Publication trends on temporomandibular disorders: a bibliometric analysis

Publication trends on temporomandibular disorders: a bibliometric analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Publication trends on temporomandibular disorders: a bibliometric analysis Camilo León-Morales, Oliver Leissner, Monal Yuwanati, Diego De Nordenflycht, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8538538/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Aim. To synthesize and analyze citation performance in the field of temporomandibular disorders (TMD) and address innovative methods to improve research in this field. Methods. A structured search of the Scopus database was performed using Boolean operators and relevant keywords, including “temporomandibular disorder” and its variations. Only English written articles were included. Data was processed and analyzed using R-Studio for statistical operations and VOSviewer for visualizing bibliometric networks. Key parameters assessed included annual publication trends, authorship patterns, institutional output, keyword co-occurrence, and international collaborations. Comprehensive data cleaning was applied to ensure the accuracy and integrity of data. Results. The dataset included 6,269 articles, revealing a substantial increase in TMD-related research, particularly from the year 2000 onwards. The most significant publication peak was observed in 2024, with 485 articles. Leading journals included Journal of Oral Rehabilitation, Cranio, and Journal of Oral and Maxillofacial Surgery. The University of São Paulo was the top contributing institution, followed by Sichuan and Peking Universities. Prolific authors such as Lobbezoo, Manfredini, and Svensson were identified as key contributors. Brazil, USA, and China emerged as the top publishing countries, though international collaborations remained modest (17.39%). Keywords like “female,” “adult,” “temporomandibular joint disorder,” and “pathophysiology” dominated the literature, while keyword trend analysis revealed a shift from diagnostic terms to themes involving “pain,” “myofascial dysfunction,” and “treatment outcomes”. Conclusion. TMD research has grown substantially in volume and scope in recent decades. While key institutions and authors have driven progress, limited international collaboration highlights opportunities for stronger global partnerships. This bibliometric profile provides a valuable resource for guiding future research directions, encouraging more integrated, interdisciplinary, and patient-centered approaches in the study and management of TMD. Dentistry Temporomandibular Joint Dysfunction Syndrome Pain Myofascial Pain Headaches Pathophysiology Bibliometrics Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 1. Introduction Temporomandibular disorders (TMD) are a group of musculoskeletal conditions affecting the masticatory system that are best defined based on symptoms and signs reflecting the underlying disease process. These conditions affect the temporomandibular joint, the masticatory muscles, and other nearby structures (1). TMD can be painful or non-painful conditions altering the orofacial biomechanics and functions. According to recent systematic reviews, the overall prevalence of TMD is approximately 31.1% for adults/elderly and 11.3% for children/adolescents ( 2 – 4 ). Most prevalent TMD diagnoses are disc displacement with reduction in adults (25.9%) and children/adolescents (7.4%), and degenerative joint disease in adults/elderly (9.8%) and children/adolescents (0.4%). The most prevalent painful TMD is myalgia ( 2 , 5 ). Painful TMD are also emotional disruptors, causing suffering and negative feelings such as anxiousness, stress, guilt, misery, isolation, and even sleeping difficulties, which could lead to the development of depression or other psychiatric conditions ( 6 , 7 ), being women more susceptible than men ( 8 ). Considering the impact of these conditions on the general population, knowing about the characteristics of scientific evidence that contributes to the knowledge and development of health providers is critical. In recent years, the volume of scientific literature on TMD has grown significantly, with new studies being published daily in peer-reviewed journals. While this expansion reflects an increasing interest and progress in the field, it also presents a major challenge: navigating through an overwhelming amount of information to identify the most relevant and influential contributions ( 9 – 12 ). Bibliometric analysis is a quantitative method which applies mathematical and statistical tools to evaluate the inter-relationships and impacts of publications, authors, institutions and countries in a specific research area ( 12 ), which identifies the impact of publications and research groups in their field of research and to quantify and qualify the available evidence. This type of analysis makes it simpler to study and decode the developments of a subject and to pursue the dynamics and evolution of scientific knowledge. Also, bibliometrics is a powerful tool to comprehensively review research trends, investigate publication performances, and provide future perspectives ( 5 ). Moreover, it facilitates the identification of leading journals and publication outlets within a specific discipline, guiding researchers on where to publish their work. It also enhances interdisciplinary collaboration by showing how different fields are connected through shared research topics or citations ( 10 ). Hence, this bibliometric study will analyze TMD in the Scopus database to look for publication trends, institutions, authors, author trends, keywords, keywords plus, and research collaborations. The purpose of this bibliometric analysis is to synthesize and analyze citation performance in the field of TMD and address innovative methods to improve research in this field. 2. Methods 2.1 Data sources and search strategies This bibliometric study was conducted by searching the Scopus database for publications on TMD till date since inception (last search was carried out on 13 February 2025). It employed a structured search strategy using Boolean operators to effectively refine the search results ( Supplementary Appendix A ). The keywords and other relevant terms related to TMDs and associated themes such as diagnosis, treatment modalities, pathophysiological mechanisms, epidemiology, bruxism, temporomandibular joint (TMJ) dysfunction, or occlusal therapies were used for the search. 2.2 Screening and Selection Documents were included if they focused on TMDs or associated themes such as diagnosis, treatment modalities, pathophysiological mechanisms, epidemiology, bruxism, temporomandibular joint (TMJ) dysfunction, or occlusal therapies. Only peer-reviewed documents published in English were included. The search was confined to documents indexed in the Scopus database due to its large sources coverage. Additionally, only records with complete bibliographic information such as title, authorship, abstract, keywords, and citation details were analysed. Exclusion criteria comprised records not directly related to TMDs, studies primarily investigating unrelated anatomical structures or conditions. Review, Book, Conference Proceeding/Paper, Book Series, Editorial, Letter, Note, Short Survey, Erratum, Retracted, Data Paper, and Trade Journal were excluded. 2.3 Bibliometric analysis and visualization. Final included records with full bibliographic information were exported. The data file was imported in Biblioshiny App through R Studio bibliometrix Package ( 13 ) to perform descriptive as well as quantitative summary analysis which included publication trends and metrics, top authors, top contributing institution, most cited sources and documents, country and authors collaborations, citation networks, and keyword trends. VOS Viewer software ( 14 ) was used for the visualization of conceptual, intellectual, and social structures, helping to identify influential contributors, emerging topics, and collaborative dynamics. 