Advances in Temporomandibular Disorders and Orofacial Pain: Mechanisms, Imaging Biomarker Integration, and Minimally Invasive Care Pathways

Temporomandibular disorders (TMDs) and orofacial pain conditions represent a heterogeneous group of musculoskeletal and neuropathic disorders characterized by multifactorial etiology and substantial impact on function and quality of life. Despite growing scientific evidence, translation of emerging knowledge into standardized, patient-centered care pathways remains inconsistent.Recent advances in pathophysiological understanding highlight the interaction between peripheral tissue alterations, central pain modulation, psychosocial factors, and parafunctional behaviors. Concurrent developments in imaging - particularly magnetic resonance imaging, cone-beam computed tomography, and emerging quantitative imaging biomarkers - are improving structural and inflammatory assessment, enabling refined phenotyping and more precise treatment planning.In parallel, minimally invasive and targeted therapeutic approaches are gaining prominence. These include arthrocentesis, intra-articular injections, regenerative and biologic adjuncts, and image-guided procedures aimed at restoring joint function while minimizing morbidity. Additionally, botulinum toxin type A (BoNT-A) has emerged as a selective neuromodulatory therapy for refractory myofascial pain, muscle hyperactivity, and bruxism-related overload, offering a mechanism-based adjunct within multimodal care strategies.The challenge remains integrating mechanistic insights, imaging findings, and targeted therapies into coherent and personalized treatment pathways.This Research Topic aims to provide a multidisciplinary update on TMD and orofacial pain by focusing on:• biological and biomechanical mechanisms underlying disease progression;• imaging biomarkers for diagnosis, prognosis, and treatment stratification;• minimally invasive and image-guided therapeutic strategies;• neuromodulatory approaches including botulinum toxin applications;• translational research bridging mechanistic insights with clinical decision-making;• development of evidence-based, patient-centered care pathways.By bringing together clinicians, imaging specialists, pain researchers, and rehabilitation experts, this collection seeks to refine diagnostic frameworks and promote personalized management strategies capable of improving functional outcomes and patient quality of life. Topic editors: Matteo Val, Margherita Gobbo Source: https://www.frontiersin.org/research-topics/82254/advances-in-temporomandibular-disorders-and-orofacial-pain-mechanisms-imaging-biomarker-integration-and-minimally-invasive-care-pathways