## 4 Discussion
### Impact of Orthodontic Treatment on TMDs Development in Adolescents  
Adolescents represent a unique demographic for orthodontic treatment due to their ongoing craniofacial growth, which can directly influence TMJ stability and morphology. This growth phase enables orthodontic interventions to maximize skeletal adjustments, achieving functional and aesthetic improvements that may otherwise be challenging in adulthood. [PERSON] et al. [62] emphasized that early orthodontic treatment for Class II malocclusion, particularly in cases with a retrusive mandible, can guide jaw growth to achieve a harmonious maxillomandibular relationship, potentially enhancing TMJ stability. [PERSON] [63] further noted that early intervention reduces functional issues, such as chewing and speaking difficulties, and lowers the risk of dental trauma, especially with protruding incisors. This proactive approach may contribute to long-term TMJ health by addressing underlying malocclusions that could otherwise lead to TMDs [64]. In addition to functional benefits, orthodontic treatment during adolescence has been shown to improve oral health-related quality of life (OHRQoL) by addressing physical and social challenges. [PERSON] et al. [65] reported that both traditional fixed appliances and clear aligners significantly enhanced overall satisfaction among adolescent patients, with aligners providing quicker adaptation and greater social confidence--attributes particularly valued by adolescents. These psychosocial benefits highlight that orthodontic treatment contributes not only to functional improvements but also to an enhanced quality of life. Moreover, [PERSON] et al. [66] emphasized that correcting abnormal occlusal patterns and functional issues during the critical adolescent growth period is crucial for preventing future dental complications, such as TMDs and tooth wear. These corrections are particularly effective during this phase, as ongoing craniofacial development can be utilized to achieve functional and structural harmony [66]. However, the success of such interventions largely depends on careful biomechanical considerations [66]. Poorly controlled forces or the use of appliances that disrupt natural mandibular movements can increase TMJ loading, potentially causing microtrauma and exacerbating vulnerabilities in individuals predisposed to TMDs [66]. Similarly, [PERSON] et al. [67] highlight mechanisms that may link orthodontic treatment to TMDs, reinforcing the importance of precise biomechanical management. For example, malocclusions such as unilateral posterior crossbite (UPCB) can disrupt occlusal balance,potentially contributing to TMDs onset [67]. However, the correction of such malocclusions does not always resolve symptoms, pointing to additional contributing factors [67]. Biomechanically, interventions like intermaximillary elastics may increase TMJ strain, particularly in Class II cases, while appliances like clear aligners can heighten masticatory muscle activity during early treatment [67]. These findings underscore the need for orthodontic approaches that not only correct structural irregularities but also account for neuromuscular adaptation [67]. The central nervous system's role in adjusting to occlusal changes and individual variability in occlusal tactile acuity further highlights the complex interplay between mechanical and neurological factors in TMDs susceptibility [67]. Integrating these perspectives ensures a more comprehensive understanding and effective management of TMDs risks during orthodontic treatment [67]. [PERSON] et al. [22] noted that common malocclusions in adolescents, including open bite, excessive overbite, prominent maxilla, and crowding, are effectively managed through orthodontic interventions. These treatments aim to optimize oral structures and aesthetics during growth. Treatment methods range from fixed appliances, which are effective for occlusal correction but require diligent oral hygiene, to removable appliances, often employed in early interventions for younger children [68; 69].