Dental Students at the Faculty of Dental Medicine in Iași: A Self-Reported Study Based on DC/TMD Criteria
by Eugenia Larisa Tarevici, Oana Tanculescu, Alina Mihaela Apostu, Sorina Mihaela Solomon, Alice-Teodora Rotaru-Costin, Adrian Doloca, Petronela Bodnar, Vlad Stefan Proca, Alice-Arina Ciocan-Pendefunda, Monica Tatarciuc, Valeriu Fala and Marina Cristina Iuliana Iordache
Diagnostics 2025, 15(15), 1908; https://doi.org/10.3390/diagnostics15151908 - 30 Jul 2025
Viewed by 509
Abstract
Temporomandibular disorders (TMDs) encompass a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and masticatory system. Due to academic stress and parafunctional habits, dental students may be particularly vulnerable to TMD. Objective: To determine the prevalence of TMD symptoms [...] Read more.
Temporomandibular disorders (TMDs) encompass a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and masticatory system. Due to academic stress and parafunctional habits, dental students may be particularly vulnerable to TMD. Objective: To determine the prevalence of TMD symptoms and their psychosocial and functional correlates among students at the Faculty of Dental Medicine, UMPh Iasi, Romania, using the diagnostic criteria for TMD (DC/TMD) self-report axis and axis II instruments. Methods: In this cross-sectional survey, 356 volunteer students (66.0% female; mean age, 22.9 ± 3.6 years) out of a total population of 1874 completed an online DC/TMD–based questionnaire. Axis I assessed orofacial pain, joint noises, and mandibular locking. Axis II instruments included the Graded Chronic Pain Scale (GCPS), Jaw Functional Limitation Scale (JFLS-20), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Oral Behaviors Checklist (OBC). Descriptive statistics summarized frequencies, means, and standard deviations; χ2 tests and t-tests compared subgroups by sex; Pearson correlations explored relationships among continuous measures (α = 0.05). Results: A total of 5% of respondents reported orofacial pain in the past 30 days; 41.6% observed TMJ noises; 19.7% experienced locking episodes. Mean JFLS score was 28.3 ± 30.5, with 4.8% scoring > 80 (severe limitation). Mean PHQ-9 was 5.96 ± 5.37 (mild depression); 15.5% scored ≥ 10. Mean GAD-7 was 5.20 ± 4.95 (mild anxiety); 16.0% scored ≥ 10. Mean OBC score was 12.3 ± 8.5; 30.1% scored ≥ 16, indicating frequent parafunctional habits. Symptom prevalence was similar by sex, except temporal headache (43.4% females vs. 24.3% males; p = 0.0008). Females reported higher mean scores for pain intensity (2.09 vs. 1.55; p = 0.0013), JFLS (32.5 vs. 18.0; p < 0.001), PHQ-9 (6.43 vs. 5.16; p = 0.048), and OBC (13.9 vs. 9.7; p = 0.0014). Strong correlation was observed between PHQ-9 and GAD-7 (r = 0.74; p < 0.001); moderate correlations were observed between pain intensity and PHQ-9 (r = 0.31) or GAD-7 (r = 0.30), between JFLS and pain intensity (r = 0.33), and between OBC and PHQ-9 (r = 0.39) (all p < 0.001). Conclusions: Nearly half of dental students reported TMD symptoms, with appreciable functional limitation and psychosocial impact. Parafunctional behaviors and psychological distress were significantly associated with pain and dysfunction. These findings underscore the need for early screening, stress-management interventions, and interdisciplinary care strategies in the dental student population. Full article
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8 pages, 232 KB  
Article
Clinical Analysis of TMJ Replacement Using a Customized Prosthesis
by Sergio Olate, Víctor Ravelo, Gonzalo Muñoz, Carlos Gaete, Rodrigo Goya and Rômulo Valente
J. Clin. Med. 2025, 14(15), 5314; https://doi.org/10.3390/jcm14155314 - 28 Jul 2025
Viewed by 375
Abstract
Background/Objectives: This study aims to uncover the variables related to the success of the intervention. Methods: A retrospective study was conducted on patients who underwent joint replacement surgery utilizing a customized alloplastic system between 2018 and 2023, comprising subjects with complete records for [...] Read more.
