TEMPOROMANDIBULAR JOINT DYSFUNCTION: CURRENT CONCEPTS IN ETIOLOGY, DIAGNOSIS, AND EVIDENCE-BASED MANAGEMENT-A NARRATIVE REVIEW

Background: Temporomandibular joint dysfunction (TMD) is a common disorder affecting the temporomandibular joint, masticatory muscles, and associated structures. It has a multifactorial etiology involving mechanical, neuromuscular, inflammatory, biological, and psychosocial factors. Recent advances in diagnostic criteria, imaging techniques, and therapeutic options have improved the understanding and management of TMD. Objective: To provide an updated narrative review of the etiology, pathogenesis, clinical manifestations, diagnosis, and evidence-based management of temporomandibular joint dysfunction, with emphasis on conservative, minimally invasive, and surgical treatment approaches. Materials and Methods: A narrative review was performed using PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar. The review included systematic reviews, meta-analyses, randomized clinical trials, clinical studies, guidelines, and consensus statements published between January 2000 and March 2026, together with landmark publications relevant to TMD diagnosis and treatment. Results: Current evidence indicates that TMD should be regarded as a multifactorial functional disorder requiring individualized assessment. Diagnosis is primarily based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), supported by magnetic resonance imaging (MRI) and conebeam computed tomography (CBCT) when clinically indicated. Conservative treatment remains the firstline approach and includes patient education, self-management, physiotherapy, therapeutic exercises, occlusal splints, pharmacological therapy, and behavioral interventions. In patients with persistent symptoms, minimally invasive procedures such as arthrocentesis, arthroscopy, and intra-articular injections of hyaluronic acid or platelet-rich plasma may improve clinical outcomes. Open surgical procedures and total joint reconstruction are reserved for severe structural abnormalities. Emerging technologies, including artificial intelligence, digital mandibular tracking, biomarkers, and regenerative medicine, may support future personalized treatment strategies. Conclusion: Effective TMD management requires an individualized, multidisciplinary, and evidencebased approach. Early diagnosis and conservative therapy remain the foundation of treatment, whereas minimally invasive and surgical interventions should be reserved for selected patients. Future integration of digital technologies and regenerative approaches may further improve personalized patient care.