Temporomandibular joint disorder: Etiologies and treatments (part 2)

Temporomandibular joint (TMJ) disorders (TMDs) are complex conditions affecting the joint and associated musculoskeletal structures, causing pain and functional impairment. This review explores the anatomical basis, etiological factors, and therapeutic strategies for TMD, emphasizing the interplay between TMJ anatomy, pathophysiology, and treatment outcomes. Myogenous and arthrogenous TMDs present distinct anatomical challenges, requiring targeted interventions. Key findings highlight the efficacy of conservative therapies, including behavioral interventions, physical therapies, and occlusal splints, as first-line treatments, followed by low-level laser therapy (LLLT), transcutaneous electrical nerve stimulation (TENS), and dry needling for myofascial pain. Botulinum toxin-A (BoNT-A) (De la Torre Canales G et al., 2024 [1]) is effective for persistent myogenous TMD but reserved for cases unresponsive to first-line treatments. Emerging therapies, such as platelet-rich plasma (PRP) and 3D-printed implants, show promise for refractory cases. This review aims to advance the understanding of TMD from an anatomical perspective, providing evidence-based insights for clinicians and researchers. Part 1 of this series, "Temporomandibular Disorder: The Anatomy of Pain", details TMJ anatomy and pain pathways, forming the foundation for this analysis.