Background/Objectives: This study aims to uncover the variables related to the success of the intervention. Methods: A retrospective study was conducted on patients who underwent joint replacement surgery utilizing a customized alloplastic system between 2018 and 2023, comprising subjects with complete records for both the planning and follow-up phases. The Student’s t-test was applied with a significance threshold of p < 0.05. Results: Forty-eight subjects were admitted for initial analysis, and 31 subjects were evaluated with a minimum follow-up of 1 year and a maximum of 7 years, with a mean age of 36.37 ± 15.53. The TMJ diagnosis was mainly with degenerative TMJ disease, followed by ankylosis and craniofacial syndromes, and an average of 2.1 ± 1.2 previous surgeries were noted. Degenerative joint disease correlated with increased pain (p < 0.0001) and a higher prevalence of prior joint surgery (p < 0.0001). Thirty-one subjects were followed up with 47 prostheses installed; 74.4% underwent complementary surgery with other facial osteotomies. Significant improvements (p < 0.0001) were observed when comparing pain levels pre- and postoperatively, with a decrease from 5.5 (±2.3) to 2.2 (±0.4). Concerning the interincisal opening, there was a significant increase (p < 0001) from 25.85 (±10.2) mm to 35.93 (±4.2) mm in mouth opening. TMJ replacement treatment is efficient and effective, demonstrating stability in follow-up assessments for up to 7 years. Conclusions: The indications for replacement are diverse and may benefit patients who have not yet progressed to end-stage TMJ disease. Full article
(This article belongs to the Special Issue Innovations in Plastic and Reconstructive Research)
15 pages, 272 KB  
Article
Assessment of Associations Between Sociodemographic and Clinical Factors and Edentulism Complications in Patients Scheduled for Hybrid Prosthetic Therapy: A Cross-Sectional Study
by Shokraei Gholamreza, Doriana Agop-Forna, Cristina Dascălu and Norina Forna
Clin. Pract. 2025, 15(7), 133; https://doi.org/10.3390/clinpract15070133 - 17 Jul 2025
Viewed by 357
Abstract
Background/Objectives: Complications of edentulism include bone resorption, muscular dysfunction, temporomandibular joint disorders (TMJ), and stomatognathic system dysfunctional syndrome (SSDS). The objectives of the study were as follows: to analyze the distribution of edentulism complications related to sociodemographic and clinical parameters and to quantify [...] Read more.
Background/Objectives: Complications of edentulism include bone resorption, muscular dysfunction, temporomandibular joint disorders (TMJ), and stomatognathic system dysfunctional syndrome (SSDS). The objectives of the study were as follows: to analyze the distribution of edentulism complications related to sociodemographic and clinical parameters and to quantify the strength of relationships between edentulism complications and these socio-demographic or clinical variables. Materials and Methods: This cross-sectional study investigated 150 edentulous subjects (mean age 61.54 +/− 8.99 years) scheduled for hybrid prosthetic therapy. The distribution of edentulism complications was assessed in relation to sex-specific and age-specific patterns, edentulism location (maxillary vs. mandibular), edentulism extension (partial reduced, partial extended, subtotal, complete edentulism), and Kennedy classification (class I vs. class II vs. class IV). Cramér’s V was used to measure the strength of the association between edentulism complications and sociodemographic and clinical factors. Results: The most prevalent complications were more frequent in males—bone resorption (74.2% vs. 40.9%), malocclusion (97.5% vs. 84.9%), TMJ disorders (74.2% vs. 57.0%), muscular disorders (62.5% vs. 31.2%), dyshomeostasis (64.2% vs. 31.2%), and SSDS (79.2% vs. 53.8%). The most relevant associations were found between age group and clinical variables such as irregular ridge (Cramer’s V = 0.737), long/thick frenum (0.711), and SSDS (0.544), while edentulism category was strongly associated with irregular ridge (0.585), TMJ disorders (0.493), and bone resorption (0.492). Conclusions: The type and stage of edentulism emerged as key determinants of complication severity, with complete and subtotal edentulism being associated with the highest rates of muscular and temporomandibular joint dysfunctions. Full article
17 pages, 1208 KB  
Article
Structural Features of the Temporomandibular Joint Evaluated by MRI and Their Association with Oral Function and Craniofacial Morphology in Female Patients with Malocclusion: A Cross-Sectional Study
by Mari Kaneda, Yudai Shimpo, Kana Yoshida, Rintaro Kubo, Fumitaka Kobayashi, Akira Mishima, Chinami Igarashi and Hiroshi Tomonari
J. Clin. Med. 2025, 14(14), 4921; https://doi.org/10.3390/jcm14144921 - 11 Jul 2025
Viewed by 584
Abstract
Background/Objectives: Temporomandibular disorders (TMDs) are a group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint (TMJ), masticatory muscles, and related anatomical structures. Although magnetic resonance imaging (MRI) is considered a noninvasive and highly informative imaging modality for assessing TMJ soft tissues, [...] Read more.