3. Results The Scopus database search retrieved 18,028 from which 6,269 documents were selected and included for bibliometric analysis after filtering the results (Fig. 1 ). 3.1 Bibliometric database characteristics The main characteristics of bibliometric research are shown in Table 1. 3.2. Publication trend and output The progression of scholarly output pertaining to TMD from 1965 to 2025 illustrates a marked increase in academic engagement and research diversity within this complex field. During the initial period from 1965 to 1983, publications were limited, with a mere single article identified in 1965, escalating to 30 articles by 1983. This early era likely reflects the foundational research aimed at identifying and characterizing disorders related to the temporomandibular joint and associated structures. As the field advanced into the late 20th century, particularly throughout the 1990s and early 2000s, there was a notable rise in the recognition of TMD multifactorial etiology, encompassing dental, oral and maxillofacial considerations, psychological influences, and aspects of rehabilitative medicine. This interdisciplinary approach has likely facilitated a substantial increase in research output. By the early 2000s, the data indicated a dramatic surge in publications, reflecting an expanding knowledge base and a diversification of research focus, including pain management strategies, psychological factors influencing these disorders, and innovative therapeutic interventions. There is a peak observed in 2024, with a total of 485 published articles, which signifies a critical maturation of the field (Fig. 2 ). This escalation can be attributed to advancements in diagnostic modalities, enhanced technological capabilities, and a more profound understanding of the biopsychosocial model of pain, which integrates both biological and psychological factors. Furthermore, this increase in literature is indicative of a heightened awareness of TMD among healthcare providers and the general population, resulting in improved clinical approaches and an enriched body of work addressing various aspects of TMD management. Research on TMD is concentrated in key dental journals, with the Journal of Oral Rehabilitation leading with 681 articles, followed by Cranio - Journal of Craniomandibular and Sleep Practice with 355 articles and Journal of Oral and Maxillofacial Surgery with 327 publications (Fig. 3 A). The Journal of Oral Rehabilitation has the highest impact with a H-index of 61, followed by the Journal of Orofacial Pain with 60, and the Journal of Oral and Maxillofacial Surgery with 56 (Fig. 3 b). This concentration reflects a strong focus on TMD research within these core publications. Additionally, most cited articles are shown in Fig. 4 . 3.3. Institutions and authors Research on TMD shows substantial contributions from various institutions globally. The University of São Paulo in Brazil leads with 399 articles, followed by Sichuan University with 321 and Shanghai Jiao Tong University School of Medicine with 199 from China. In North America, the University of Minnesota and the University of Washington contribute 126 and 123 articles, respectively. European institutions, such as the Malmö University (184), University of Amsterdam (171), University of Padova (110) and Karolinska Institutet in Sweden (98), also play significant roles. Figure 5 reveals that the five institutions with the highest publication rates have consistently increased over the years. Additionally, Fig. 6 displays the authors that published the highest number of articles on TMD over time. The top ten authors are led by Lobbezoo with 116 publications, Manfredini with 74, Svensson with 73 and Carlsson with 58 publications. 3.4. Authorship trends The United States leads in the total number of published articles (3609), followed by Brazil (3315), China (2190), Japan (1995), and Italy (1472). In terms of citation impact, the United States also ranks highest with 18840 citations, followed by Brazil with 10152 and Italy with 7147. An examination of publication trends across countries offers insights into patterns of authorship, particularly regarding the choice between single and multiple corresponding authors. A clear majority of articles from these leading countries favor a single corresponding author, as illustrated in Fig. 7 . The bibliometric indicators, such as the number of co-authors per article (mean 4.46) and proportion of international collaborations (17.39%), reveal moderate but growing cross-national research activity. 3.5. Global TMD article's collaborations The collaboration landscape in research related to TMD showcases a diverse array of international partnerships, particularly highlighted by the active involvement of countries like the USA (49 countries, 590 articles), Brazil (29 countries, 194 articles), and China (25 countries, 111 articles). The global collaboration map is displayed in Fig. 8 . 3.6. Most frequent keywords The data presents the frequency of various terms related to health research, highlighting a significant focus on gender and age demographics, as well as specific health conditions. The term “female” appears 7,061 times, closely followed by “male” at 6,362 occurrences. “Adult” and “human” also feature prominently, with 5,773 and 5,656 mentions, respectively. In terms of specific conditions, “temporomandibular joint disorder” and its variations account for significant occurrences, indicated by 3,463 and 3,325 mentions. The broad term “article” appears 3,234 times, reflecting the overall volume of published works. Age-related terms like “adolescent”, “middle aged”, and “aged” indicate a diverse age representation, while “facial pain” and “face pain” are notable with 1,693 and 1,455 occurrences, respectively. “Pathophysiology” appears 1,147 times, emphasizing an interest in the underlying mechanisms of disorders, and “treatment outcome” is mentioned 1,037 times, pointing to a focus on the effectiveness of various interventions. Overall, the data underscores the diverse areas of interest within healthcare research, particularly related to demographics and temporomandibular joint disorders. 3.7. Trending topic of keywords over time The data presented highlights several notable trends in research publications related to various health topics from 1987 to 2022. “Temporomandibular joint dysfunction syndrome” saw a peak in research activity, reaching 670 publications since 1987, which indicates an increasing recognition of TMJ disorders over time, particularly notable around 1997 and again in 2008. Similarly, the term "pain" has been documented, with a total of 654 publications recorded between 2004 and 2022. The data indicates a notable focus on pain-related research within this time frame, suggesting that it has remained a significant area of inquiry in the health sciences. “Myofascial pain” has also attracted consistent interest, with 587 publications beginning in 1988, especially between the late 1990s and early 2000s. Research on “headaches” accumulated 563 publications, gaining momentum from 1996 onward with clear growth evident through 2015. “Pathophysiology” emerged as the most frequently researched topic, boasting 1,147 publications and demonstrating a consistent upward trend from 1995 through the following decades. Lastly, the broad term “article” recorded the highest frequency, with 3,234 publications, indicating a substantial volume of published works beginning in this time frame. Results regarding trending topic of keywords over time are shown in Fig. 9 . 