## 1 Introduction
The multifactorial nature of adolescent TMDs--encompassing growth, hormonal, psychological, and behavioral influences--underscores the importance of tailored diagnostic and therapeutic approaches. Emerging minimally invasive treatments offer promising solutions, particularly for severe or chronic cases [16; 17]. Orthodontic treatment during adolescence is widely regarded as essential for improving both oral health and quality of life by addressing malocclusions, enhancing oral function, and supporting psychological well-being [18; 19]. The period of growth in adolescence amplifies the effectiveness of orthodontic intervention, allowing for the correction of aberrant occlusal patterns and functional anomalies, which may otherwise lead to long-term complications such as TMDs or dental attrition [20]. Frequently observed malocclusion types among adolescents, including open bite, deep bite, and dental crowding, can be effectively managed through orthodontic interventions aimed at optimizing both structural and aesthetic aspects of the oral cavity during growth [21]. Orthodontic appliances used during this developmental stage primarily include fixed and removable options [22]. Fixed appliances, such as brackets and archives, provide effective guidance for tooth movement and occlusal improvement but necessitate prolonged treatment duration and rigorous oral hygiene maintenance [20]. In contrast, removable appliances offer ease of maintenance but are generally limited to early orthodontic intervention in younger children [23]. The selection of an orthodontic appliance depends on various factors, including the patient's oral health status, growth patterns, and lifestyle considerations [21]. Despite these recognized benefits, the impact of orthodontic treatment on TMDs remains a topic of ongoing debate. Fixed appliances are commonly used during adolescence to address malocclusions, improve occlusal function, and enhance facial aesthetics [24]. However, some studies propose that orthodontic forces might elevate the risk of TMDs by altering occlusion or stressing the TMJ, especially in cases involving elastic bands or significant occlusal adjustments [25; 26; 27; 28]. In contrast, other research suggests that correcting malocclusions may reduce TMDs risk by enhancing occlusal stability and decreasing functional strain on the TMJ [29; 30]. These conflicting findings underscore the complexity of the relationship between orthodontic treatment and TMDs, suggesting that additional factors may influence the onset of TMDs symptoms in orthodontically treated patients. Diagnosing TMDs in adolescents presents unique challenges due to variations in clinical presentation and the influence of growth-related factors [12]. Although diagnostic tools such as the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), originally developed for adults, have recently been adapted for younger populations to enhance diagnostic accuracy, diagnostic variability persists [12; 31]. While some studies employ clinical examinations or imaging tools like magnetic resonance imaging (MRI) and cone beam computed tomography (CBCT) to diagnose TMDs, others rely on self-reported symptoms or general clinical assessments, leading to inconsistencies in TMDs identification and prevalence estimates [32; 33]. This variability complicates the assessment of TMDs, especially in adolescents undergoing significant physiological changes, emphasizing the need for standardized diagnostic criteria across studies [31]. Adolescence is a critical developmental phase marked by rapid growth and hormonal changes that can affect musculoskeletal health, including the TMJ [24; 31]. Given the potential interplay between these developmental factors and orthodontic interventions, understanding the relationship between fixed orthodontic treatment and TMDs in this age group is particularly important [24; 28].