Background/Objectives: Temporomandibular disorders (TMDs) are a group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint (TMJ), masticatory muscles, and related anatomical structures. Although magnetic resonance imaging (MRI) is considered a noninvasive and highly informative imaging modality for assessing TMJ soft tissues, few studies have examined how TMJ structural features observed on MRI findings relate to oral function and craniofacial morphology in female patients with malocclusion. To investigate the associations among TMJ structural features, oral function, and craniofacial morphology in female patients with malocclusion, using MRI findings interpreted in conjunction with a preliminary assessment based on selected components of the DC/TMDs Axis I protocol. Methods: A total of 120 female patients (mean age: 27.3 ± 10.9 years) underwent clinical examination based on DC/TMDs Axis I and MRI-based structural characterization of the TMJ. Based on the structural features identified by MRI, patients were classified into four groups for comparison: osteoarthritis (OA), bilateral disk displacement (BDD), unilateral disk displacement (UDD), and a group with Osseous Change/Disk Displacement negative (OC/DD (−)). Occlusal contact area, occlusal force, masticatory efficiency, tongue pressure, and lip pressure were measured. Lateral cephalometric analysis assessed skeletal and dental patterns. Results: OA group exhibited significantly reduced occlusal contact area (p < 0.0083, η2 = 0.12) and occlusal force (p < 0.0083, η2 = 0.14) compared to the OC/DD (−) group. Cephalometric analysis revealed that both OA and BDD groups had significantly larger ANB angles (OA: 5.7°, BDD: 5.2°, OC/DD (−): 3.7°; p < 0.0083, η2 = 0.21) and FMA angles (OA: 32.4°, BDD: 31.8°, OC/DD (−): 29.0°; p < 0.0083, η2 = 0.17) compared to the OC/DD (−) group. No significant differences were observed in masticatory efficiency, tongue pressure, or lip pressure. Conclusions: TMJ structural abnormalities detected via MRI, especially osteoarthritis, are associated with diminished oral function and skeletal Class II and high-angle features in female patients with malocclusion. Although orthodontic treatment is not intended to manage TMDs, MRI-based structural characterization—when clinically appropriate—may aid in treatment planning by identifying underlying joint conditions. Full article
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12 pages, 677 KB  
Systematic Review
Quality of Life Outcomes Following Total Temporomandibular Joint Replacement: A Systematic Review of Long-Term Efficacy, Functional Improvements, and Complication Rates Across Prosthesis Types
by Luis Eduardo Almeida, Samuel Zammuto and Louis G. Mercuri
J. Clin. Med. 2025, 14(14), 4859; https://doi.org/10.3390/jcm14144859 - 9 Jul 2025
Cited by 1 | Viewed by 910
Abstract
Introduction: Total temporomandibular joint replacement (TMJR) is a well-established surgical solution for patients with severe TMJ disorders. It aims to relieve chronic pain, restore jaw mobility, and significantly enhance quality of life. This systematic review evaluates QoL outcomes following TMJR, analyzes complication profiles, [...] Read more.
