To evaluate the presence of TMJ disc perforation on MRI and investigate its associations with internal disc derangements, disc configuration, condylar bone marrow signal patterns, joint effusion, and demographic or clinical variables such as age, sex, dental status, and pain severity.

This study will prospectively evaluate temporomandibular joint (TMJ) disc perforation using magnetic resonance imaging (MRI) in a diverse adult population. The investigation will focus on identifying the prevalence of disc perforation and examining its relationship with key TMJ structural and functional parameters. Specifically, the study will assess internal disc derangements, variations in disc morphology, condylar bone marrow signal characteristics, and the presence of joint effusion. In addition, demographic and clinical factors-including age, sex, dental status, and pain severity-will be analyzed to determine their potential association with disc perforation.

MRI-based assessments will be performed using standardized imaging protocols, and all findings will be systematically recorded and evaluated. By integrating radiologic and clinical data, the study aims to improve the understanding of factors contributing to TMJ disc perforation and to support future diagnostic and therapeutic strategies.

Inclusion Criteria:

• Patients with available temporomandibular joint (TMJ) MRI scans (both open- and closed-mouth)
• Age ≥14 years
• Complete clinical records including Visual Analogue Scale (VAS) pain scores and dental status
• Willingness to participate in the study and provide informed consent (for prospective studies)

Exclusion Criteria:

• Presence of systemic disorders affecting bone metabolism, including rheumatoid arthritis, chronic systemic corticosteroid therapy, Paget's disease, hypo- or hyperparathyroidism, osteomalacia, or renal osteodystrophy
• History of medications that could alter bone architecture
• Current orthodontic treatment
• History of head and neck trauma or surgery
• Presence of head and neck cystic or tumoral pathology
• Prior radiotherapy or chemotherapy
• Pregnancy
• Presence of ferromagnetic objects in the head (contraindication to MRI)

The study population will consist of approximately 282 patients (200 females and 82 males) aged 14-79 years who have undergone TMJ MRI scans for clinical evaluation. Patients will be included if they have complete MRI images (open- and closed-mouth) and corresponding clinical records, including Visual Analogue Scale (VAS) pain scores and detailed dental status. Individuals with systemic disorders affecting bone metabolism, history of bone-altering medications, current orthodontic treatment, prior head or neck trauma or surgery, head or neck cystic or tumoral pathology, previous radiotherapy or chemotherapy, pregnancy, or presence of ferromagnetic objects in the head will be excluded. The population will be stratified into two cohorts based on the presence or absence of TMJ disc perforation as determined by MRI.