Temporomandibular joint disorder: Anatomy of pain (part 1)

Abstract

The temporomandibular joint (TMJ) is a complex synovial articulation connecting the mandible to the temporal bone, facilitating essential functions like chewing and speaking through rotational and translational movements. Temporomandibular disorders (TMDs) cause significant pain and dysfunction, often involving myogenous, arthrogenous, or multifactorial etiologies. This review elucidates TMJ anatomy, embryology, and pain pathways, with a focus on central pain mechanisms underlying TMD. Key anatomical components include the mandibular condyle, articular disc, and masticatory muscles, innervated by the mandibular nerve (V3) and vascularized by the maxillary artery. Pain in TMD involves peripheral and central sensitization, modulated by the spinal trigeminal nucleus, thalamus, and somatosensory cortex. This work aims to guide clinicians in evidence-based TMD diagnosis and management, emphasizing multidisciplinary approaches and future research into molecular pain pathways.