The Web of Science Core Collection (WoSCC), a globally recognized database platform by Clarivate Analytics, was selected for its authoritative coverage of over 12,000 international academic journals (26). Therefore, according to previous studies, we chose it to obtain global academic information for bibliometric analysis (27, 28). We extracted all the published literature from WoSCC, and the search date was from 1 January 2004 to 31 December 2024. In present study, the detailed search strategy was as follows: (TS = (“TMJOA”) OR TS = (“Temporomandibular joint osteoarthritis”) OR TS = (“TMJ osteoarthritis”) OR TS = (“osteoarthritis of temporomandibular joint”) OR TS = (“osteoarthritis of the temporomandibular joint”) OR TS = (“OA of TMJ”) OR TS = (“osteoarthritis of TMJ”) OR TS = (“OA of temporomandibular joint”) OR TS = (“TMJ osteoarthrosis”)) AND Document types = (ARTICLE OR REVIEW) AND Language = (English). Using the Web of Science filter tool to remove other types of publications, 584 publications were selected, and all valid data, including publishing year, title, author names, nationalities, affiliations, abstract, keywords, H-index, and name of journals, were exported in TXT format. Ethical approval was not required as no animals or humans were involved in the study.

We used VOSviewer 1.6.20, CiteSpace 6.4.R1, R package “Bibliometrix” software, and the Bibliometrics website for bibliometric analysis. Specifically, VOSviewer was performed to analyze the co-authorship, co-citation, and co-occurrence in detail. In addition, CiteSpace, developed by Professor Chen C (Drexel University, USA), was used to build a dual-map overlay for journals, cluster analysis of co-citation, and detection of references and intense citation bursts. Moreover, the R package “bibliometrix” software (biblioshiny) was used in this study to visualize publications output across countries, authors, and journals, as well as to generate a three-field plot analysis.

According to the search strategy, 622 literatures were identified from 2004 to 2024. Subsequently, 587 literatures were identified by excluding the meeting abstract (21), letter (5), correction (4), editorial material (4), and proceedings papers (1). Eventually, 584 literatures were identified by excluding 3 non-English literatures (Figure 1). The leading information was described in Figure 2A, using the “biblioshiny”. The analysis revealed that these 584 articles involved 2,183 authors and were published across 199 journals. We also found that the annual growth rate of publications in this field was 18.2%. The international co-authorship accounted for 17.29%. Besides, there were a total of 16,273 references and 1,142 keywords in the field of TMJOA. The average age of articles was 5.86, while the average number of citations per article was 20.46. The results indicate that TMJOA research has demonstrated remarkable growth over the past two decades, and this field features an active international collaboration network.

Figure 2B presents the total number of publications from each identified country and the collaboration patterns. China published the most papers (275, 47.1%), followed by the USA (76, 13.0%), Japan (48, 8.2%), Korea (28, 4.8%) and Italy (22, 3.8%). We also found that the Multiple Country Publication (MCP) of the top three countries were 30 (10.91%), 26 (34.21%), and 11 (22.92%), respectively, indicating their active role in promoting international collaboration. As illustrated in Figure 2C, the general trend of the number of publications in the field of TMJOA was an increase. The annual publications of the top 10 countries/regions increased by 79 from 2004 (3) to 2024 (82). Furthermore, the number of publications from 2022 to 2024 was 225 (38.5% of total publications), indicating that TMJOA research has increasingly become a focal point for researchers and has entered a phase of rapid development.

Figure 3A and Table 1 illustrate that publications from China had the highest total citation frequencies (4,194). The USA ranked second with a number of 1,669, followed by Japan (1,256), Italy (698) and Korea (583). Regarding the average article citations (Figure 3B), Singapore had the highest average citation frequencies (374). Yemen ranked second with a number of 140, prior to Latvia (89), Greece (69.8), and Canada (45). In respect of the global collaboration analysis, Figures 3C,D showed that China exhibited the highest output volume and worked closely with the USA, Netherlands, Australia, and Singapore.

A ranking of the top 10 contributing institutions based on publication output is presented in Table 2. The first was Sichuan University (145 publications), followed by Wuhan University (81 publications), Fourth Military Medical University (69 publications), and the University of California Davis (39 publications). Concerning the number of citations, Fourth Military Medical University ranked first for total citations, whereas the University of North Carolina ranked first for average citations. Figure 4A exhibited the network visualization of collaboration between institutions, which showed that there was a strong cooperation relationship between institutions such as Sichuan University, Shanghai Jiao Tong University, Fourth Military Medical University, and Shandong University in China and the University of North Carolina, University of Michigan in the USA.

