A Disfunção Temporomandibular e sua relação com a posição/anatomia condilar

Abstract

Introduction Temporomandibular dysfunction (TMD) is a clinical entity with a complex and often controversial etiology. It brings together a multiplicity of conditions that compromise the anatomy and functionality of the temporomandibular joint (TMJ), which can cause orofacial pain, dysfunction, joint noises, or mechanical limitations, with a consequent impact on patients' quality of life. Objectives This research aimed to study the abstruse relationship between anatomical variations, more specifically, the positions of the mandibular condyles and TMD. In this context, the interaction between these positions and the development or worsening of TMD was critically explored, seeking to elucidate the underlying mechanisms and provide guidelines for more effective diagnostic and treatment strategies. Methods A narrative literature review was carried out, searching for articles published between 2019 and 2024 in the PubMed database, using search terms such as "temporomandibular joint dysfunction," "mandibular condyle," "mandibular condyle position" and "condylar position". After the search, the published theoretical and empirical data were synthesized for a more comprehensive understanding of the phenomenon studied, in this case, the relationship between TMD and condylar position. Results The results point to an association between changes in the morphology and position of the mandibular condyle and increased risk and severity of TMD. The interaction between condylar position and the mechanisms underlying the development of TMD have been clearly elucidated. Advanced imaging techniques such as cone-beam computed tomography and magnetic resonance imaging have proved fundamental for a more precise diagnosis and more appropriate therapeutic planning. Pharmacological therapies, specialized physiotherapy and the use of occlusal plates seem to contribute to condylar repositioning and the resolution of symptoms. Conclusion The evidence suggests that a thorough knowledge of condylar anatomy and biomechanics is essential for a more effective approach to TMD. Detailed condylar assessment can help individualize treatments, making them more effective in mitigating symptoms and optimizing TMJ functionality. This study aimed to contribute to clinical practice by highlighting the importance of multidisciplinary approaches and suggesting directions for future research.