4. Discussion The present bibliometric analysis shows a detailed and data-driven overview of research activity in the field of TMD over the last six decades. The results demonstrate a significant and sustained increase in academic output, particularly over the past two decades, reflecting the growing complexity and clinical importance of TMD. Key contributors, including prolific authors, top institutions, and leading journals, have shaped a research environment that is increasingly interdisciplinary and globally collaborative ( 11 , 15 , 16 ). This study presents a large-scale bibliometric dataset comprising 6,269 articles on TMD published between 1965 and early 2025, drawn from the Scopus database. The high volume of references (166,850) and average citation count per document (24.29) indicate a mature and well-integrated field of research. The inclusion of a wide range of document types, although focused exclusively on English written articles, ensures consistency in citation behavior and enhances comparability. The average document age of 14.4 years reflects both historical depth and continued relevance, consistent with similar analyses in TMD research ( 5 , 9 , 10 ). The exponential increase in publications, particularly after the year 2000, signals a pivotal shift in how TMD is conceptualized and managed. This growth correlates strongly with advances in diagnostic criteria-most notably the introduction and refinement of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and its evolution into the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). These frameworks have standardized clinical and research definitions, enabling more consistent data reporting and international collaboration. Furthermore, the surge in 2024 publications, culminating in a peak of 485 documents, could be attribute to increase in prevalence of TMD secondary to psychological stress among population during and post-covid (2020–2023) ( 17 ). Regarding the key dental journals with the highest number of articles, present results are like those found by other authors ( 18 , 19 ). In line with these developments, the analysis of top-cited articles reflects a sustained focus on epidemiology, diagnostic reliability, and the psychosocial dimensions of TMD. The foundational works by Dworkin et al. (1990) and Lipton et al. (1993) continue to anchor current research, emphasizing the persistent value of robust epidemiological data, these results may variate with those found by other authors, depending on the methodology used to conduct the research ( 9 , 10 , 20 ). The dominance of institutions such as the University of São Paulo, Sichuan University, and Peking University highlights the geographic diversification of TMD research. Brazilian institutions, in particular, have benefited from strong public health policies and investment in oral health research, while Chinese centers have scaled publication output through national science initiatives ( 5 , 21 ). Well-known authors like Lobbezoo, Manfredini, and Svensson are acknowledged not just for how much they publish but also for their role in creating agreements and developing clinical guidelines; these highly cited authors are similar to those found in other studies based on the research year, but they differ when looking specifically at children ( 9 , 20 ). The analysis of authorship structures revealed that Brazil leads in total publication volume, followed closely by the United States and China. Most articles are authored by single corresponding authors, a pattern typical of clinical specialties with strong academic hierarchies ( 2 , 11 ). However, the relatively low rate of multiple corresponding authors (MCP) may indicate opportunities to further enhance collaboration, particularly across disciplines such as neurology, physical therapy, and behavioral science ( 22 , 23 ). Regarding the low rate of international co-authorship (17.39%), though improving, it suggests a need to strengthen global research networks; these metrics are comparable to other clinical subspecialties and reflect increased emphasis on team science and multidisciplinary approaches to pain and dysfunction ( 1 , 12 ). Platforms like the International Network for Orofacial Pain and Related Disorders (INfOrm) from the International Association of Dental Research (IADR) could serve as catalysts for such transnational synergies ( 24 , 25 ). Keyword frequency analysis revealed a dominant focus on gender and age demographics (“female,” “male,” “adult”) alongside core clinical terms such as “temporomandibular joint disorder” and “facial pain.” However, keyword analysis showed under-representation research on pediatric TMD even though few systematic review highlighted prevalence of TMD among this population ( 4 , 20 ). The high occurrence of terms related to “pathophysiology” and “treatment outcome” suggests an increasing orientation toward understanding disease mechanisms and evaluating therapeutic efficacy-key pillars of evidence-based care ( 22 , 26 , 27 ). Keyword trends from 1965 to 2025 reveal the evolving focus of TMD research in parallel with changes in diagnostic frameworks, therapeutic priorities, and patient-centered care. Early peaks in “temporomandibular joint dysfunction syndrome” reflect pre-RDC/TMD and DC/TMD terminology, while sustained attention to “pain” and “myofascial pain” emphasizes ongoing symptom-centered approaches ( 28 ). The rise of “headaches” highlights growing recognition of comorbid craniofacial pain disorders and interdisciplinary management, and the prominence of “pathophysiology” signals a shift toward mechanistic understanding supported by advances in neurophysiology and imaging ( 29 ). Recurrent gender- and age-related terms further illustrate the field’s movement toward personalized diagnosis and precision-based interventions and interdisciplinary care ( 30 ). This bibliometric analysis aims for a patient-centered approach that integrates biopsychosocial factors, emphasizing shared decision-making, patient-reported outcomes, and coordinated interdisciplinary management in the TMD field. As dental healthcare providers, our responsibility extends beyond oral health to encompass the patient’s overall well-being ( 31 ). Identifying and educating patients about underlying influencing factors, while providing them with self-management skills, not only improves their capacity to manage current pain but also empowers them to better cope with future painful or traumatic events ( 32 ). Finally, this approach also coexists with scientific literature that shows an overproliferation of systematic reviews in TMD, often conducted by individuals without specific expertise in the subject, which may contribute little to advancing knowledge. Aspiring TMD researchers are encouraged to prioritize original clinical research, thereby acquiring the subject-matter expertise, methodological skills, and critical judgment necessary to interpret and apply evidence effectively. Such an approach looks for a deeper understanding of the methodological, clinical, research, and patient-centered dimensions of evidence-based dentistry ( 33 ). Although a rigorous methodology was performed to identify general publication trends, the following gaps and limitations should be considered: 1. Only a single database was used to obtain the publication trends, which may leave some relevant published articles outside the results; 2. only English-written articles were included, which may have an impact on the results considering that a critical amount of articles are published in Chinese, Portuguese, or Spanish and may even be considered bias; 3. no specification of the patient age was incorporated, in terms of adults or children, which may lead to some underestimation of the pediatric population; 4. no classification of study design was performed, which would be interesting to objectively recognize the apparent lack of primary study in some specific topics; and finally 5. considering that there is an apparent insufficient interdisciplinary collaboration in the TMD field, which has led to a knowledge gap, the present method did not incorporate keywords from related disciplines. 