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Underlying Causes of TMD 

The development and persistence of temporomandibular disorder (TMD) result from a complex interplay of various contributing factors that can reinforce and chronify each other. These can be categorized into the following dimensions: 

1. Structural and Functional Factors 

  • Jaw joint misalignments, incongruent joint surfaces, degenerative cartilage changes 
  • Occlusal interferences, poorly fitted restorations, dental misalignments 
  • Muscular imbalances in the masticatory system, disturbed neuromuscular control 

2. Biomechanical and Postural Influences 

  • Postural asymmetries, e.g., in the cervical spine or pelvis 
  • Imbalances in muscular chains that transfer tension to the jaw region 
  • Improper loading due to unilateral chewing or movement habits 

3. Psychosocial and Emotional Aspects 

  • Chronic stress, emotional tension, inner restlessness 
  • Coping mechanisms such as clenching or grinding as physical responses to psychological strain 
  • The influence of anxiety, chronic pain, or depressive disorders on muscle tone and pain perception 

4. Behavioral Components 

  • Parafunctional activities like bruxism, lip biting, or nail chewing 
  • Sleep disorders or poor sleeping positions 
  • Poor posture caused by prolonged screen time or lack of physical activity 

5. Systemic and Pathophysiological Influences 

  • Inflammatory-rheumatic conditions 
  • Hormonal imbalances 
  • Neurological or vascular dysfunctions affecting neuromuscular coordination 

This wide range of contributing factors underscores that TMD is a complex condition with highly individualized causes. Successful diagnosis and treatment therefore require a holistic and interdisciplinary approach.