Treating Temporomandibular Disorders Through Orthodontics: A Scoping Review of Evidence, Gaps, and Clinical Guidance.

Abstract

<b>Introduction:</b> Evidence on orthodontic interventions for temporomandibular disorders (TMD) is fragmented and inconclusive, creating a gap in guidance for clinical decision-making. This study addresses that gap by evaluating current knowledge on these interventions. <b>Methods:</b> A PRISMA-ScR scoping review was conducted with a systematic search of PubMed, Scopus, and Web of Science (2018-2023). Eligible studies were peer-reviewed, English-language, human studies examining TMD treatment and/or etiology. Three independent reviewers screened records and extracted data and a fourth reviewer performed random audits. <b>Results:</b> Of 899 records, 10 studies met inclusion criteria (non-surgical, <i>n</i> = 7: 4 case reports, 2 prospective, 1 longitudinal; combined orthodontic-surgical, <i>n</i> = 3: 1 case report, 2 longitudinal; participant ages 15-71 years). Diagnostics included imaging, clinical examination, occlusal analysis, and questionnaires, although few used RDC/TMD or DC/TMD criteria. Non-surgical orthodontic modalities (fixed appliances, camouflage, TADs, stabilization splints) showed mixed results, with several studies reporting short-term symptom improvement, while others found no effect on TMD onset or progression. Combined orthodontic-surgical approaches (e.g., bilateral sagittal split osteotomy, Le Fort I) also showed variable outcomes. <b>Conclusions:</b> Low-to-moderate quality evidence suggests that orthodontic-surgical interventions may alleviate TMD symptoms in select patients; however, heterogeneity and limited use of standardized diagnostics constrain the certainty of these findings. Future research should prioritize DC/TMD-based diagnostics, core outcomes, comparative designs, and ≥12-24 months of follow-up to identify prognostic factors and responsive subgroups.