5. Conclusion This bibliometric analysis functions as both a guiding framework and a reference point, offering key insights for researchers, clinicians, and policymakers seeking to advance the understanding, diagnosis, and management of TMD. The field has transitioned from foundational characterization to complex investigations involving neurobiology, psychosocial variables, and patient-reported outcomes. Moving forward, continued emphasis on global collaboration, high-quality clinical trials, and integration with broader pain science frameworks will be critical for translating research into effective, individualized patient care. Declarations Conflict of interest statement: The authors declare no conflicts of interest with respect to the authorship or publication of this article. Funding sources: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Author Contributions: Conceptualization: CL-M, OL, AG, and AC; Investigation & validation: CL-M, OL, MY, DDN, NA, and AC ; Formal analysis: CL-M, OL, DDN, MY, and NA ; Writing – Original Draft: CL-M, DDN, MY, AC and NA ; Writing – Review & editing: All authors. Data availability statement: All data used in this study is publicly available from the Scopus database. The dataset is available upon reasonable request from the corresponding author. References Ohrbach R, Sharma S (2024) Temporomandibular disorders: Definition and etiology. Semin Orthod [Internet]. ;30(3):237–42. Available from: http://dx.doi.org/10.1053/j.sodo.2023.12.011 Valesan LF, Da-Cas CD, Réus JC, Denardin ACS, Garanhani RR, Bonotto D et al (2021) Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis. Clin Oral Investig [Internet]. ;25(2):441–53. 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A commentary on current publishing trends in the field of temporomandibular disorders and bruxism. J Oral Rehabil [Internet]. ;46(1):1–4. Available from: http://dx.doi.org/10.1111/joor.12707 Table Table 1 is available in the Supplementary Files section. Additional Declarations The authors declare no competing interests. Supplementary Files Table1.docx Summary of the main characteristics of the bibliometric dataset SupplementaryAppendixA.docx Search terms & strategy used in Scopus database Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8538538","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":570660618,"identity":"81c5cbcc-fa8f-4705-abbc-1d639920a7ff","order_by":0,"name":"Camilo León-Morales","email":"","orcid":"","institution":"Department of Oral Physiology, Temporomandibular Disorders and Orofacial Pain, Universidad de Valparaíso, Valparaíso, Chile","correspondingAuthor":false,"prefix":"","firstName":"Camilo","middleName":"","lastName":"León-Morales","suffix":""},{"id":570660619,"identity":"131d0ebe-40f0-44ba-92c9-908fb37781d9","order_by":1,"name":"Oliver 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Nordenflycht","suffix":""},{"id":570660622,"identity":"29d2bcf0-a31c-4f60-93c3-51f5e2653632","order_by":4,"name":"Akhilanand Chaurasia","email":"data:image/png;base64,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","orcid":"https://orcid.org/0000-0002-8356-9512","institution":"Department of Oral Medicine and Radiology, King George’s Medical University, 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06:05:32","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":93534,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8538538/v1/83826b2b82608b34d042ed78.html"},{"id":100010346,"identity":"cd828572-8193-47bc-9fc4-f23241d909e7","added_by":"auto","created_at":"2026-01-12 06:05:31","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1734719,"visible":true,"origin":"","legend":"\u003cp\u003ePRISMA flowchart (Search strategy and selection process)\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8538538/v1/19fb2cf36be8fd10975664b7.jpg"},{"id":100010350,"identity":"f7615068-b1dd-47b9-bd72-5f0bff71ae03","added_by":"auto","created_at":"2026-01-12 06:05:31","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":806260,"visible":true,"origin":"","legend":"\u003cp\u003eAnnual publication of articles in the TMD field from 1965 to February 2025.\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8538538/v1/462e66900967e6306bedfee9.jpg"},{"id":100362017,"identity":"931cedb6-e07c-4bdc-b274-d6601990a938","added_by":"auto","created_at":"2026-01-16 07:46:05","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":260082,"visible":true,"origin":"","legend":"\u003cp\u003eA- Top journals with the largest number of articles in the TMD field\u003c/p\u003e","description":"","filename":"Figure3A.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8538538/v1/eaf9a873ee7aadbd312cb925.jpg"},{"id":100361534,"identity":"b6c8a9c6-9eea-4352-b6a6-2e15b1892f29","added_by":"auto","created_at":"2026-01-16 07:45:15","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":921414,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 3B- the quality and relevance of their publications expressed in the H-index.\u003c/p\u003e","description":"","filename":"Figure3B.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8538538/v1/d445ac0fbf8378244a546c87.jpg"},{"id":100010351,"identity":"b17452e1-4bcf-45f1-a80d-619d862612d2","added_by":"auto","created_at":"2026-01-12 06:05:31","extension":"jpeg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":169790,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 4: Top 10 most globally cited articles with the number of total citations.\u003c/p\u003e","description":"","filename":"Figure4.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8538538/v1/9a9f78e671d7fb908628759d.jpeg"},{"id":100010357,"identity":"cefec4ef-4214-46c7-8ce0-1bb7f6f9a6a3","added_by":"auto","created_at":"2026-01-12 06:05:32","extension":"jpg","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":484897,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 5: Top five institutions with the most articles published and their production over the time between 1996 and February 2025.\u003c/p\u003e","description":"","filename":"Figure5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8538538/v1/5cc90601b48b74aa7afcbc36.jpg"},{"id":100010355,"identity":"dadafd89-5acc-40d3-a3f8-66d2036dbe4c","added_by":"auto","created_at":"2026-01-12 06:05:31","extension":"jpg","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":1267759,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 6: The top 10 authors’ productivity over time, with the number of published articles represented by the size of the circles and total citations (TC) indicated by their colour.\u003c/p\u003e","description":"","filename":"Figure6.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8538538/v1/569df8ae6326a4f747fb8d40.jpg"},{"id":100010360,"identity":"885a7d72-c3b3-42c2-b26f-39344ee0971a","added_by":"auto","created_at":"2026-01-12 06:05:32","extension":"jpg","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":988093,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 7: Publications by corresponding authors by country, distinguishing between single-country publications (SCP) and multiple-country publications (MCP).\u003c/p\u003e","description":"","filename":"Figure7.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8538538/v1/bc131c4ac43467bdf37f56f5.jpg"},{"id":100010356,"identity":"401ee053-8b70-4891-a6d2-13d95a75a80d","added_by":"auto","created_at":"2026-01-12 06:05:31","extension":"jpg","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":189953,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 8: Global visualization of country collaborations and partnerships mapping the landscape of TMD articles.\u003c/p\u003e","description":"","filename":"Figure8.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8538538/v1/c04ac0e42af729d45314169f.jpg"},{"id":100361723,"identity":"f437a443-3b63-4247-a8c9-765c04fe0d76","added_by":"auto","created_at":"2026-01-16 07:45:35","extension":"jpg","order_by":10,"title":"Figure 10","display":"","copyAsset":false,"role":"figure","size":304359,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 9: Trending topic keywords over time, with term frequency represented by the size of the circles.\u003c/p\u003e","description":"","filename":"Figure9.