Prevalence of signs and symptoms related to temporomandibular disorders and orofacial pain in patients indicated for orthognathic surgery: a meta-analysis

Clin Oral Investig. 2023 Jul;27(7):3307-3319. doi: 10.1007/s00784-023-05110-2. Epub 2023 Jun 17.

Abstract

Objective: To evaluate the prevalence of signs and symptoms related to temporomandibular disorders (TMD) and orofacial pain in patients with indication for orthognathic surgery.

Methods: The search was carried out in seven electronic databases and gray literature. Studies that evaluated the frequency of signs and symptoms related to TMD and orofacial pain were included. The risk of bias was assessed using the Joanna Briggs Critical Appraisal tool. A meta-analysis of proportions with a random effect model was performed and the GRADE tool judged the certainty of evidence.

Results: After searching the databases, 1859 references were retrieved, 18 of which were selected for synthesis. The prevalence of individuals with at least one TMD symptom was 51% [CI95% = 44-58%], and 44% of the subjects had temporomandibular joint click/crepitus [CI95% = 37-52%]. Additionally, 28% exhibited symptoms related to muscle disorders [CI95% = 22-35%], 34% had disc displacement with or without reduction [CI95% = 25-44%], and 24% had inflammatory joint disorders [CI95% = 13-36%]. The prevalence of headache was 26% [CI95% = 8-51%]. The certainty of evidence was considered very low.

Conclusion: Approximately 1 in 2 patients with dentofacial deformity presents some sign and symptom related to TMD. Myofascial pain and headache may be present in approximately a quarter of patients with dentofacial deformity.

Clinical relevance: A multidisciplinary treatment is necessary for these patients, involving a professional with expertise in the management of TMD.

Keywords: Dentofacial deformities; Orthognathic surgery; Systematic review; Temporomandibular joint disorders.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Dentofacial Deformities* / surgery
  • Facial Pain / epidemiology
  • Headache
  • Humans
  • Orthognathic Surgery*
  • Prevalence
  • Temporomandibular Joint Disorders* / diagnosis