A recent article in CRANIO, “The temporomandibular joint disc: A complex fable about an elusive butterfly” by Louis G. Mercuri, Charles S. Greene, and Daniele Manfredini, published on April 10, 2025, challenges long-standing beliefs about the temporomandibular joint.
Understanding the TMJ and Its Disc
The temporomandibular joint connects the jawbone to the skull and includes a small soft tissue disc that acts as a cushion and shock absorber between the bones. Historically, misalignment or displacement of this disc has been thought to cause Temporomandibular Disorders (TMDs), leading to treatments aimed at repositioning the disc.
Shifting the Focus: Synovitis Over Disc Position
The authors argue that inflammation of the joint lining, known as synovitis, especially when it becomes chronic, is a more significant factor in TMJ pain and dysfunction than disc position. This perspective suggests that treatments should prioritize reducing inflammation rather than correcting disc alignment.
Implications for Treatment
Recognizing synovitis as a primary cause of symptoms of TMDs encourages the use of non-invasive, conservative treatments focused on managing inflammation. This approach may help patients avoid unnecessary and potentially irreversible and costly procedures aimed at repositioning the TMJ disc.
Conclusion
This research invites both healthcare providers and patients to reconsider the emphasis placed on TMJ disc position in diagnosing and treating TMDs. By focusing on inflammation management, there is potential for more effective and less invasive treatment options.