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8538538/v1/ddb929ba180b165c8ab70f10.jpg"},{"id":100380971,"identity":"4997ba5a-6fec-43aa-8197-b49afffc57e1","added_by":"auto","created_at":"2026-01-16 10:36:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":7737836,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8538538/v1/cc345d1e-d017-49d0-871e-6b4af7b10be3.pdf"},{"id":100010348,"identity":"5abcb58b-6d8e-4c91-b0cf-e6e3a9881e45","added_by":"auto","created_at":"2026-01-12 06:05:31","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":927085,"visible":true,"origin":"","legend":"\u003cp\u003eSummary of the main characteristics of the bibliometric dataset\u003c/p\u003e","description":"","filename":"Table1.docx","url":"https://assets-eu.researchsquare.com/files/rs-8538538/v1/eec2dff2b456c73a7a0550e0.docx"},{"id":100010344,"identity":"cff39a01-a85a-4607-b40d-3a2596275547","added_by":"auto","created_at":"2026-01-12 06:05:31","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":12769,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSearch terms \u0026amp; strategy used in Scopus database\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"SupplementaryAppendixA.docx","url":"https://assets-eu.researchsquare.com/files/rs-8538538/v1/fa01ec72a1fc1130afc204a9.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003ePublication trends on temporomandibular disorders: a bibliometric analysis \u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eTemporomandibular disorders (TMD) are a group of musculoskeletal conditions affecting the masticatory system that are best defined based on symptoms and signs reflecting the underlying disease process. These conditions affect the temporomandibular joint, the masticatory muscles, and other nearby structures (1). TMD can be painful or non-painful conditions altering the orofacial biomechanics and functions. According to recent systematic reviews, the overall prevalence of TMD is approximately 31.1% for adults/elderly and 11.3% for children/adolescents (\u003cspan additionalcitationids=\"CR3\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMost prevalent TMD diagnoses are disc displacement with reduction in adults (25.9%) and children/adolescents (7.4%), and degenerative joint disease in adults/elderly (9.8%) and children/adolescents (0.4%). The most prevalent painful TMD is myalgia (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Painful TMD are also emotional disruptors, causing suffering and negative feelings such as anxiousness, stress, guilt, misery, isolation, and even sleeping difficulties, which could lead to the development of depression or other psychiatric conditions (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e), being women more susceptible than men (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Considering the impact of these conditions on the general population, knowing about the characteristics of scientific evidence that contributes to the knowledge and development of health providers is critical.\u003c/p\u003e \u003cp\u003eIn recent years, the volume of scientific literature on TMD has grown significantly, with new studies being published daily in peer-reviewed journals. While this expansion reflects an increasing interest and progress in the field, it also presents a major challenge: navigating through an overwhelming amount of information to identify the most relevant and influential contributions (\u003cspan additionalcitationids=\"CR10 CR11\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Bibliometric analysis is a quantitative method which applies mathematical and statistical tools to evaluate the inter-relationships and impacts of publications, authors, institutions and countries in a specific research area (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e), which identifies the impact of publications and research groups in their field of research and to quantify and qualify the available evidence. This type of analysis makes it simpler to study and decode the developments of a subject and to pursue the dynamics and evolution of scientific knowledge. Also, bibliometrics is a powerful tool to comprehensively review research trends, investigate publication performances, and provide future perspectives (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Moreover, it facilitates the identification of leading journals and publication outlets within a specific discipline, guiding researchers on where to publish their work. It also enhances interdisciplinary collaboration by showing how different fields are connected through shared research topics or citations (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHence, this bibliometric study will analyze TMD in the Scopus database to look for publication trends, institutions, authors, author trends, keywords, keywords plus, and research collaborations. The purpose of this bibliometric analysis is to synthesize and analyze citation performance in the field of TMD and address innovative methods to improve research in this field.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Data sources and search strategies\u003c/h2\u003e \u003cp\u003eThis bibliometric study was conducted by searching the Scopus database for publications on TMD till date since inception (last search was carried out on 13 February 2025). It employed a structured search strategy using Boolean operators to effectively refine the search results (\u003cb\u003eSupplementary Appendix A\u003c/b\u003e). The keywords and other relevant terms related to TMDs and associated themes such as diagnosis, treatment modalities, pathophysiological mechanisms, epidemiology, bruxism, temporomandibular joint (TMJ) dysfunction, or occlusal therapies were used for the search.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Screening and Selection\u003c/h2\u003e \u003cp\u003eDocuments were included if they focused on TMDs or associated themes such as diagnosis, treatment modalities, pathophysiological mechanisms, epidemiology, bruxism, temporomandibular joint (TMJ) dysfunction, or occlusal therapies. Only peer-reviewed documents published in English were included. The search was confined to documents indexed in the Scopus database due to its large sources coverage. Additionally, only records with complete bibliographic information such as title, authorship, abstract, keywords, and citation details were analysed. Exclusion criteria comprised records not directly related to TMDs, studies primarily investigating unrelated anatomical structures or conditions. Review, Book, Conference Proceeding/Paper, Book Series, Editorial, Letter, Note, Short Survey, Erratum, Retracted, Data Paper, and Trade Journal were excluded.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Bibliometric analysis and visualization.\u003c/h2\u003e \u003cp\u003eFinal included records with full bibliographic information were exported. The data file was imported in Biblioshiny App through R Studio bibliometrix Package (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) to perform descriptive as well as quantitative summary analysis which included publication trends and metrics, top authors, top contributing institution, most cited sources and documents, country and authors collaborations, citation networks, and keyword trends. VOS Viewer software (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) was used for the visualization of conceptual, intellectual, and social structures, helping to identify influential contributors, emerging topics, and collaborative dynamics.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003eThe Scopus database search retrieved 18,028 from which 6,269 documents were selected and included for bibliometric analysis after filtering the results (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Bibliometric database characteristics\u003c/h2\u003e \u003cp\u003eThe main characteristics of bibliometric research are shown in Table\u0026nbsp;1.