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SCREENING INSTRUMENTS FOR TEMPOROMANDIBULAR DISORDERS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Axel Kutschke1, Oliver Schierz2, Anna Lövgren3
1Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Orofacial Pain and Jaw Function, Gävle County Hospital, Public Dental Health County Council of Gävleborg, Gävle, Sweden; Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden.
Background:
Screening methods are crucial in enabling prevention and early intervention for individuals with temporomandibular disorders (TMDs) in the general population. Several screening instruments for TMDs have been published, making it challenging to choose the best-suited one for identifying patients with TMDs in daily practice.
Objective:
To evaluate the diagnostic accuracy of available screening instruments for TMDs in the general adult population.
Methods:
The study's protocol was registered in PROSPERO (CRD42024527919). PubMed/Medline, Web of Science, and Scopus were searched on April 12, 2024, supplemented by a hand search, to identify studies reporting diagnostic accuracy of screening instruments for TMDs in the general adult population. Two independent reviewers performed abstract screening, full-text assessment, risk-of-bias assessment (QUADAS-2), and data extraction.
Results:
The search identified 3608 studies. After abstract screening, 151 studies were reviewed in full text, and five studies on diagnostic accuracy with 2556 participants were included. Two included studies reported reliability measures for the Short Form Fonseca Amnestic Index (SFAI) compared with other questionnaires. Three studies included in the meta-analysis evaluated the Fonseca Amnestic Index (FAI), its short form (SFAI), and Three Screening Questions for TMDs (3Q/TMD): they report sensitivity of 86% (FAI and SFAI) and 81% (3Q/TMD), and specificity of 92% (FAI), 96 % (SFAI), and 79% (3Q/TMD) respectively. All included studies had high risk of bias for the index test but low risk of bias for patient selection.
Conclusion:
FAI, SFAI, and 3Q/TMD demonstrate high sensitivity and specificity, suggesting their suitability for screening for TMD in the general population.