In this study, we identified 2,183 authors in the field of TMJOA in total. The top 10 prolific authors were analyzed, along with the total citations and h-index. Figure 4B illustrates that Long X had the most publications (23), followed by Liu Y (21) and Zhang J (23). Regarding the h-index, LIU Y, MANFREDINI D, and GUARDA-NARDINI L ranked in the top 3 in the field of TMJOA; in addition, the three of them were also among the top three in total citation numbers.

VOSviewer also visualized the network between authors, as shown in Figure 4C. Authors from the same country collaborated more frequently and had strong connections. The co-citation analysis considered the relatedness of the items based on the numbers they were co-cited. Figure 4D illustrated that 330 authors with a minimum of 10 documents were analyzed using VOSviewer. The top 5 authors with the largest total link strength were as follows: Wang, XD (total link strength = 3,751 times), Tanaka, E (total link strength = 3,186 times), Jiao, K (total link strength = 2,240 times), Manfredini, D (total link strength = 2,186 times), and Guarda-Nardini, L (total link strength = 2,132 times).

We presented the publication counts, impact factors (IF), and H-index values of the top 10 most productive journals involved in this study, as detailed in Table 3. The Journal of Oral Rehabilitation (impact factor = 3.1, 2024) ranked first with 32 publications. There were 29 publications in the Journal of Oral and Maxillofacial Surgery (IF = 2.3, 2024), 27 publications in the Journal of Dental Research (IF = 5.7, 2024), 22 publications in the International Journal of Oral and Maxillofacial Surgery (IF = 2.2, 2024) and 17 articles in Archives of Oral Biology (IF = 2.2, 2024). Figure 5A illustrates the core sources identified through Bradford's Law, utilizing the biblioshiny. The core zone comprised 10 journals, which collectively published 199 articles, accounting for 34.08% of the total 584 articles in the field. In addition, a co-citation analysis of journals was conducted by VOSviewer, with journals having a minimum of 10 citations included in the analysis. As shown in Figure 5B, a total of 414 journals were represented based on their link strength. The top 5 journals with most total link strength are as follows: Osteoarthritis and Cartilage (total link strength = 57,167 times), Journal of Dental Research (total link strength = 50,542 times), Journal of Oral and Maxillofacial Surgery (total link strength = 33,597 times), Archives of Oral Biology (total link strength = 23,472 times), and Journal of Oral Rehabilitation (total link strength = 20,581 times).

Besides, a treemap diagram was employed to visually present the top 20 research fields, as shown in Figure 5C. In detail, the most prevalent research fields were dentistry oral surgery medicine, surgery, cell biology, medicine research experimental, and orthopedics. Figure 5D depicts five primary citation paths marked in yellow and grey. The two main paths revealed that documents published in the field of molecular, biology, and genetics were predominantly cited by researchers from molecular, biology, and immunology as well as dentistry, dermatology, and surgery. The remaining three citation pathways showed that articles published in sports, rehabilitation, and sport, as well as dermatology, dentistry, and surgery, were mainly cited by documents in molecular, biology, and immunology, as well as dentistry, dermatology, and surgery.

As presented in Figure 6A, 144 articles in the field of TMJOA had over 25 citations. Table 4 shows the top 10 most cited articles. There were 579 citations for “Degenerative disorders of the temporomandibular joint: etiology, diagnosis, and treatment”, followed by “MSC exosomes alleviate temporomandibular joint osteoarthritis by attenuating inflammation and restoring matrix homeostasis”, with 374 citations. The third-ranked document was “Current understanding of pathogenesis and treatment of TMJ osteoarthritis”, with 339 citations.

Moreover, we used Citespace to program a co-citation analysis (Figure 6B) to show the most influential literature. Figures 7A,B showed that the co-cited documents were assigned to 12 leading cluster labels as follows: critical signaling molecular; TMJ osteoarthritis; low-intensity pulsed ultrasound; platelet-rich plasma; sodium hyaluronate; temporomandibular joint pathology; recent advances; microarchitectural change; inhibiting chondrocyte ferroptosis; peripheral blood; temporomandibular joint condylar morphology; artificial intelligence. Upon further analysis, these 12 clusters revealed three dominant research trends. The first trend centered on pathogenic mechanisms underlying TMJOA (#0, #1, #5, #7, #8, #10). The second trend concerned research on novel treatment strategies for TMJOA (#2, #3, #4, #9), while the third focused on artificial intelligence and medicine (#6, #11). In addition, this visualization illustrated the evolution of research trends and the interdependent relationships among the various clusters.