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.2. Publication trend and output\u003c/h2\u003e \u003cp\u003eThe progression of scholarly output pertaining to TMD from 1965 to 2025 illustrates a marked increase in academic engagement and research diversity within this complex field. During the initial period from 1965 to 1983, publications were limited, with a mere single article identified in 1965, escalating to 30 articles by 1983. This early era likely reflects the foundational research aimed at identifying and characterizing disorders related to the temporomandibular joint and associated structures. As the field advanced into the late 20th century, particularly throughout the 1990s and early 2000s, there was a notable rise in the recognition of TMD multifactorial etiology, encompassing dental, oral and maxillofacial considerations, psychological influences, and aspects of rehabilitative medicine. This interdisciplinary approach has likely facilitated a substantial increase in research output. By the early 2000s, the data indicated a dramatic surge in publications, reflecting an expanding knowledge base and a diversification of research focus, including pain management strategies, psychological factors influencing these disorders, and innovative therapeutic interventions. There is a peak observed in 2024, with a total of 485 published articles, which signifies a critical maturation of the field (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). This escalation can be attributed to advancements in diagnostic modalities, enhanced technological capabilities, and a more profound understanding of the biopsychosocial model of pain, which integrates both biological and psychological factors. Furthermore, this increase in literature is indicative of a heightened awareness of TMD among healthcare providers and the general population, resulting in improved clinical approaches and an enriched body of work addressing various aspects of TMD management.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eResearch on TMD is concentrated in key dental journals, with the Journal of Oral Rehabilitation leading with 681 articles, followed by Cranio - Journal of Craniomandibular and Sleep Practice with 355 articles and Journal of Oral and Maxillofacial Surgery with 327 publications (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e3\u003c/span\u003eA). The Journal of Oral Rehabilitation has the highest impact with a H-index of 61, followed by the Journal of Orofacial Pain with 60, and the Journal of Oral and Maxillofacial Surgery with 56 (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e3\u003c/span\u003eb). This concentration reflects a strong focus on TMD research within these core publications. Additionally, most cited articles are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.3. Institutions and authors\u003c/h2\u003e \u003cp\u003eResearch on TMD shows substantial contributions from various institutions globally. The University of S\u0026atilde;o Paulo in Brazil leads with 399 articles, followed by Sichuan University with 321 and Shanghai Jiao Tong University School of Medicine with 199 from China. In North America, the University of Minnesota and the University of Washington contribute 126 and 123 articles, respectively. European institutions, such as the Malm\u0026ouml; University (184), University of Amsterdam (171), University of Padova (110) and Karolinska Institutet in Sweden (98), also play significant roles. Figure\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e5\u003c/span\u003e reveals that the five institutions with the highest publication rates have consistently increased over the years. Additionally, Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e6\u003c/span\u003e displays the authors that published the highest number of articles on TMD over time. The top ten authors are led by Lobbezoo with 116 publications, Manfredini with 74, Svensson with 73 and Carlsson with 58 publications.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.4. Authorship trends\u003c/h2\u003e \u003cp\u003eThe United States leads in the total number of published articles (3609), followed by Brazil (3315), China (2190), Japan (1995), and Italy (1472). In terms of citation impact, the United States also ranks highest with 18840 citations, followed by Brazil with 10152 and Italy with 7147. An examination of publication trends across countries offers insights into patterns of authorship, particularly regarding the choice between single and multiple corresponding authors. A clear majority of articles from these leading countries favor a single corresponding author, as illustrated in Fig.\u0026nbsp;\u003cspan refid=\"Fig8\" class=\"InternalRef\"\u003e7\u003c/span\u003e. The bibliometric indicators, such as the number of co-authors per article (mean 4.46) and proportion of international collaborations (17.39%), reveal moderate but growing cross-national research activity.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.5. Global TMD article's collaborations\u003c/h2\u003e \u003cp\u003eThe collaboration landscape in research related to TMD showcases a diverse array of international partnerships, particularly highlighted by the active involvement of countries like the USA (49 countries, 590 articles), Brazil (29 countries, 194 articles), and China (25 countries, 111 articles). The global collaboration map is displayed in Fig.\u0026nbsp;\u003cspan refid=\"Fig9\" class=\"InternalRef\"\u003e8\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.6. Most frequent keywords\u003c/h2\u003e \u003cp\u003eThe data presents the frequency of various terms related to health research, highlighting a significant focus on gender and age demographics, as well as specific health conditions. The term \u0026ldquo;female\u0026rdquo; appears 7,061 times, closely followed by \u0026ldquo;male\u0026rdquo; at 6,362 occurrences. \u0026ldquo;Adult\u0026rdquo; and \u0026ldquo;human\u0026rdquo; also feature prominently, with 5,773 and 5,656 mentions, respectively. In terms of specific conditions, \u0026ldquo;temporomandibular joint disorder\u0026rdquo; and its variations account for significant occurrences, indicated by 3,463 and 3,325 mentions. The broad term \u0026ldquo;article\u0026rdquo; appears 3,234 times, reflecting the overall volume of published works. Age-related terms like \u0026ldquo;adolescent\u0026rdquo;, \u0026ldquo;middle aged\u0026rdquo;, and \u0026ldquo;aged\u0026rdquo; indicate a diverse age representation, while \u0026ldquo;facial pain\u0026rdquo; and \u0026ldquo;face pain\u0026rdquo; are notable with 1,693 and 1,455 occurrences, respectively. \u0026ldquo;Pathophysiology\u0026rdquo; appears 1,147 times, emphasizing an interest in the underlying mechanisms of disorders, and \u0026ldquo;treatment outcome\u0026rdquo; is mentioned 1,037 times, pointing to a focus on the effectiveness of various interventions. Overall, the data underscores the diverse areas of interest within healthcare research, particularly related to demographics and temporomandibular joint disorders.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.7. Trending topic of keywords over time\u003c/h2\u003e \u003cp\u003eThe data presented highlights several notable trends in research publications related to various health topics from 1987 to 2022. \u0026ldquo;Temporomandibular joint dysfunction syndrome\u0026rdquo; saw a peak in research activity, reaching 670 publications since 1987, which indicates an increasing recognition of TMJ disorders over time, particularly notable around 1997 and again in 2008. Similarly, the term \"pain\" has been documented, with a total of 654 publications recorded between 2004 and 2022. The data indicates a notable focus on pain-related research within this time frame, suggesting that it has remained a significant area of inquiry in the health sciences. \u0026ldquo;Myofascial pain\u0026rdquo; has also attracted consistent interest, with 587 publications beginning in 1988, especially between the late 1990s and early 2000s. Research on \u0026ldquo;headaches\u0026rdquo; accumulated 563 publications, gaining momentum from 1996 onward with clear growth evident through 2015. \u0026ldquo;Pathophysiology\u0026rdquo; emerged as the most frequently researched topic, boasting 1,147 publications and demonstrating a consistent upward trend from 1995 through the following decades. Lastly, the broad term \u0026ldquo;article\u0026rdquo; recorded the highest frequency, with 3,234 publications, indicating a substantial volume of published works beginning in this time frame. Results regarding trending topic of keywords over time