Treating Temporomandibular Disorders Through Orthodontics: A Scoping Review of Evidence, Gaps, and Clinical Guidance
Abstract
1. Introduction
2. Methods
2.1. Protocol Reporting
2.2. Eligibility Criteria
2.3. Information Sources and Search Strategy
2.4. Selection Process
2.5. Data Collection Process
2.6. Critical Appraisal (Risk of Bias)
2.7. Synthesis Methods
2.8. Ethics and Funding
3. Results
3.1. Article Selection
3.2. Study Characteristics
3.3. Orthodontic-TMD Relationship Findings
4. Discussion
4.1. Principle Findings and Context
4.2. Non-Surgical Orthodontic Interventions
4.3. Surgical Orthodontic Interventions
4.4. Outcomes by Domain (Pain, Function, Joint Sounds, PROs)
4.5. Diagnostics and Applicability
4.6. Risk of Bias, Heterogeneity, and Durability
4.7. Limitations and the Evidence and of This Review
4.8. Implications for Practice
4.9. Future Research
4.10. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Inclusion Criteria | Exclusion Criteria |
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|
|
Author (Year) | Types of TMD | Study Design | Diagnostic Method(s) | Key Outcome |
---|---|---|---|---|
Giray & Sadry (2021) [36] | Not specified | Prospective | CE, Lat ceph, Pan, JVA, occlusion analysis | No association with TMD development |
Hoshi et al. (2022) [37] | MP, DD | Case Report | CE, MRI, CT, interview | Ortho + mini-implants → pain resolved; no recurrence at 2 years |
Kaku et al. (2019) [32] | OA, DDwR | Case Report | MRI | Ortho + stabilization splint → pain resolved during treatment |
Kato & Ono (2018) [33] | OA | Case Report | EMG, CBCT | Pain resolved; no recurrence at 2 years |
Kau et al. (2020) [38] | TMD (significant pain), ICR | Case Report | CBCT, full ortho records, clinical photos | Ortho + orthognathic surgery → symptoms eliminate |
Lee et al. (2019) [34] | ICR, TMD | Case Report | CBCT, Lat ceph, Pan | Ortho + mini-implants + stabilization splint → symptoms resolved; no recurrence at 2 years |
Myllymäki et al. (2023) [39] | MP, arthralgia, TMJ clicking | Prospective | Questionnaire, CE | No association between orthodontic treatment and TMD symptoms |
Paunonen et al. (2019) [40] | Myalgia, MP, arthralgia, DJD, DDWR, DDWoR | Longitudinal | Questionnaire, CE | Ortho + orthognathic surgery ↓ TMD prevalence |
Ruf & Bock (2019) [25] | Myalgia, Arthralgia, DJD, DD | Longitudinal | CE | Herbst-based orthodontics: ↓ symptoms post-treatment; no long-term effect |
Zibo et al. (2022) [35] | Myalgia, arthralgia | Longitudinal | Cephalometric radiographs | Ortho + orthognathic surgery: no effect on prevalence/severity |
Author (Year) | Intervention | Key Outcome Metrics Used | Duration/Follow-Up | Overall Signal |
---|---|---|---|---|
Giray & Sadry (2021) [36] | Non-surgical | T-Scan® occlusal parameters (e.g., disclusion time), chewing pattern analysis; Joint Vibration Analysis (JVA) for TMD screening | During active treatment (~6 months) | No effect on TMD onset/progression |
Myllymäki et al. (2023) [39] | Non-surgical | Self-reported TMD symptoms questionnaire at ages 12/15/32; PAR Index (occlusal severity/changes); multivariable logistic regression (OR, 95% CI) (e.g., TMJ sounds, headache) | Longitudinal (~20 years) | No effect (treatment not a driver); risk factors noted |
Ruf & Bock (2019) [25] | Non-surgical | RDC/TMD & DC/TMD clinical classification; Helkimo Index; prevalence of signs/symptoms across timepoints | Long-term (≥15 years) | Mixed/no durable effect |
Hoshi et al. (2022) [37] | Non-surgical | 6-DOF jaw-movement recording (Gnathohexagraph: incisal/condylar path lengths; symmetry); TMJ MRI (disk position); cephalometrics; clinical TMJ sounds & pain | ~24 months (with extended retention notes) | Improved |
Kato & Ono (2018) [33] | Non-surgical | Surface EMG of masticatory muscles (masseter/temporalis/digastric) during MVC; CBCT of TMJ; cephalometrics; clinical symptom status | ~2–2.5 years | Improved |
Kaku et al. (2019) [32] | Non-surgical | TMJ MRI (disk displacement), cephalometric angles (ANB, FMA, etc.); occlusal relationships; clinical TMD symptoms; panoramic/Schüller radiographs | ~2 years | Improved |
Lee et al. (2019) [34] | Non-surgical | Clinical joint symptom status (pain/clicking); occlusal stability; routine orthodontic records/radiographs (case-level reporting) | ~2 years | Improved |
Paunonen et al. (2019) [40] | Surgical | DC/TMD Axis I subdiagnoses (e.g., myalgia, arthralgia); symptom questionnaire; comparison of prevalence vs. non-treated Class II controls | Medium term (~4–8 years) | Improved (pain prevalence) |
Zibo et al. (2022) [35] | Surgical | Mandibular movement amplitude (incl. mouth opening and deviation), TMJ pain, pathological TMJ sounds, masticatory muscle tenderness on palpation; cephalometrics, overjet/overbite | Short-term (14 days & 6 months) | No clear benefit (short-term) |
Kau et al. (2020) [38] | Surgical | Maximum interincisal opening (MIO), lateral excursions, subjective pain/dysfunction, airway dimension (post-op), occlusal stability | Short-term (months) | Improved |
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Hung, M.; Gardner, J.D.; Lee, S.; Birmingham, W.C.; Stevens, R.M.; Schwartz, C.; Karimi, N.; Mohajeri, A. Treating Temporomandibular Disorders Through Orthodontics: A Scoping Review of Evidence, Gaps, and Clinical Guidance. Clin. Pract. 2025, 15, 182. https://doi.org/10.3390/clinpract15100182
Hung M, Gardner JD, Lee S, Birmingham WC, Stevens RM, Schwartz C, Karimi N, Mohajeri A. Treating Temporomandibular Disorders Through Orthodontics: A Scoping Review of Evidence, Gaps, and Clinical Guidance. Clinics and Practice. 2025; 15(10):182. https://doi.org/10.3390/clinpract15100182
Chicago/Turabian StyleHung, Man, Jacob Daniel Gardner, Samantha Lee, Wendy C. Birmingham, Richard M. Stevens, Connor Schwartz, Nader Karimi, and Amir Mohajeri. 2025. "Treating Temporomandibular Disorders Through Orthodontics: A Scoping Review of Evidence, Gaps, and Clinical Guidance" Clinics and Practice 15, no. 10: 182. https://doi.org/10.3390/clinpract15100182
APA StyleHung, M., Gardner, J. D., Lee, S., Birmingham, W. C., Stevens, R. M., Schwartz, C., Karimi, N., & Mohajeri, A. (2025). Treating Temporomandibular Disorders Through Orthodontics: A Scoping Review of Evidence, Gaps, and Clinical Guidance. Clinics and Practice, 15(10), 182. https://doi.org/10.3390/clinpract15100182