Ionela Racaru, Filip Alexandru, Forna Norina
ABSTRACT
Aim of the study Temporomandibular disorders (TMDs) and orofacial pain syndromes represent a heterogeneous group of musculoskeletal and neuropathic conditions affecting the temporomandibular joint, masticatory muscles, and associated craniofacial structures. This narrative review aimed to synthesize current evidence regarding diagnostic criteria, imaging modalities, and therapeutic strategies, with emphasis on conservative and multidisciplinary approaches. Material and methods: A comprehensive literature search was conducted across PubMed/MEDLINE, Scopus, and Web of Science for peer-reviewed articles published between 1992 and 2024. A total of 50 references were selected based on relevance, methodological quality, and currency, covering systematic reviews, meta-analyses, randomized controlled trials, clinical guidelines, and expert narrative reviews. Results: The DC/TMD (2014) and ICOP (2020) constitute the validated diagnostic reference frameworks. CBCT and MRI provide complementary imaging data for osseous and soft-tissue assessment, respectively. Conservative treatment — occlusal splint therapy, physiotherapy, pharmacotherapy, cognitive-behavioral therapy (CBT), and botulinum toxin injection — represents the first-line approach supported by the current evidence. Intra-articular interventions are reserved for refractory articular cases. Conclusions: TMDs and orofacial pain syndromes require individualized, interdisciplinary management. No single treatment is universally superior; multimodal strategies addressing both physical and psychosocial dimensions yield the best long-term outcomes in oral rehabilitation.
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