Introduction: Total temporomandibular joint replacement (TMJR) is a well-established surgical solution for patients with severe TMJ disorders. It aims to relieve chronic pain, restore jaw mobility, and significantly enhance quality of life. This systematic review evaluates QoL outcomes following TMJR, analyzes complication profiles, compares custom versus stock prostheses, explores pediatric applications, and highlights technological innovations shaping the future of TMJ reconstruction. Methods: A systematic search of PubMed, Embase, and the Cochrane Library was conducted throughout April 2025 in accordance with PRISMA 2020 guidelines. Sixty-four studies were included, comprising 2387 patients. Results: Primary outcomes assessed were QoL improvement, pain reduction, and functional gains such as maximum interincisal opening (MIO). Secondary outcomes included complication rates and technological integration. TMJR consistently led to significant pain reduction (75–87%), average MIO increases of 26–36 mm, and measurable QoL improvements across physical, social, and psychological domains. Custom prostheses were particularly beneficial in anatomically complex or revision cases, while stock devices generally performed well for standard anatomical conditions. Pediatric TMJR demonstrated functional and airway benefits with no clear evidence of growth inhibition over short- to medium-term follow-up. Complications such as heterotopic ossification (~20%, reduced to <5% with fat grafting), infection (3–4.9%), and chronic postoperative pain (~20–30%) were reported but were largely preventable or manageable. Recent advancements, including CAD/CAM planning, 3D-printed prostheses, augmented-reality-assisted surgery, and biofilm-resistant materials, are enhancing personalization, precision, and implant longevity. Conclusions: TMJR is a safe and transformative treatment that consistently improves QoL in patients with end-stage TMJ disease. Future directions include long-term registry tracking, growth-accommodating prosthesis design, and biologically integrated smart implants. Full article
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15 pages, 2359 KB  
Article
Mapping the Maxillary Artery and Lateral Pterygoid Muscle Relationship: Insights from Radiological and Meta-Analytic Evidence
by Maria Piagkou, George Triantafyllou, Panagiotis Papadopoulos-Manolarakis, Fotis Demetriou, George Tsakotos, Łukasz Olewnik and Fabrice Duparc
Medicina 2025, 61(7), 1201; https://doi.org/10.3390/medicina61071201 - 30 Jun 2025
Viewed by 388
Abstract
Background/Objectives: Variations in the course of the maxillary artery (MA) relative to the lateral pterygoid muscle (LPM) pose critical challenges in surgical, anesthetic, and interventional procedures involving the infratemporal fossa (ITF). These variations can increase the risk of hemorrhage, nerve injury, or [...] Read more.
Background/Objectives: Variations in the course of the maxillary artery (MA) relative to the lateral pterygoid muscle (LPM) pose critical challenges in surgical, anesthetic, and interventional procedures involving the infratemporal fossa (ITF). These variations can increase the risk of hemorrhage, nerve injury, or incomplete anesthesia. The present study aimed to elucidate the topographic relationship between the MA and LPM by combining high-resolution radiological imaging with a comprehensive analysis of anatomical literature. Materials and Methods: A retrospective review of 250 brain computed tomography angiographies (CTAs), totaling 500 sides, was conducted to classify the MA course as lateral (superficial), medial (deep), or intramuscular. Additionally, a systematic review and meta-analysis of 32 eligible studies—including 5938 arteries—was performed following PRISMA 2020 and Evidence-Based Anatomy (EBA) guidelines. Study quality and risk of bias were assessed using the Anatomical Quality Assurance (AQUA) tool. Results: In the imaging cohort, the MA coursed lateral to the LPM in 64.2% of sides, medial in 29.6%, and through the muscle fibers in 6.2%. A rare temporalis-traversing variant was identified in 3.0% of cases. Bilateral symmetry was observed in 77.6% of patients. Meta-analytic findings indicated a pooled prevalence of 79.6% for the lateral course, 19.9% for the medial course, and 0.01% for the intramuscular course. Cadaveric studies and Asian populations showed a higher incidence of lateral variants, while imaging-based studies more frequently detected medial and transmuscular paths. Conclusions: While the MA most often follows a lateral course relative to the LPM, clinically significant variation—including medial, intramuscular, and temporalis-traversing routes—exists. These variants complicate access during maxillofacial surgery, TMJ procedures, and regional anesthesia. Findings emphasize the importance of individualized preoperative vascular mapping to improve procedural safety and outcomes in the ITF. Full article
(This article belongs to the Special Issue The Aesthetic Face of Orthognathic Surgery)
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16 pages, 1963 KB  
Article
Temporomandibular Joint Ankylosis: Long-Term Outcomes with One-Stage Resection and Reconstruction Using Total Joint Alloplastic Replacement—A 20-Year Experience
by Giovanni Gerbino, Michela Omedè, Elisa Raveggi, Sara Silvestri, Emanuele Zavattero and Guglielmo Ramieri
J. Clin. Med. 2025, 14(13), 4639; https://doi.org/10.3390/jcm14134639 - 30 Jun 2025
Viewed by 805
Abstract
Background/Objectives: Temporomandibular joint (TMJ) ankylosis, characterized by osseous–fibrous fusion, severely impairs mandibular function. While alloplastic total joint replacement (TJR) is the gold standard, long-term outcomes remain understudied. The aim of this study is to evaluate the long-term esthetic and functional outcomes of prosthetic [...] Read more.
