Dergiler / Selcuk Dental Journal / 2026 / Volume: 13 Issue: 2

Temporomandibular Joint Disorders: A Contemporary Review of Anatomy, Biomechanics, Diagnosis, and Treatment Approaches

Ela Türmeli(Selçuk üniversitesi sağlık bilimleri enstitüsü)0009-0008-6631-0198
Mevsim Yayman(LOKMAN HEKIM UNIVERSITY, FACULTY OF DENTISTRY)0000-0003-1669-6834
Serhan Akman(SELÇUK ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ)0000-0001-7362-6619
Sayfa
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Yayın Tarihi
2026-08-24
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Systematic evaluation of joint sounds provides valuable information for clinical decision-making.

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Amaç & Hipotez:Background: The temporomandibular joint (TMJ) is a complex anatomical structure responsible for essential functions such as mastication, speech, and swallowing.
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Temel Bulgular & Veri:Conclusion: Accurate diagnosis and effective management of temporomandibular disorders require a thorough understanding of the anatomical, biomechanical, and functional characteristics of the temporomandibular joint.
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Sonuç & Katkı:Systematic evaluation of joint sounds provides valuable information for clinical decision-making.
🔬Tür:Literatür & Derleme Çalışması
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:joint sounds · temporomandibular disorders · tmj diagnosis

Abstract

Background: The temporomandibular joint (TMJ) is a complex anatomical structure responsible for essential functions such as mastication, speech, and swallowing. Disorders affecting this system are collectively referred to as temporomandibular disorders (TMDs) and represent one of the most common causes of non-dental orofacial pain. TMDs have a multifactorial etiology and may involve muscular, articular, and disc-related pathologies. Clinically, these disorders are characterized by pain, joint sounds, restricted mandibular movements, and functional limitations. Joint sounds are considered important clinical indicators in the early diagnosis of TMDs. Objective: The aim of this review is to describe the anatomical structure, biomechanics, and condylar movement pathways of the temporomandibular joint, and to evaluate the terminology, classification, etiology, and clinical features of temporomandibular disorders in light of current literature. In addition, Summary of Evidence: The physical characteristics, clinical significance, and objective recording methods of TMJ sounds are discussed in detail. The diagnostic process, including anamnesis, clinical examination, muscle and joint assessment, and radiographic imaging techniques, is comprehensively reviewed. Treatment approaches are classified as reversible and irreversible methods, with particular emphasis on the indications and clinical effects of occlusal splint therapy. Conclusion: Accurate diagnosis and effective management of temporomandibular disorders require a thorough understanding of the anatomical, biomechanical, and functional characteristics of the temporomandibular joint. Systematic evaluation of joint sounds provides valuable information for clinical decision-making.

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Bu Makaleye Atıf Yap

Uludağ, A., Türmeli, E., Yayman, M., Akman, S. (2026). Temporomandibular Joint Disorders: A Contemporary Review of Anatomy, Biomechanics, Diagnosis, and Treatment Approaches. Selcuk Dental Journal, Volume: 13 Issue: 2. https://doi.org/10.15311/selcukdentj.1903361

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Kaynakça (94)

