Zhaoyichun Zhang1,2,3  · Shibin Yu4  · Shengxi Wu2,3  · Zuolin Jin1  · Ze Fan2,3,5  · Jing Huang2,

1 State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China 

2 Department of Neurobiology, Basic Medical Science Academy, The Fourth Military Medical University, Xi’an 710032, China 

3 The Shaanxi Province Key Laboratory of Brain Function Analysis and Modulation, Xi’an 710032, China 

4 State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Oral Anatomy and Physiology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China 

5 State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Anesthesiology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China

Abstract

Temporomandibular disorders (TMDs) comprise a spectrum of conditions affecting the temporomandibular joint, masticatory musculature, dental occlusion, and even multiple systemic structures. Epidemiological data indicate that approximately 40% of patients with TMDs experience comorbid affective disorders, creating complex diagnostic and therapeutic challenges, further resulting in suboptimal management. This review summarizes the comorbidity spectrum of TMDs, especially focusing on the bidirectional relationship between TMD-related pain and affective disorders, with the aims of (1) elucidating shared neurobiological mechanisms involving central sensitization, maladaptive neuroplasticity, and neuro-endocrine-immune dysregulation in TMDs; (2) analyzing the role of psychosocial factors in perpetuating this comorbidity; and (3) evaluating evidence-based treatment strategies that address both somatic and psychological symptoms. This review concludes by highlighting emerging new technologies with the potential for improved risk assessment and advocates for personalized treatment paradigms in this complex patient population. Future research directions should prioritize longitudinal studies examining the trajectories of comorbidity as well as testing emerging intervention approaches.

Keywords

Temporomandibular disorders; Chronic pain; Affective disorder; Comorbidity

[SpringerLink]