are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig10\" class=\"InternalRef\"\u003e9\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe present bibliometric analysis shows a detailed and data-driven overview of research activity in the field of TMD over the last six decades. The results demonstrate a significant and sustained increase in academic output, particularly over the past two decades, reflecting the growing complexity and clinical importance of TMD. Key contributors, including prolific authors, top institutions, and leading journals, have shaped a research environment that is increasingly interdisciplinary and globally collaborative (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study presents a large-scale bibliometric dataset comprising 6,269 articles on TMD published between 1965 and early 2025, drawn from the Scopus database. The high volume of references (166,850) and average citation count per document (24.29) indicate a mature and well-integrated field of research. The inclusion of a wide range of document types, although focused exclusively on English written articles, ensures consistency in citation behavior and enhances comparability. The average document age of 14.4 years reflects both historical depth and continued relevance, consistent with similar analyses in TMD research (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe exponential increase in publications, particularly after the year 2000, signals a pivotal shift in how TMD is conceptualized and managed. This growth correlates strongly with advances in diagnostic criteria-most notably the introduction and refinement of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and its evolution into the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). These frameworks have standardized clinical and research definitions, enabling more consistent data reporting and international collaboration. Furthermore, the surge in 2024 publications, culminating in a peak of 485 documents, could be attribute to increase in prevalence of TMD secondary to psychological stress among population during and post-covid (2020\u0026ndash;2023) (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Regarding the key dental journals with the highest number of articles, present results are like those found by other authors (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). In line with these developments, the analysis of top-cited articles reflects a sustained focus on epidemiology, diagnostic reliability, and the psychosocial dimensions of TMD. The foundational works by Dworkin et al. (1990) and Lipton et al. (1993) continue to anchor current research, emphasizing the persistent value of robust epidemiological data, these results may variate with those found by other authors, depending on the methodology used to conduct the research (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe dominance of institutions such as the University of S\u0026atilde;o Paulo, Sichuan University, and Peking University highlights the geographic diversification of TMD research. Brazilian institutions, in particular, have benefited from strong public health policies and investment in oral health research, while Chinese centers have scaled publication output through national science initiatives (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Well-known authors like Lobbezoo, Manfredini, and Svensson are acknowledged not just for how much they publish but also for their role in creating agreements and developing clinical guidelines; these highly cited authors are similar to those found in other studies based on the research year, but they differ when looking specifically at children (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe analysis of authorship structures revealed that Brazil leads in total publication volume, followed closely by the United States and China. Most articles are authored by single corresponding authors, a pattern typical of clinical specialties with strong academic hierarchies (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). However, the relatively low rate of multiple corresponding authors (MCP) may indicate opportunities to further enhance collaboration, particularly across disciplines such as neurology, physical therapy, and behavioral science (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRegarding the low rate of international co-authorship (17.39%), though improving, it suggests a need to strengthen global research networks; these metrics are comparable to other clinical subspecialties and reflect increased emphasis on team science and multidisciplinary approaches to pain and dysfunction (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Platforms like the International Network for Orofacial Pain and Related Disorders (INfOrm) from the International Association of Dental Research (IADR) could serve as catalysts for such transnational synergies (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eKeyword frequency analysis revealed a dominant focus on gender and age demographics (\u0026ldquo;female,\u0026rdquo; \u0026ldquo;male,\u0026rdquo; \u0026ldquo;adult\u0026rdquo;) alongside core clinical terms such as \u0026ldquo;temporomandibular joint disorder\u0026rdquo; and \u0026ldquo;facial pain.\u0026rdquo; However, keyword analysis showed under-representation research\u003c/p\u003e \u003cp\u003eon pediatric TMD even though few systematic review highlighted prevalence of TMD among this population (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). The high occurrence of terms related to \u0026ldquo;pathophysiology\u0026rdquo; and \u0026ldquo;treatment outcome\u0026rdquo; suggests an increasing orientation toward understanding disease mechanisms and evaluating therapeutic efficacy-key pillars of evidence-based care (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eKeyword trends from 1965 to 2025 reveal the evolving focus of TMD research in parallel with changes in diagnostic frameworks, therapeutic priorities, and patient-centered care. Early peaks in \u0026ldquo;temporomandibular joint dysfunction syndrome\u0026rdquo; reflect pre-RDC/TMD and DC/TMD terminology, while sustained attention to \u0026ldquo;pain\u0026rdquo; and \u0026ldquo;myofascial pain\u0026rdquo; emphasizes ongoing symptom-centered approaches (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). The rise of \u0026ldquo;headaches\u0026rdquo; highlights growing recognition of comorbid craniofacial pain disorders and interdisciplinary management, and the prominence of \u0026ldquo;pathophysiology\u0026rdquo; signals a shift toward mechanistic understanding supported by advances in neurophysiology and imaging (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Recurrent gender- and age-related terms further illustrate the field\u0026rsquo;s movement toward personalized diagnosis and precision-based interventions and interdisciplinary care (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis bibliometric analysis aims for a patient-centered approach that integrates biopsychosocial factors, emphasizing shared decision-making, patient-reported outcomes, and coordinated interdisciplinary management in the TMD field. As dental healthcare providers, our responsibility extends beyond oral health to encompass the patient\u0026rsquo;s overall well-being (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). Identifying and educating patients about underlying influencing factors, while providing them with self-management skills, not only improves their capacity to manage current pain but also empowers them to better cope with future painful or traumatic events (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Finally, this approach also coexists with scientific literature that shows an overproliferation of systematic reviews in TMD, often conducted by individuals without specific expertise in the subject, which may contribute little to advancing knowledge. Aspiring TMD researchers are encouraged to prioritize original clinical research, thereby acquiring the subject-matter expertise, methodological