Anatomy and variations of the temporomandibular joints and masticatory muscles − clinical implications

Abstract

Introduction. Contemporary approaches to dental treatment increasingly emphasize the comprehensive assessment of the functioning of the stomatognathic system, a key component of which is the temporomandibular joint (TMJ) and the masticatory muscles. Due to their complex anatomy and function, TMJ disorders (TMD) are becoming an increasingly common subject of interdisciplinary diagnostics and therapy. Aim. The aim of the study was to present practical aspects of normal anatomy and anatomical variations of the temporomandibular joints and masticatory muscles, together with their clinical significance, especially in the context of diagnosis and treatment of TMJ disorders. Material and methods. A literature review was conducted in the PubMed/Medline databases, encompassing English-language publications from 2000-2025 and selected older, substantively relevant publications. Review articles, original studies, and case reports were included. The analysis included 68 papers that assessed normal anatomy, morphological variants, and associations with TMJ function and pathology. Results. Significant anatomical variability was observed in the TMJ components, particularly the shape of the condylar process and ligamentous structures, which significantly influence the biomechanics of the joint. These variability may predispose to disc displacement, pain syndromes, and degenerative changes. Functional stimuli (e.g., parafunctions, open bite) may lead to joint remodeling, and some variations − such as a bifid condyle − may be associated with the development of pathology. Conclusions. Understanding the detailed anatomy of the TMJ and masticatory muscles, as well as their anatomical variations, is essential for the effective diagnosis and treatment of TMD. Modern imaging techniques and functional studies allow for the identification of structural and functional changes that influence the patient’s clinical condition. The relationship between joint morphology and function emphasizes the need for an interdisciplinary approach to therapy, and future research directions should include the development of tissue engineering methods for the treatment of advanced degenerative changes in the TMJ.