  1. Okeson JP. Management of temporomandibular disorders and occlusion-E-book: Elsevier Health Sciences; 2019.
  2. Moseley EG. Medical dictionaries and studies of terminology. Bulletin of the Medical Library Association. 1961;49(3):374.
  3. Gerards M. Musculoskeletal ultrasound of the temporomandibular joint muscles. Fontys University of Applied Sciences. 2015.
  4. Greco PM. Temporomandibular disorders. Mosby's Orthodontic Review-E-Book. 2014:286.
  5. Heffez L, Jordan S. A classification of temporomandibular joint disk morphology. Oral surgery, oral medicine, oral pathology. 1989;67(1):11-9.
  6. Bag AK, Gaddikeri S, Singhal A, Hardin S, Tran BD, Medina JA, et al. Imaging of the temporomandibular joint: An update. World journal of radiology. 2014;6(8):567.
  7. Hiatt JL. Textbook of head and neck anatomy: Jones & Bartlett Learning; 2020.
  8. Odabaş B, Arslan SG. Temporomandibular eklem anatomisi ve rahatsızlıkları. Dicle Tıp Dergisi. 2008;35(1):77-85.
  9. Laskin DM, Greene CS, Hylander WL. Temporomandibular disorders: an evidence-based approach to diagnosis and treatment. 2006.
  10. Okeson JP, Ckeson JP. Management of temporomandibular disorders and occlusion: Elsevier/Mosby St. Louis, MO; 2013.
  11. Rozylo-Kalinowska I, Orhan K. Imaging of the temporomandibular joint. 2019.
  12. Sarnat BG, Laskin DM, Williams RA. The temporomandibular joint: a biological basis for clinical practice. Plastic and Reconstructive Surgery. 1992;90(3):534.
  13. Hylander WL. Functional anatomy and biomechanics of the masticatory apparatus. Temporomandibular disorders: an evidenced approach to diagnosis and treatment New York: Quintessence Pub Co. 2006:3-34.
  14. Erdoğan M. Bruksizmli Bireylerde İki Farklı Splint Kullanımı Öncesi ve Sonrası Temporomandibular Eklem Seslerinin ve Radyolojik Verilerin Değerlendirilmesi. Ankara: Doktora Tezi, Gazi Üniversitesi Sağlık Bilimleri Enstitüsü; 2010.
  15. Kurt H, editor. Temporomandibular Bozukluklar. 1. Baskı ed. İstanbul: Medya Yayın Grubu; 2016.
  16. Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2009;107(6):844-60.
  17. Harorlı A, Akgül H, Yılmaz A, Bilge O, Dağistan S, Çakur B, et al. Ağız, Diş ve Çene Radyolojisi. İstanbul: Nobel Tıp Kitabevleri. 2014(s 176).
  18. Laskin D, Greene C. Hylander WL. Temporomandibular disorders: An evidence-based approach to diagnosis and treatment Batavia, Illnois: Quintessence Pub. 2006.
  19. Peterson L. Oral and Maxillofacial Surgery, Vol. 3. Lippincott-Raven Pub., Philadelphia; 1992.
  20. Dawson PE. Evaluation, diagnosis, and treatment of occlusal problems. オクルージョンの臨床 その理論 診断 治療. 1974:231-47.
  21. Okeson JP. Orofacial Pain: Guidelines for Assessment, Diagnosis, and. Management, 3rd ed Chicago: Quintessence. 1996:45-52.
  22. Costen JB. I. A syndrome of ear and sinus symptoms dependent upon disturbed function of the temporomandibular joint. Annals of Otology, Rhinology & Laryngology. 1934;43(1):1-15.
  23. de Kanter RJ, Battistuzzi PG, Truin G-J. Temporomandibular disorders:“occlusion” matters! Pain Research and Management. 2018;2018.
  24. Schwartz LL. A temporomandibular joint pain-dysfunction syndrome. Journal of chronic diseases. 1956;3(3):284-93.
  25. Laskin DM. Etiology of the pain-dysfunction syndrome. The Journal of the American Dental Association. 1969;79(1):147-53.
  26. Bell WE. Temporomandibular disorders. Classification, diagnosis, management. 1990.
  27. Valesan LF, Da-Cas CD, Réus JC, Denardin ACS, Garanhani RR, Bonotto D, et al. Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis. Clinical Oral Investigations. 2021; 25:441-53.
  28. Maydana AV, Tesch RdS, Denardin OVP, Ursi WJdS, Dworkin SF. Possible etiological factors in temporomandibular disorders of articular origin with implications for diagnosis and treatment. Dental Press Journal of Orthodontics. 2010; 15:78-86.
