NON-STEROIDAL ANTI-INFLAMMATORY AGENTS IN TEMPOROMANDIBULAR JOINT DISORDERS: CURRENT EVIDENCE AND THERAPEUTIC PERSPECTIVES

Temporomandibular joint disorders (TMDs) represent a prevalent group of musculoskeletal conditions that significantly affect oral function and quality of life. Inflammation plays a central role in the pathogenesis of TMDs, contributing to pain, joint dysfunction, and progressive structural damage. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used as first-line pharmacological agents to alleviate pain and control inflammation in TMDs. Their mechanism of action is based on the inhibition of cyclooxygenase (COX) enzymes, which reduces prostaglandin synthesis and attenuates inflammatory responses. Both non-selective NSAIDs and selective COX-2 inhibitors have demonstrated clinical efficacy in reducing TMJ pain and improving joint function, particularly in acute and inflammatory TMDs. However, concerns regarding gastrointestinal, renal, and cardiovascular adverse effects, especially with prolonged systemic use, necessitate careful patient selection and consideration of alternative administration routes, such as topical or intra-articular formulations. Current clinical evidence supports the short-term efficacy of NSAIDs, but their role in chronic TMDs and optimal treatment protocols remains a subject of debate. This review summarizes the available evidence regarding NSAID use in TMDs, highlights their therapeutic limitations, and discusses future research directions aimed at optimizing safety and clinical outcomes.