Abstract

Temporomandibular disorders (TMD) comprise a complex set of musculoskeletal and functional conditions affecting the temporomandibular joints and/or masticatory muscles. Despite advances in diagnostic and therapeutic approaches, recurrence and chronic symptoms remain common. A growing body of evidence supports a biopsychosocial model, highlighting the interplay of biomechanics, psychoemotional factors, habitual behaviors, and sleep disorders in both etiology and treatment. Surgical approach with mini-invasive techniques are the first-line approach for most intra-articular conditions. Muscular dysfunctions can undermine intra-articular treatments unless addressed through structured rehabilitation. This editorial proposes an integrated model combining the intra-articular procedures, Ângelo Botulinum Toxin Protocol®, specialized physiotherapy, sleep improvement,  behavioral and emotional interventions. Anxiety, depression, and parafunctional habits significantly contribute to symptom persistence. Caution is advised with intraoral devices and irreversible procedures like third molar extraction, occlusal adjustments, and orthodontics, which must be individually assessed, especially in TMD patients. A comprehensive, multidisciplinary approach targeting mechanical, psychological, and behavioral factors, supported by surgical treatment and ongoing physiotherapy, as essential for long-term clinical success in TMD management.

Keywords

• temporomandibular disorders
• muscle dysfunction
• arthroscopy
• botulinum toxin
• physiotherapy
• biopsychosocial model

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