  29. Nekora‐Azak A, Evlioglu G, Ordulu M, Işsever H. Prevalence of symptoms associated with temporomandibular disorders in a Turkish population. Journal of Oral Rehabilitation. 2006;33(2):81-4.
  30. Poveda Roda R, Díaz Fernández JM, Hernández Bazán S, Jiménez Soriano Y, Margaix Muñoz M, Sarrión Pérez MG. A review of temporomandibular joint disease (TMJD). Part II: Clinical and radiological semiology. Morbidity processes. 2008.
  31. Almeida-Leite CM, Stuginski-Barbosa J, Conti PCR. How psychosocial and economic impacts of COVID-19 pandemic can interfere on bruxism and temporomandibular disorders? Journal of Applied Oral Science. 2020;28.
  32. Oral K, Bal Küçük B, Ebeoğlu B, Dincer S. Etiology of temporomandibular disorder pain. Agri. 2009;21(3):89-94.
  33. Yule PL, Durham J, Wassell RW. Pain part 6: temporomandibular disorders. Dental update. 2016;43(1):39-48.
  34. Chang C-L, Wang D-H, Yang M-C, Hsu W-E, Hsu M-L. Functional disorders of the temporomandibular joints: Internal derangement of the temporomandibular joint. The Kaohsiung journal of medical sciences. 2018;34(4):223-30.
  35. Kaymak D, Karakis D, Dogan A. Evolutionary spectral analysis of temporomandibular joint sounds before and after anterior repositioning splint therapy in patients with internal derangement. Int J Prosthodont. 2019;32(6):475-81.
  36. Okeson J. Management of Temporomandibular Disorders and Occlusion. New York State Dental Journal. 2003;69(7):61.
  37. Baba K, Tsukiyama Y, Yamazaki M, Clark GT. A review of temporomandibular disorder diagnostic techniques. The Journal of prosthetic dentistry. 2001;86(2):184-94.
  38. Isberg A. Temporomandibular joint dysfunction: a practitioner's guide: CRC Press; 2001.
  39. Bush FM, Butler JH, Abbott DM. The relationship of TMJ clicking to palpable facial pain: A study. Journal of Craniomandibular Practice. 1983;1(4):43-8.
  40. McNeill C. Current controversies in temporomandibular disorders. American Journal of Orthodontics and Dentofacial Orthopedics. 1993; 104:101-.
  41. Westesson P-L. Arthrography of the temporomandibular joint. The Journal of prosthetic dentistry. 1984;51(4):535-43.
  42. Eriksson L, Westesson P-L, Rohlin M. Temporomandibular joint sounds in patients with disc displacement. International journal of oral surgery. 1985;14(5):428-36.
  43. Gay T, Bertolami C. The spectral properties of temporomandibular joint sounds. Journal of dental research. 1987;66(6):1189-94.
  44. Okeson JP. Joint intracapsular disorders: diagnostic and nonsurgical management considerations. Dental Clinics. 2007;51(1):85-103.
  45. Widmalm S-E, Williams W, Christiansen R, Gunn SM, Park D. Classification of temporomandibular joint sounds based upon their reduced interference distribution. Journal of oral rehabilitation. 1996;23(1):35-43.
  46. Kaplan AS, Assael LA. Temporomandibular disorders: diagnosis and treatment. (No Title). 1991.
  47. Pertes RA, Gross SG. Clinical management of temporomandibular disorders and orofacial pain. (No Title). 1995.
  48. Prinz J, Ng K. Characterization of sounds emanating from the human temporomandibular joints. Archives of oral biology. 1996;41(7):631-9.
  49. Leader J, Robert Boston J, Rudy T, Greco C, Zaki H, Henteleff H. Quantitative description of temporomandibular joint sounds: defining clicking, popping, egg shell crackling and footsteps on gravel. Journal of oral rehabilitation. 2001;28(5):466-78.
  50. Zhang J, Whittle T, Wang L, Murray G. The reproducibility of temporomandibular joint vibrations over time in the human. Journal of Oral Rehabilitation. 2014;41(3):206-17.
  51. Öğüt F. Objektif ses analizi. Turkiye Klinikleri Journal of ENT. 2002;2(2):121-6.
  52. Dagar SRS, Turakiya V, Pakhan AJ, Jaggi N, Kalra A, Vaidya V. Modified stethoscope for auscultation of temporomandibular joint sounds. Journal of International Oral Health: JIOH. 2014;6(2):40.