Background/Objectives: Temporomandibular joint (TMJ) ankylosis, characterized by osseous–fibrous fusion, severely impairs mandibular function. While alloplastic total joint replacement (TJR) is the gold standard, long-term outcomes remain understudied. The aim of this study is to evaluate the long-term esthetic and functional outcomes of prosthetic replacement and to retrospectively analyze our 20-year experience. Methods: A retrospective observational study (2003–2024) was conducted at a tertiary referral center in Turin and enrolled patients who underwent alloplastic total joint replacement for TMJ ankylosis. Data collected included demographic variables, etiology, characteristics of the ankylosis, prosthesis type (stock/custom), surgical details, and outcomes (maximal interincisal opening [MIO], pain, quality of life, diet consistency, Helkimo index, complications). Results: Among 28 patients (61% female, mean age 51.8 years), etiologies included post-traumatic (39%), osteoarthritis (32%), congenital (25%) and neoplastic (4%) causes. Custom prostheses were used in 57% of cases. Median follow-up was 11.5 years. Significant improvements were observed in MIO (p = 0.001), pain level (p = 0.001), quality of life (p = 0.001), diet score (p = 0.002), and Helkimo index (p = 0.001). Complications included facial nerve dysfunction (32.1%), salivary leakage (14.3%), and one recurrence (2.2%). Conclusions: Alloplstic TJR provides durable functional and esthetic restoration for TMJ ankylosis, with custom prostheses excelling in complex anatomies. Long-term stability (>10 years) supports its role as a definitive solution. Full article
(This article belongs to the Special Issue New Perspective of Oral and Maxillo-Facial Surgery)
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20 pages, 2612 KB  
Article
Influence of Maxillofacial Morphology on Temporomandibular Joint Degenerative Alterations and Condyle Position Assessed by CBCT in Class II Malocclusion Adult Patients—A Cross-Sectional Study
by Sebastian Dygas, Izabela Szarmach, Ilona Radej and José Chaqués-Asensi
J. Clin. Med. 2025, 14(13), 4499; https://doi.org/10.3390/jcm14134499 - 25 Jun 2025
Viewed by 567
Abstract
Background/Objectives: This cross-sectional analytical study investigated the relationship between the craniofacial morphology, condylar displacement, and degenerative changes in the temporomandibular joints (TMJs) in adult patients with class II skeletal malocclusion. To compare cephalometric variables, joint space dimensions, and centric slide measurements between patients [...] Read more.
Background/Objectives: This cross-sectional analytical study investigated the relationship between the craniofacial morphology, condylar displacement, and degenerative changes in the temporomandibular joints (TMJs) in adult patients with class II skeletal malocclusion. To compare cephalometric variables, joint space dimensions, and centric slide measurements between patients with and without CBCT-confirmed TMJ degenerative alterations. Methods: Sixty adults with class II malocclusion were divided into two equal groups (n = 30) based on the presence or absence of TMJ degenerative changes on CBCT. Joint spaces were measured, condylar displacement was evaluated using a condylar position indicator (CPI), and cephalometric analysis was performed in both maximal intercuspation and centric relation. Statistical comparisons were performed using t-tests, chi-squared tests, and Pearson’s correlation analysis. Significance was set at p < 0.05. Results: Patients with degenerative TMJ changes exhibited significantly greater overjet (p = 0.0001) and a trend toward increased ANB angles (p = 0.055). The superior joint space was reduced on the right side (p = 0.031). Condylar displacements ≥ 2 mm were more frequent in the affected group and correlated with sagittal cephalometric discrepancies (45% vs. 24% in controls). Conclusions: Aggravated skeletal class II malocclusion with increased overjet could be associated with TMJ degenerative changes. CR-based cephalometry and CBCT evaluation may aid in diagnostic assessment, but longitudinal studies are needed to confirm the clinical relevance. Full article
(This article belongs to the Special Issue Orthodontics: Current Advances and Future Options)
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21 pages, 2424 KB  
Review
The Role of Biomarkers in Temporomandibular Disorders: A Systematic Review
by Joana Maria Soares, Bruno Daniel Carneiro and Daniel Humberto Pozza
Int. J. Mol. Sci. 2025, 26(13), 5971; https://doi.org/10.3390/ijms26135971 - 21 Jun 2025
Viewed by 1303
Abstract
Temporomandibular disorders (TMDs) impact quality of life and present diagnostic and treatment challenges. Biomarkers may serve as an additional tool to support diagnosis and monitor disease progression, offering supplementary information for treatment strategies in specific and selected patients. This systematic review aimed to [...] Read more.
