Masticatory Muscle Disorders in the Course of Temporomandibular Joint Dysfunction – Contemporary Methods of Diagnosis and Conservative Treatment. A Literature Review

Abstract

Introduction and aim: Temporomandibular disorders (TMD) are among the most common causes of chronic orofacial pain of non-dental origin, with a muscular component dominating in 50–70% of patients. Global prevalence reaches 34%, with marked female predominance and peak incidence at 18–60 years, making masticatory muscle disorders a significant clinical and public health problem. The aim of this review was to systematize current knowledge on the epidemiology, etiopathogenesis, classification, diagnosis, and conservative treatment of masticatory muscle disorders, with emphasis on clinical and instrumental assessment tools. Material and methods: This is a descriptive (narrative) literature review. The search was conducted in PubMed/MEDLINE, PMC, Europe PMC, and Google Scholar, including systematic reviews, meta-analyses, cohort studies, and expert guidelines. Results: Etiopathogenesis is multifactorial and biopsychosocial, involving genetic predisposition, psychosocial factors, central sensitization, bruxism, and sleep disturbances. The DC/TMD classification differentiates muscle pain subtypes of varying prognostic significance. Diagnosis relies on standardized clinical examination, supplemented by instrumental methods (sEMG, ultrasound elastography, MRI), whose value remains complementary. Conservative treatment includes exercise therapy, occlusal splints, pharmacotherapy, and needling techniques, with generally low-to-moderate quality evidence. Conclusions: Masticatory muscle disorders require an integrated, multidisciplinary approach accounting for the patient's biopsychosocial profile and active secondary prevention. Further progress depends on diagnostic standardization and higher-quality research.