  53. Widmalm S-E, Williams W, Adams B. The wave forms of temporomandibular joint sound clicking and crepitation. Journal of oral rehabilitation. 1996;23(1):44-9.
  54. Ishigaki S, Bessette RW, Maruyama T. Vibration analysis of the temporomandibular joints with degenerative joint disease. CRANIO®. 1993;11(4):276-83.
  55. Sano T, Widmalm SE, Westesson PL, Takahashi K, Yoshida H, Michi K, et al. Amplitude and frequency spectrum of temporomandibular joint sounds from subjects with and without other signs/symptoms of temporomandibular disorders. Journal of oral rehabilitation. 1999;26(2):145-50.
  56. Widmer CG. Temporomandibular joint sounds: a critique of techniques for recording and analysis. Journal of Craniomandibular Disorders. 1989;3(4).
  57. Manfredini D, Basso D, Salmaso L, Guarda-Nardini L. Temporomandibular joint click sound and magnetic resonance-depicted disk position: which relationship? Journal of dentistry. 2008;36(4):256-60.
  58. Tanzilli R, Tallents R, Katzberg R, Kyrkanides S, Moss M. Temporomandibular joint sound evaluation with an electronic device and clinical evaluation. Clinical Orthodontics and Research. 2001;4(2):72-8.
  59. Yoshida H, Sano T, Kataoka R, Takahashi K, Michi K-i. A preliminary investigation of a method of detecting temporomandibular joint sounds. Journal of orofacial pain. 1994;8(1).
  60. Widmalm S, Williams W, Ang B, McKay D. Localization of TMJ sounds to side. Journal of oral rehabilitation. 2002;29(10):911-7.
  61. Okeson JP. Bell's oral and facial pain. (No Title). 2014.
  62. Mohl ND, Lund JP, Widmer CG, McCall Jr W. Devices for the diagnosis and treatment of temporomandibular disorders. Part II: Electromyography and sonography. The Journal of prosthetic dentistry. 1990;63(3):332-6.
  63. Özek E, Köroğlu T, Karakoc F, Kilic T, Tangören M, Pamir N, et al. Transcranial Doppler assessment of cerebral blood flow velocity in term newborns. European journal of pediatrics. 1995; 154:60-3.
  64. Puri P, Kambylafkas P, Kyrkanides S, Katzberg R, Tallents RH. Comparison of Doppler sonography to magnetic resonance imaging and clinical examination for disc displacement. The Angle Orthodontist. 2006;76(5):824-9.
  65. Yayman M, Akman S. Temporomandibular Eklem Seslerini Değerlendirme Yöntemleri. Selcuk Dental Journal. 2023;10(3):600-4.
  66. Sharma S, Crow HC, McCall W, Gonzalez YM. Systematic review of reliability and diagnostic validity of joint vibration analysis for diagnosis of Temporomandibular disorders. Journal of Orofacial Pain. 2013;27(1).
  67. Badwal RS. The application of fractal dimension to temporomandibular joint sounds. Computers in biology and medicine. 1993;23(1):1-14.
  68. Akan A, Ünsal RB. Time–frequency analysis and classification of temporomandibular joint sounds. Journal of the Franklin Institute. 2000;337(4):437-51.
  69. Chen HM, Liu MQ, Yap AUJ, Fu KY. Physiological effects of anterior repositioning splint on temporomandibular joint disc displacement: a quantitative analysis. Journal of oral rehabilitation. 2017;44(9):664-72.
  70. Dimitroulis G. Temporomandibular disorders: a clinical update. Bmj. 1998;317(7152):190-4.
  71. Okeson J, Moreno Hay I. Clinical evaluation of orofacial pain. Contemporary oral medicine Cham: Springer International Publishing. 2016:1-23.
  72. Goiato MC, Zuim PRJ, Moreno A, Dos Santos DM, da Silva EVF, de Caxias FP, et al. Does pain in the masseter and anterior temporal muscles influence maximal bite force? Archives of oral biology. 2017; 83:1-6.
  73. Suzuki S, Arima T, Kitagawa Y, Svensson P, Castrillon E. Influence of glutamate‐evoked pain and sustained elevated muscle activity on blood oxygenation in the human masseter muscle. European Journal of Oral Sciences. 2017;125(6):453-62.
  74. Muhtaroğullari M, Demirel F, Saygili G. Temporomandibular disorders in Turkish children with mixed and primary dentition: prevalence of signs and symptoms. Turk J Pediatr. 2004;46(2):159-63.
