Comparative Analysis of Evidence Based Practices of Biomechanical Modeling and Clinical Management of TMJ Disc Displacement: A Systematic Review and Meta-Analysis

Background: TMJ disc displacement without reduction (DDWoR) results in excruciating pain and functional issues. The management of TMJ disc displacement without reduction has improved thanks to biomechanical modelling and clinical interventions; however, more work is required to integrate biomechanical insights with patient outcomes. The goal of this review was to combine clinical and biomechanical data regarding treatment approaches for disc displacement without reduction in the temporomandibular joint (TMJ). Methods: The review's systematic evaluation procedure was carried out under PRISMA 2020 guidelines. PubMed, Web of Science, and Scopus databases were used in the study conducted in April 2025. Finite element biomechanical models, clinical trials, or cohorts assessing treatment outcomes were included in the studies that were approved for analysis. The GRADE methodology was used to evaluate the evidence certainty, and a fixed-effect analysis of randomised controlled trials was conducted. Results: Five biomechanical modelling studies and five clinical studies were included in the research analysis. Both mandibular springs and splints showed their capacity to redistribute stress in the joint area within models. The combination of arthrocentesis and splint treatments resulted in a pooled risk ratio of 1.46 (95% CI 1.17–1.82) with transparent result consistency (I² = 0%) and positive effects on maximum mouth opening and pain reduction. The levels of evidence that were obtained were moderate to high. Discussion: The effectiveness of splint and arthrocentesis treatments for TMJ disc displacement was supported by a combined strategy that incorporated biomechanical research and clinical observations. Future studies must create customized patient models and run experiments in several medical facilities instead of one.