The Predictors of Pain in Patients with Temporomandibular Disorders: A Systematic Review

Background: Temporomandibular disorder (TMD) constitutes a set of joint and muscle conditions of the craniomandibular-cervical region that can trigger signs and symptoms, such as pain in the region of the temporomandibular joint (TMJ), headache, pain in the muscles of mastication, otalgia, facial pain, functional limitation, neck pain, fatigue, limited mouth opening, pain when chewing, ringing in the ears, jaw pain.

Aim: The aim of the present study was to perform a systematic literature review investigating the more frequent predictors of pain in patients with temporomandibular disorder (TMD).

Study Design: Observational cohort studies that evaluated predictors of pain in patients with TMD were reviewed. Searches were conducted in the Medline, EMBASE, BVS, LILACS (Latin American and Caribbean Health Sciences Literature) and the Cochrane Collaboration’s Center Register of Controlled Clinical Trials (CENTRAL) databases.

Results: The search strategy led to the retrieval of 714 studies, 78 articles of which were submitted to analysis and 18 were eligible for review. The selected studies were separated by predictors of pain in TMD: sleep (n = 2), parafunction (n = 2), psychosocial factors (n = 10), genetic factors (n = 3), myofascial pain (n = 2), occlusion (n = 1). Two articles were included in the review of two predictors.

Conclusion: The predictors most associated with TMD are psychosocial factors, parafunction, sleep, genetic factors, occlusion and myofascial pain.

Implications for Practice: Knowledge regarding predictors of pain in patients with TMD can assist in the diagnosis and treatment using the biopsychosocial model and, consequently, diminish the chronicity of this condition.