Citation burst serves as a significant indicator, reflecting the references that attract heightened interest from researchers within a specific domain over a defined period (29). We used CiteSpace to identify the top 25 references with the strongest citation bursts and presented the results in Figure 7C. The article “Current understanding of pathogenesis and treatment of TMJ osteoarthritis”, published in 2008, ranked first in strength (21.09).

Keyword analysis plays a pivotal role for researchers in identifying emerging trends and key research hotspots in TMJOA. To conduct the keyword analysis, we performed a word cloud analysis using the “biblioshiny” tool to assess the frequency and prominence of various keywords. As shown in Figure 8A, “disorders” and “expression” were the two most prevalent keywords. Additionally, we also used “biblioshiny” for trend topic analysis and identified the top 30 keywords with the highest burst strength, as shown in Figure 8B. In 2010, the keyword “synovium” emerged and remained prevalent until 2020. During this period, additional keywords related to etiology and risk factors also surfaced, including “malocclusion”, “mechanical stress”, and “IL-1 beta”. In recent years, the focus of research has shifted towards the pathogenic mechanisms of TMJOA, with keywords such as “oxidative stress” and “endoplasmic reticulum stress” gaining prominence.

In bibliometrics, keyword co-occurrence analysis is widely used to identify emerging research topics and trends. We conducted this analysis using VOSviewer, with keywords defined as those occurring over 5 times in the titles or abstracts of all selected papers. After eliminating duplicates, the results are presented in Figure 8C. The 197 identified keywords were mainly classified into 4 clusters as follows: Cluster 1: pathogenic mechanisms (red); Cluster 2: clinical manifestations (green); Cluster 3: regeneration research (blue); Cluster 4: therapy research (yellow). These results exhibited the most prominent research topics in TMJOA so far. The primary keywords in the “pathogenic mechanisms” cluster were expression, degeneration, subchondral bone, and angiogenesis. The keywords frequently used for the “clinical manifestations” cluster were internal derangement, biomarkers, pain, and disorders. In the “regeneration research” cluster, the principal keywords were synovial fluid, proliferation, inflammation, and repair. The keywords used most in the “therapy research” cluster were arthrocentesis, sodium hyaluronate and platelet-rich plasma. The results revealed that the most prominent areas of TMJOA research encompassed the 4 directions mentioned above.

Figure 8D represented a three-field graph generated using “biblioshiny”, associating authors, keywords, and journals. It was possible to observe the links between the principal elements through this, and their relationship was exhibited directly by the strength of the connection links (30). The most frequent keywords were “Temporomandibular joint”, “osteoarthritis”, “dental pathology”, “hyaluronic acid”, and “cartilage”. The authors Kass PH and Verstraete FJM were strongly connected with the keywords “dental pathology” and “Temporomandibular joint”, establishing the relatively strongest links. In turn, it can be found that the heaviest links were related to the Journal of Oral Rehabilitation, and it also covered most of the papers related to the keywords “Temporomandibular joint” and “osteoarthritis”. Moreover, the keyword “cartilage” was strongly connected with the Journal of Dental Research. Therefore, this visualization suggested that as the primary site of pathology in temporomandibular joint osteoarthritis (TMJOA), cartilage remained the central focus of current research in this field.

This bibliometric analysis identified key trends in temporomandibular joint osteoarthritis (TMJOA) research within the Web of Science Core Collection (WoSCC) from 2004 to 2024. The 2004–2024 timeframe was selected based on our preliminary bibliometric analysis that revealed a notable publication surge in 2008, with annual output tripling compared to the previous year (12 publications vs. 4 publications), indicating markedly increased research attention in TMJOA. Following a six-year stabilization period, the field has demonstrated consistent growth since 2014. This developmental trajectory motivated our systematic investigation of research trends spanning the two-decade period from 2004 to 2024. Annual publications increased steadily from 2004 to 2024 (Figure 2). Globally, 52 countries contributed to TMJOA studies, with China leading in total publications (275, 47.1%), followed by the USA (76, 13.0%), Japan (48, 8.2%), South Korea (28, 4.8%), and Italy (22, 3.8%). While China ranked first in both publications and total citations, its lower average citation count suggests room for improving research impact. Notably, Singapore achieved the highest average citations (374), surpassing Yemen (140) and Latvia (89), underscoring their significant influence despite fewer publications.

