Exploring the Bidirectional Association Between Migraine and Temporomandibular Disorders: A Systematic Review and Meta-Analysis.

BACKGROUND

Migraine and temporomandibular disorders (TMD) are comorbid conditions that are highly frequent among patients.

OBJECTIVE

This systematic review with meta-analysis (MA) aimed to evaluate the bidirectional association between migraine and TMD in adults.

METHODS

The protocol was registered with the International Prospective Register of Systematic Reviews. The literature was searched in 5 main databases and 3 grey literature databases from inception until May 12, 2025. The review included observational cross-sectional studies that based TMD classification on the Research Diagnostic Criteria for TMD (RDC/TMD) or the Diagnostic Criteria for TMD (DC/TMD), and migraine was diagnosed according to any edition of the International Classification of Headache Disorders (ICHD). The risk of bias (Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument tools) and the certainty of evidence (GRADE) were assessed.

RESULTS

From 7329 studies, 17 were included in the qualitative assessment and 6 in the quantitative analysis. Seven studies were classified as low risk of bias, nine as moderate, and one as high. The qualitative assessment demonstrated an association between both conditions. MA revealed that patients with migraine were significantly more likely to have TMD (OR = 6.08; 95% CI: 4.80-7.68), and patients with TMD were more likely to have migraine (OR = 2.64; 95% CI: 2.19-3.18). The certainty of evidence was rated high.

CONCLUSION

The study identified a strong bidirectional association between migraine and TMD. Clinicians should systematically screen for both conditions, especially in the presence of one of them, to optimize treatment outcomes.