Temporomandibular disorders (TMDs) impact quality of life and present diagnostic and treatment challenges. Biomarkers may serve as an additional tool to support diagnosis and monitor disease progression, offering supplementary information for treatment strategies in specific and selected patients. This systematic review aimed to assess the role of biomarkers in diagnosing TMD and guiding personalized treatment. It also examined key biomarkers linked to chronic temporomandibular joint (TMJ) pain and how therapies affect biomarker levels and clinical outcomes. A comprehensive search was conducted in PubMed, Scopus, and Web of Science to identify observational and interventional studies assessing the role of biomarkers in synovial fluid/tissue, saliva, and blood. The research was registered in PROSPERO, adhered to PRISMA guidelines, and employed Cochrane Risk of Bias tools. To assess the effect, only studies examining biomarker levels were considered. A total of forty-six studies met the inclusion criteria: three randomized controlled trials were rated as having some concerns, as were most of the observational studies. Elevated levels of interleukins (1ß and 6), tumour necrosis factor alpha, and prostaglandin E2 in synovial fluid were correlated with temporomandibular joint (TMJ) inflammation. Increased matrix metalloproteinases (2, 7, and 9) indicated cartilage deterioration, while oxidative stress markers such as malondialdehyde were higher in TMD patients. Treatments including hyaluronic acid, platelet-rich plasma, and low-level laser therapy effectively reduced inflammatory biomarkers and improved symptoms. Biomarkers show potential to contribute to the understanding of pathophysiological mechanisms in TMD and may support future diagnostic and therapeutic strategies for selected patients. After high-quality studies confirm these findings, this approach will enable personalized medicine by tailoring treatments to individual patient profiles, ultimately leading to improved outcomes and quality of life. Full article
(This article belongs to the Special Issue Pain in Human Health and Disease)
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12 pages, 784 KB  
Article
Temporomandibular Joint Sound Frequencies and Mouth-Opening Distances: Effect of Gender and Age
by Serdar Gözler, Ali Seyedoskuyi, Ayşe Apak, Tan Fırat Eyüboğlu and Mutlu Özcan
J. Clin. Med. 2025, 14(13), 4399; https://doi.org/10.3390/jcm14134399 - 20 Jun 2025
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Abstract
Background/Objectives: Temporomandibular joint disorders (TMDs) affect the temporomandibular joint and associated structures of the stomatognathic system. Joint Vibration Analysis (JVA) is a non-invasive method used to assess TMJ dysfunction through vibration frequencies. This study aimed to explore how age and gender influence TMJ [...] Read more.
Background/Objectives: Temporomandibular joint disorders (TMDs) affect the temporomandibular joint and associated structures of the stomatognathic system. Joint Vibration Analysis (JVA) is a non-invasive method used to assess TMJ dysfunction through vibration frequencies. This study aimed to explore how age and gender influence TMJ vibration characteristics, hypothesizing that these factors may affect diagnostic accuracy in TMJ evaluations. Methods: This cross-sectional study includes 251 participants (143 females and 108 males) aged 10 to 30 years. TMJ evaluation used JVA to assess range of motion, integral values, and frequency distributions over and under 300 Hz. Participants with a history of TMJ disorders or significant maxillofacial trauma were excluded. Statistical analysis was conducted using employing Kolmogorov–Smirnov tests for data distribution, Kruskal–Wallis test for group comparisons, and Pearson correlation test for variable relationships. Results: Significant gender differences in range of motion (ROM) were observed, with males exhibiting higher values (p = 0.005). Age notably influenced vibration frequencies, particularly in total integral values (TIL and TIR) and frequency distributions around 300 Hz, suggesting links to degenerative changes. Females showed more pronounced age-related effects on vibration parameters. However, gender did not greatly affect vibration characteristics across all frequency bands, indicating that other factors also impact TMJ function. Conclusions: Age and gender significantly influence TMJ vibrations and the interpretation of JVA in clinical settings. Personalized approaches considering these demographic factors may enhance the accuracy of TMJ dysfunction diagnoses. Full article
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)
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16 pages, 2357 KB  
Article
A Novel Integrated CAD-Multibody Approach for TMJ Prosthesis Design
by Talal Bin Irshad, Giulia Pascoletti, Stefano Pagano, Chiara Valenti and Elisabetta Maria Zanetti
Designs 2025, 9(4), 78; https://doi.org/10.3390/designs9040078 - 20 Jun 2025
Viewed by 464
Abstract
This study presents a methodology for optimizing the design of the fossa component in temporomandibular joint (TMJ) prostheses, particularly in cases requiring replacement due to severe pathology or trauma. Leveraging advancements in 3D printing, the research aims to align prosthetic function with natural [...] Read more.