skills, and critical judgment necessary to interpret and apply evidence effectively. Such an approach looks for a deeper understanding of the methodological, clinical, research, and patient-centered dimensions of evidence-based dentistry (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAlthough a rigorous methodology was performed to identify general publication trends, the following gaps and limitations should be considered: 1. Only a single database was used to obtain the publication trends, which may leave some relevant published articles outside the results; 2. only English-written articles were included, which may have an impact on the results considering that a critical amount of articles are published in Chinese, Portuguese, or Spanish and may even be considered bias; 3. no specification of the patient age was incorporated, in terms of adults or children, which may lead to some underestimation of the pediatric population; 4. no classification of study design was performed, which would be interesting to objectively recognize the apparent lack of primary study in some specific topics; and finally 5. considering that there is an apparent insufficient interdisciplinary collaboration in the TMD field, which has led to a knowledge gap, the present method did not incorporate keywords from related disciplines.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThis bibliometric analysis functions as both a guiding framework and a reference point, offering key insights for researchers, clinicians, and policymakers seeking to advance the understanding, diagnosis, and management of TMD. The field has transitioned from foundational characterization to complex investigations involving neurobiology, psychosocial variables, and patient-reported outcomes. Moving forward, continued emphasis on global collaboration, high-quality clinical trials, and integration with broader pain science frameworks will be critical for translating research into effective, individualized patient care.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eConflict of interest statement: The authors declare no conflicts of interest with respect to the authorship or publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding sources:\u003c/strong\u003e This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u003c/strong\u003e Conceptualization: CL-M, OL, AG, and AC; Investigation \u0026amp; validation: CL-M, \u0026nbsp;OL, MY, DDN, NA, and AC ; Formal analysis: CL-M, \u0026nbsp;OL, DDN, MY, \u0026nbsp;and NA ; Writing – Original Draft: CL-M, DDN, MY, \u0026nbsp;AC and NA ; Writing – Review \u0026amp; editing: All authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement:\u003c/strong\u003e All data used in this study is publicly available from the Scopus database. 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Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://dx.doi.org/10.1177/00220345221110443\u003c/span\u003e\u003cspan address=\"10.1177/00220345221110443\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eManfredini D, H\u0026auml;ggman-Henrikson B, Al Jaghsi A, Baad-Hansen L, Beecroft E, Bijelic T et al (2025) Temporomandibular disorders: INfORM/IADR key points for good clinical practice based on standard of care. Cranio [Internet]. ;43(1):1\u0026ndash;5. 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Cranio [Internet]. ;43(1):6\u0026ndash;7. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://dx.doi.org/10.1080/08869634.2024.2430944\u003c/span\u003e\u003cspan address=\"10.1080/08869634.2024.2430944\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKandasamy S (2024) The painful mind. Cranio [Internet]. ;42(4):361\u0026ndash;3. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://dx.doi.org/10.1080/08869634.2024.2333178\u003c/span\u003e\u003cspan address=\"10.1080/08869634.2024.2333178\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eManfredini D, Greene CS, Ahlberg J, De Laat A, Lobbezoo F, Klasser GD (2019) Evidence-based dentistry or meta-analysis illness? A commentary on current publishing trends in the field of temporomandibular disorders and bruxism. J Oral Rehabil [Internet]. ;46(1):1\u0026ndash;4. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://dx.doi.org/10.1111/joor.12707\u003c/span\u003e\u003cspan address=\"10.1111/joor.12707\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Table","content":"\u003cp\u003eTable 1 is available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"King George's Medical University,India","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Temporomandibular Joint Dysfunction Syndrome, Pain, Myofascial Pain, Headaches, Pathophysiology, Bibliometrics","lastPublishedDoi":"10.21203/rs.3.rs-8538538/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8538538/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eAim.\u003c/h2\u003e \u003cp\u003eTo synthesize and analyze citation performance in the field of temporomandibular disorders (TMD) and address innovative methods to improve research in this field.\u003c/p\u003e\u003ch2\u003eMethods.\u003c/h2\u003e \u003cp\u003eA structured search of the Scopus database was performed using Boolean operators and relevant keywords, including \u0026ldquo;temporomandibular disorder\u0026rdquo; and its variations. Only English written articles were included. Data was processed and analyzed using R-Studio for statistical operations and VOSviewer for visualizing bibliometric networks. Key parameters assessed included annual publication trends, authorship patterns, institutional output, keyword co-occurrence, and international collaborations. Comprehensive data cleaning was applied to ensure the accuracy and integrity of data.\u003c/p\u003e\u003ch2\u003eResults.\u003c/h2\u003e \u003cp\u003eThe dataset included 6,269 articles, revealing a substantial increase in TMD-related research, particularly from the year 2000 onwards. The most significant publication peak was observed in 2024, with 485 articles. Leading journals included Journal of Oral Rehabilitation, Cranio, and Journal of Oral and Maxillofacial Surgery. The University of S\u0026atilde;o Paulo was the top contributing institution, followed by Sichuan and Peking Universities. Prolific authors such as Lobbezoo, Manfredini, and Svensson were identified as key contributors. Brazil, USA, and China emerged as the top publishing countries, though international collaborations remained modest (17.39%). Keywords like \u0026ldquo;female,\u0026rdquo; \u0026ldquo;adult,\u0026rdquo; \u0026ldquo;temporomandibular joint disorder,\u0026rdquo; and \u0026ldquo;pathophysiology\u0026rdquo; dominated the literature, while keyword trend analysis revealed a shift from diagnostic terms to themes involving \u0026ldquo;pain,\u0026rdquo; \u0026ldquo;myofascial dysfunction,\u0026rdquo; and \u0026ldquo;treatment outcomes\u0026rdquo;.\u003c/p\u003e\u003ch2\u003eConclusion.\u003c/h2\u003e \u003cp\u003eTMD research has grown substantially in volume and scope in recent decades. While key institutions and authors have driven progress, limited international collaboration highlights opportunities for stronger global partnerships. This bibliometric profile provides a valuable resource for guiding future research directions, encouraging more integrated, interdisciplinary, and patient-centered approaches in the study and management of TMD.\u003c/p\u003e","manuscriptTitle":"Publication trends on temporomandibular disorders: a bibliometric analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-12 06:05:26","doi":"10.21203/rs.3.rs-8538538/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9a725f3e-6853-428a-8a46-c7304667f57f","owner":[],"postedDate":"January 12th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":60725704,"name":"Dentistry"}],"tags":[],"updatedAt":"2026-01-12T06:05:27+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-12 06:05:26","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8538538","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8538538","identity":"rs-8538538","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}