Temporomandibular joint osteoarthritis (TMJOA) is a kind of degenerative lesion in temporomandibular joint disorders. The pathogenesis of TMJOA is complex. Among them, excessive mechanical stress plays an important role, which can cause a series of pathological changes, including synovial inflammation, chondrocyte death, osteogenic and adipogenic differentiation, degradation of extracellular matrix of cartilage, angiogenesis, osteochondral interface sclerosis, subchondral bone remodeling, degeneration of articular discs, etc. In the pathogenesis of TMJOA, it involves multiple signal pathways and epigenetic regulation, which may become potential therapeutic targets of TMJOA. In this paper, the research progress on the pathologic mechanism of TMJOA in recent years is reviewed to provide a basis for finding new therapeutic targets of TMJOA.颞下颌关节骨关节炎(temporomandibular joint osteoarthritis,TMJOA)是颞下颌关节紊乱病中的一类退行性病变。TMJOA的发病机制复杂。其中,过度机械应力发挥了重要作用,可引起一系列病理变化,包括滑膜炎症、软骨细胞外基质降解、血管生成、骨软骨界面硬化、软骨下骨重塑、关节盘退变,以及软骨细胞的死亡及成骨、成脂分化等。TMJOA的发病过程涉及多种信号通路和表观遗传的调控,可能成为TMJOA的潜在治疗靶点。本文对近年TMJOA病变机制的研究进展作一综述,以期为寻找TMJOA新的治疗靶点提供依据。.