SCREENING INSTRUMENTS FOR TEMPOROMANDIBULAR DISORDERS: A SYSTEMATIC REVIEW AND META-ANALYSIS.

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.