This study presents a methodology for optimizing the design of the fossa component in temporomandibular joint (TMJ) prostheses, particularly in cases requiring replacement due to severe pathology or trauma. Leveraging advancements in 3D printing, the research aims to align prosthetic function with natural jaw movements. A multibody simulation model was used to evaluate different designs based on key performance indicators: range of motion, condylar trajectory accuracy, and contact force magnitudes. Three designs were analyzed: a compact design fossa (CDF) with a spherical condyle, an enhanced design fossa (EDF) with a more anatomically realistic structure, and a simulation-driven design (MEDF) derived from condylar motion patterns. The results indicate that CDF could lead to dislocation at 13° of mouth opening. In contrast, EDF and MEDF safely enabled full opening (20°), closely replicated natural condyle trajectories (with deviations under 2.5 mm in all directions), and reduced contact forces, which can contribute to a longer prosthesis lifespan. MEDF showed the lowest peak contact force (−21% compared to EDF). The study successfully established a framework for evaluating and guiding patient-specific TMJ prosthetic designs, enhancing both functional rehabilitation and mechanical durability by minimizing wear through optimized contact dynamics. Full article
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13 pages, 629 KB  
Article
Axis I of DC/TMD in Diagnosis of Temporomandibular Disorders in People with Multiple Sclerosis—Preliminary Reports
by Martyna Odzimek, Hubert Lipiński, Piotr Dubiński, Marek Żak and Waldemar Brola
J. Clin. Med. 2025, 14(12), 4338; https://doi.org/10.3390/jcm14124338 - 18 Jun 2025
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Abstract
Background: The primary objective of our preliminary study was to estimate the prevalence of temporomandibular disorders (TMDs) in people with multiple sclerosis (MS). Furthermore, we aimed to investigate whether there is a correlation between the presence of TMDs and the level of MS-related [...] Read more.
Background: The primary objective of our preliminary study was to estimate the prevalence of temporomandibular disorders (TMDs) in people with multiple sclerosis (MS). Furthermore, we aimed to investigate whether there is a correlation between the presence of TMDs and the level of MS-related disability. Methods: The study was conducted at two centers in Poland dealing with the treatment of MS between March 2025 and April 2025. The study used an original survey questionnaire, the European Academy of Craniomandibular Diseases (EACD) questionnaire and the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). The study group included people with multiple sclerosis, while the control group consisted of healthy people without neurological deficits. The study group was examined using the following methods: the McDonald criteria and the Expanded Disability Status Scale (EDSS). Results: The study involved 90 people (45 in both groups). The majority of the study participants were women (80.0%), aged 20–30 years (51.1%) and people living in small towns (51.1%). The largest number of patients with MS were noted with RRMS (75.5%). The duration of the disease was on average 3.3 ± 2.4, and the EDSS score was on average 2.5 ± 1.5. People from the study group significantly (p ≤ 0.05; ES = 0.52–0.86) reported TMDs more frequently based on EACD (pain on opening the mouth: 86.7%; facial pain: 57.8%; joint locking: 28.9%; headaches: 75.3%). The diagnosis of TMDs was confirmed in 40.0% of people with MS and 11.1% of healthy volunteers (p ≤ 0.05). Patients most frequently reported muscle pain and disk displacement with reduction (p ≤ 0.05). The disability score in the MS group did not exhibit differences in the occurrence of TMDs (p > 0.05). Conclusions: The study showed that TMDs are more common in people with multiple sclerosis. The degree of disability did not differentiate the occurrence of TMDs. The authors intend to expand research on the influence of potential risk factors on the occurrence of TMDs in people with multiple sclerosis. Full article
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)
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