Comorbidities in Patients with Acute and Chronic Temporomandibular Disorders: An Exploratory Retrospective Study with...

Temporomandibular disorders (TMDs) affect the masticatory muscles, temporomandibular joints, and related tissues and are frequently associated with pain and functional limitation. Patients with chronic TMD may present multiple comorbidities that complicate clinical management and contribute to symptom persistence. This study aimed to identify comorbid conditions associated with chronic TMD, compare their distribution between chronic and acute TMD presentations, and propose a conceptual interdisciplinary assessment framework.

A retrospective observational study included 82 patients with TMD and at least one symptomatic or documented comorbidity identified during interdisciplinary clinical assessment or within the previous three months. Of these, 58 patients had chronic TMD and 24 had acute TMD. Categorical variables were compared using Fisher's exact test, with odds ratios and 95% confidence intervals calculated for each comparison. False discovery rate (FDR) correction was applied, and age- and sex-adjusted Firth-penalized logistic regression models were also fitted.

In direct group comparisons, chronic TMD was associated with higher frequencies of primary headache, secondary headache, neck pain, lower back pain, endocrine/hormonal disorders, Axis II findings, and kinesiophobia. After age- and sex-adjusted Firth-penalized logistic regression analyses and FDR correction, primary headache, secondary headache, neck pain, lower back pain, endocrine/hormonal disorders, and kinesiophobia remained significantly associated with chronic TMD. No significant differences were observed for sleep bruxism, awake bruxism, or poor sleep quality.

Given the retrospective design and limited sample size, the results should be interpreted as exploratory associations rather than causal relationships. Further prospective studies are needed to evaluate and validate the proposed framework and assess its clinical applicability.