  75. Clemente MP, Mendes J, Moreira A, Vardasca R, Ferreira AP, Amarante JM. Wind instrumentalists and temporomandibular disorder: from diagnosis to treatment. Dentistry Journal. 2018;6(3):41.
  76. Agerberg G. Maximal mandibular movements in children. Acta Odontologica Scandinavica. 1974;32(3):147-59.
  77. Bitlar G. Range of jaw opening in an elderly non-patient population. J Dent Res. 1991;70(419):1225.
  78. McCarroll R, Hesse J, Naeije M, Yoon C, Hansson T. Mandibular border positions and their relationships with peripheral joint mobility. Journal of Oral Rehabilitation. 1987;14(2):125-31.
  79. Aksoy S, Orhan K. Temporomandibular eklemin disk deplasmanları. Gazi Üniversitesi Diş Hekimliği Fakültesi Dergisi. 2010;27(1):65-73.
  80. Schoenen J. Differential diagnosis of facial pain. Acta neurologica Belgica. 2001;101(1):6-9.
  81. Paradowska-Stolarz A, Wiland P, Shiau Y-Y. Temporomandibular Disorders and Oral Parafunctions: Mechanism, Diagnostics, and Therapy.
  82. Gray R, Davies S, Quayle A. A clinical approach to temporomandibular disorders: A clinical approach to treatment. British Dental Journal. 1994; 177:101-.
  83. Farrar W, McCarty Jr W. Inferior joint space arthrography and characteristics of condylar paths in internal derangements of the TMJ. The Journal of Prosthetic Dentistry. 1979;41(5):548-55.
  84. Lundh H, Westesson P-L, Kopp S, Tillström B. Anterior repositioning splint in the treatment of temporomandibular joints with reciprocal clicking: comparison with a flat occlusal splint and an untreated control group. Oral Surgery, Oral Medicine, Oral Pathology. 1985;60(2):131-6.
  85. Simmons III HC, Gibbs SJ. Anterior repositioning appliance therapy for TMJ disorders: specific symptoms relieved and relationship to disk status on MRI. CRANIO®. 2005;23(2):89-99.
  86. Conti PCR, Miranda JES, Conti ACCF, Pegoraro LF, Araújo CdRPd. Partial time use of anterior repositioning splints in the management of TMJ pain and dysfunction: a one-year controlled study. Journal of Applied Oral Science. 2005; 13:345-50.
  87. Tecco S, Caputi S, Teté S, Orsini G, Festa F. Intra-articular and muscle symptoms and subjective relief during TMJ internal derangement treatment with maxillary anterior repositioning splint or SVED and MORA splints: A comparison with untreated control subjects. Cranio®. 2006;24(2):119-29.
  88. Summer JD, Westesson P-L. Mandibular repositioning can be effective in treatment of reducing TMJ disk displacement. A long-term clinical and MR imaging follow-up. CRANIO®. 1997;15(2):107-20.
  89. Abekura H, Kotani H, Tokuyama H, Hamada T. Effects of occlusal splints on the asymmetry of masticatory muscle activity during maximal clenching. Journal of oral rehabilitation. 1995;22(10):747-52.
  90. Lindfors E, Arima T, Baad-Hansen L, Bakke M, De Laat A, Giannakopoulos NN, et al. Jaw exercises in the treatment of temporomandibular disorders—an international modified Delphi study. J Oral Facial Pain Headache. 2019;33(4):389-98.
  91. Shimada A, Ishigaki S, Matsuka Y, Komiyama O, Torisu T, Oono Y, et al. Effects of exercise therapy on painful temporomandibular disorders. Journal of oral rehabilitation. 2019;46(5):475-81.
  92. Shimada A, Ogawa T, Sammour SR, Narihara T, Kinomura S, Koide R, et al. Effectiveness of exercise therapy on pain relief and jaw mobility in patients with pain-related temporomandibular disorders: a systematic review. Frontiers in oral health. 2023; 4:1170966.
  93. McLean L. The effect of postural correction on muscle activation amplitudes recorded from the cervicobrachial region. Journal of Electromyography and Kinesiology. 2005;15(6):527-35.
  94. Ohrbach R, Sharma S. Behavioral therapy for temporomandibular disorders. Frontiers of Oral and Maxillofacial Medicine. 2021; 3:37-.