Our analysis revealed that China and the USA emerged as the leading contributors to TMJOA research, collectively dominating both authorship and institutional output (Table 1). Similarly, the top 10 institutions were exclusively based in these two countries, underscoring their pivotal role in advancing the field. As illustrated in Figure 4B, Liu Y, Manfredini D, and Guarda-Nardini L ranked highest in citation frequency and H-indices, reflecting their global recognition and scholarly impact. However, collaboration networks remained limited, with partnerships primarily confined to intra-institutional efforts and minimal cross-border engagement (Figure 4C). In the future, researchers from various countries and institutions should strengthen their collaboration to improve the research of TMJOA.

Our study constructed a co-occurrence network of keywords based on the frequency of keyword occurrence in the titles and abstracts of all included publications. Figure 8C showed 4 main clusters, each representing a distinct research trend: pathogenic mechanisms (red), clinical manifestations (green), regeneration research (blue), and therapy research (yellow). These clusters highlight current research priorities and provide a foundation for predicting future trajectories.

According to the analysis above, predicting future trends and possible impacts on the search of TMJOA is significant. As illustrated in Figure 7B, the research directions have changed from “sodium hyaluronate”, “microarchitectural change”, “temporomandibular joint pathology”, “temporomandibular joint condylar morphology”, and “tmj osteoarthritis” to “critical signaling molecule”, “inhibiting chondrocyte ferroptosis”, “artificial intelligence”, “low-intensity pulsed ultrasound”, and “recent advance”, which could significantly influence future researchers. Notably, trend topic analysis (Figure 8B) identifies “oxidative stress”, “endoplasmic reticulum stress”, and “bone resorption regulation” as the most emergent research fronts, which also indicate that molecular mechanism elucidation represents the most promising research direction. Regarding pathological mechanisms, beyond classical chondrocyte apoptosis, emerging evidence highlights the critical involvement of novel programmed cell death modalities—particularly chondrocyte ferroptosis and pyroptosis—as breakthrough areas in TMJOA research. Ferroptosis of chondrocytes via multiple pathways provides novel insights into the pathogenesis of TMJOA, offering clinicians a more comprehensive understanding of its pathophysiological mechanisms. These findings also facilitate the development of targeted therapeutic strategies for TMJOA management. For instance, novel nanomaterials and traditional Chinese medicines targeting ferroptosis and pyroptosis of chondrocytes were found to alleviate the TMJOA. Specifically, mechanistic investigations have demonstrated that plumbagin, a bioactive naphthoquinone derivative isolated from Plumbago species (63–65), potently suppresses H2O2-induced chondrocyte ferroptosis through modulation of the MAPK signaling cascade (p38/JNK/ERK pathways), thereby mitigating TMJOA progression (66). Furthermore, emerging evidence demonstrated that poly (p-coumaric acid) nanoparticles (PCA NPs), as a novel nanotherapeutic platform, exhibit potent antioxidant and anti-inflammatory properties while effectively suppressing chondrocyte ferroptosis, thereby attenuating TMJOA progression (13). In addition, researchers found that resatorvid, a novel chemopreventive agent, alleviates TMJOA pathology by inhibiting chondrocyte pyroptosis and degeneration (67). These findings offer novel mechanistic insights into TMJOA pathogenesis, identifying potential therapeutic strategies for chondrocyte protection and regeneration, thereby guiding future translational research.

This study offers a systematic overview of research hotspots and trends in TMJOA, providing actionable insights for researchers. However, several limitations warrant consideration. Firstly, reliance on the Web of Science Core Collection (WoSCC) database excluded studies from other platforms (e.g., PubMed, Cochrane, Embase), potentially introducing selection and publication bias. Furthermore, restricting inclusion to English-language articles and reviews may have omitted relevant non-English literature and non-article document types. In addition, the 2024 cutoff date for publication inclusion could exclude recent high-impact studies. Finally, the analysis did not evaluate citation context (e.g., supportive vs. critical citations) and may overlook smaller or interdisciplinary collaborations, which are often underrepresented in traditional bibliometric metrics.