Abstract: Chronic pain around the temporomandibular joint and masticatory muscles is usually the primary complaint of patients with temporomandibular disorders（TMD）. As pain is a brain response，the development of chronic pain in TMD is closely related to alterations in the central nervous system（CNS），though the underlying neuropathological mechanisms remain incompletely understood，which poses significant challenges in clinical management. Functional magnetic resonance imaging（fMRI），a non-invasive medical imaging technology for measuring cerebral activity，has been extensively employed in pain-related research and various clinical fields. This paper will review the findings from both task-state fMRI and resting-state fMRI studies investigating cerebral activity changes related to painful TMD. Furthermore，the effects of occlusal splint therapy on cerebral activity in painful TMD patients will also be reviewed. By providing neuroimaging perspectives on the mechanisms underlying orofacial pain generation in TMD，this paper aims to offer valuable insights for clinical diagnosis and treatment of painful TMD.

Key words: temporomandibular disorders, orofacial pain, functional magnetic resonance imaging, occlusal splint therapy

摘要： 颞下颌关节和咀嚼肌周围的慢性疼痛通常是颞下颌关节紊乱病（temporomandibular disorders，TMD）患者的主诉，由于疼痛是大脑的反应，TMD慢性疼痛的形成与中枢神经系统的变化密切相关，但其复杂的神经病理机制尚未阐明，导致治疗难度较大。功能磁共振成像（functional magnetic resonance imaging，fMRI）是一种可测量大脑活动的非侵入性方法，现已广泛应用于研究包括疼痛在内的多个领域。文章就疼痛性TMD相关脑功能改变的任务态与静息态fMRI研究进展做一综述，并结合疼痛性TMD的常用治疗方法——咬合板治疗对脑激活模式的影响，为理解TMD产生口面部疼痛的机制提供神经影像学视角，为临床诊疗疼痛性TMD提供参考。

关键词: 颞下颌关节紊乱病, 口面部疼痛, 功能磁共振成像, 咬合板治疗