Abstract
Background
The primary objective of this systematic review was to answer the following question
systematically: Is there any association between primary headaches (PHs) and temporomandibular
disorders (TMDs) in adults?
Types of Studies Reviewed
The protocol was registered with the International Prospective Register of Systematic
Reviews. The authors performed the search in 7 main databases and 3 gray literature
sources. The included articles had to have adult samples. PHs must have been diagnosed
using the International Classification of Headache Disorders, and TMDs must have been
diagnosed using Research Diagnostic Criteria for Temporomandibular Disorders, Diagnostic
Criteria for Temporomandibular Disorders, or International Classification of Orofacial
Pain. Risk of bias was evaluated using the Joanna Briggs Institute Meta-Analysis of
Statistics Assessment and Review Instrument tools. The meta-analysis was performed
using Review Manager software, Version 5.4. Certainty of evidence was screened according
to Grading of Recommendations Assessment, Development and Evaluation.
Results
Eight of 2,574 articles reviewed met the inclusion criteria for qualitative analysis
and, of these, 6 met the inclusion criteria for quantitative analysis. Odds ratios
(ORs) for painful TMD and tension-type headache (OR, 3.16; 95{b8727dad3e87009fdf7522b8034efdb701cdc6055ba8d220b20c1758c4dd8d79} CI, 1.80 to 5.54 to
OR, 13.06; 95{b8727dad3e87009fdf7522b8034efdb701cdc6055ba8d220b20c1758c4dd8d79} CI, 2.79 to 61.12), migraines (OR, 5.35; 95{b8727dad3e87009fdf7522b8034efdb701cdc6055ba8d220b20c1758c4dd8d79} CI, 3.04 to 9.40 to OR,
6.22; 95{b8727dad3e87009fdf7522b8034efdb701cdc6055ba8d220b20c1758c4dd8d79} CI, 3.81 to 10.14), and chronic headaches (OR, 40.40; 95{b8727dad3e87009fdf7522b8034efdb701cdc6055ba8d220b20c1758c4dd8d79} CI, 8.67 to 188.15
to OR, 95.93; 95{b8727dad3e87009fdf7522b8034efdb701cdc6055ba8d220b20c1758c4dd8d79} CI, 12.53 to 734.27) were calculated. Articular TMDs without pain
were evaluated in only 1 article, in which ORs of 1.78 (95{b8727dad3e87009fdf7522b8034efdb701cdc6055ba8d220b20c1758c4dd8d79} CI, 0.90 to 3.51) for
migraines and 1.04 (95{b8727dad3e87009fdf7522b8034efdb701cdc6055ba8d220b20c1758c4dd8d79} CI, 0.53 to 2.06) for tension-type headache were reported.
Three studies were classified as moderate risk of bias and 5 as low risk of bias.
The certainty of evidence varied between very low and low.
Conclusions and Practical Implications
Recognizing the positive association between painful TMD and PHs can help dentists
and physicians treat the pain and avoid it, or recommend the patient to a specialist.
Key Words
Headache disorders, primary
migraine disorders
tension-type headache
temporomandibular disorder
systematic review
Abbreviation Key:
DC/TMD (Diagnostic Criteria for Temporomandibular Disorders), ICHD (International Classification of Headache Disorders), MA (Meta-analysis), PH (Primary headache), RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders), TMD (Temporomandibular disorder), TTH (Tension-type headache)
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Biography
Dr. Reus is a PhD student, Brazilian Centre for Evidence Based Research, Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil.
Biography
Dr. Polmann is a PhD student, Brazilian Centre for Evidence Based Research, Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil.
Biography
Dr. Souza is an adjunct professor, Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil.
Biography
Dr. Flores-Mir is a professor, Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Biography
Dr. Goncalves is an adjunct professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University, School of Dentistry, Araraquara, Brazil.
Biography
Dr. de Queiroz is a neurologist, University Hospital of the Federal University of Santa Catarina, Florianopolis, Brazil.
Biography
Dr. Okeson is a professor and chief, Division of Orofacial Pain, and director, Orofacial Pain Program, University of Kentucky College of Dentistry, Lexington, KY.
Biography
Dr. De Luca Canto is an associate professor, Brazilian Centre for Evidence Based Research, Department of Dentistry. Federal University of Santa Catarina, Florianopolis, Brazil.
Article Info
Publication History
Published online: October 12, 2021
Publication stage
In Press Corrected Proof
Footnotes
Disclosure. None of the authors reported any disclosures.
The authors thank Maria Gorete Manteguti Savi, librarian, for the instructions regarding the search strategy in this review’s first stage.
Identification
DOI: https://doi.org/10.1016/j.adaj.2021.07.021
Copyright
(C) 2021 American Dental Association. All rights reserved.
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