Non-Cochrane · prognostic · PM41760141
Prognostic factors for pain intensity and function in individuals with temporomandibular disorders (TMDs): a systematic review and meta-analysis.
Amaral Maitê, Fukusawa Leandro, Lourenço Bianca Martins, et al. · BMJ open · 2026 · PubMed · doi:10.1136/bmjopen-2025-103638
Findings
Population Adults with temporomandibular disorders (TMD)
17 findings
| Prognostic factor: Somatization level | Lower level or absence of the factor (reference not specified) | Pain intensity/course of TMD pain over follow-up (unadjusted analysis) Follow-up 6 months to 11 years across studies · Not specified | OR 1.044 [1.014, 1.074] GRADE not reported Studies not reported |
| Higher somatization level (prognostic factor) | Lower somatization level | Pain intensity course (worse pain prognosis), adjusted analysis Follow-up of 3 months or longer (6 months to 11 years across studies) · Not specified · Adjusted estimates | OR 1.476 [0.519, 4.2] Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias 2 studies |
| Prognostic factor: Self-efficacy | Lower level or absence of the factor (reference not specified) | Pain intensity/course of TMD pain over follow-up (unadjusted analysis) Follow-up 6 months to 11 years across studies · Not specified | OR 0.86 [0.72, 1.02] GRADE not reported Studies not reported |
| Higher self-efficacy (prognostic factor) | Lower self-efficacy | Functional outcome (mandibular function), adjusted analysis Follow-up of 3 months or longer (6 months to 11 years across studies) · Not specified · Adjusted estimates | OR 0.971 [0.593, 1.59] Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias 2 studies |
| Prognostic factor: Self-efficacy | Lower level or absence of the factor (reference not specified) | Pain intensity/course of TMD pain over follow-up (adjusted analysis) Follow-up 6 months to 11 years across studies · Not specified | OR 0.971 [0.593, 1.59] Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias 2 studies |
| Higher baseline pain intensity (prognostic factor) | Lower baseline pain intensity | Functional outcome (mandibular function), adjusted analysis Follow-up of 3 months or longer (6 months to 11 years across studies) · Not specified · Adjusted estimates | OR 1.386 [1.138, 1.689] Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias 2 studies |
| Prognostic factor: Pain intensity | Lower level or absence of the factor (reference not specified) | Pain intensity/course of TMD pain over follow-up (unadjusted analysis) Follow-up 6 months to 11 years across studies · Not specified | OR 1.23 [1.13, 1.49] GRADE not reported Studies not reported |
| Prognostic factor: Pain intensity | Lower level or absence of the factor (reference not specified) | Pain intensity/course of TMD pain over follow-up (adjusted analysis) Follow-up 6 months to 11 years across studies · Not specified | OR 1.16 [0.786, 1.711] Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias 3 studies |
| Prognostic factor: Number of disability days | Lower level or absence of the factor (reference not specified) | Pain intensity/course of TMD pain over follow-up (adjusted analysis) Follow-up 6 months to 11 years across studies · Not specified | OR 1.079 [0.939, 1.239] Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias 2 studies |
| Greater number of disability days (prognostic factor) | Fewer disability days | Functional outcome (mandibular function), adjusted analysis Follow-up of 3 months or longer (6 months to 11 years across studies) · Not specified · Adjusted estimates | OR 1.079 [0.939, 1.239] Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias 2 studies |
| Prognostic factor: Gender | Lower level or absence of the factor (reference not specified) | Pain intensity/course of TMD pain over follow-up (adjusted analysis) Follow-up 6 months to 11 years across studies · Not specified | OR 1.121 [0.474, 2.652] Low Downgraded: risk of bias, publication bias 2 studies |
| Prognostic factor: Gender | Lower level or absence of the factor (reference not specified) | Pain intensity/course of TMD pain over follow-up (unadjusted analysis) Follow-up 6 months to 11 years across studies · Not specified | OR 1.73 [1.16, 2.59] GRADE not reported Studies not reported |
| Prognostic factor: Depression | Lower level or absence of the factor (reference not specified) | Pain intensity/course of TMD pain over follow-up (unadjusted analysis) Follow-up 6 months to 11 years across studies · Not specified | OR 1.29 [0.48, 3.48] GRADE not reported Studies not reported |
| Prognostic factor: Depression | Lower level or absence of the factor (reference not specified) | Pain intensity/course of TMD pain over follow-up (adjusted analysis) Follow-up 6 months to 11 years across studies · Not specified | OR 1.063 [0.813, 1.39] Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias 2 studies |
| Prognostic factor: Age | Lower level or absence of the factor (reference not specified) | Pain intensity/course of TMD pain over follow-up (unadjusted analysis) Follow-up 6 months to 11 years across studies · Not specified | OR 1 [0.99, 1.01] GRADE not reported Studies not reported |
| Prognostic factor: Age | Lower level or absence of the factor (reference not specified) | Pain intensity/course of TMD pain over follow-up (adjusted analysis) Follow-up 6 months to 11 years across studies · Not specified | OR 1 [0.982, 1.018] Moderate Downgraded: risk of bias 2 studies |
| Prognostic factor: Disability (function-related) | Lower level or absence of the factor (reference not specified) | Pain intensity/course of TMD pain over follow-up (unadjusted analysis) Follow-up 6 months to 11 years across studies · Not specified | OR 1.057 [0.907, 1.232] GRADE not reported Studies not reported |
Included primary studies 9
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Banafa 2020 Factors associated with signs of temporomandibular pain: an 11-year-follow-up study on Finnish adults. PMID:31401930 | 2020 | this review only | not stated | not extracted yet |
| Banafa 2023 Association between cynical hostility and temporomandibular pain mediated through somatization and depression: an 11-year follow-up study… PMID:35731236 | 2023 | this review only | Pain intensity course (worse pain prognosis), adjusted analysis | not extracted yet |
| Forssell 2017 Predictors for future clinically significant pain in patients with temporomandibular disorder: A prospective cohort study. PMID:27461164 | 2017 | this review only | Pain intensity/course of TMD pain over follow-up (adjusted analysis); PM41760141-P2-O2; PM41760141-P3-O2; PM41760141-P4-O2 | not extracted yet |
| Jung 2021 Influence of psychological factors on the prognosis of temporomandibular disorders pain. PMID:33384819 | 2021 | this review only | not stated | not extracted yet |
| Lovgren 2025 Women are worse off in developing and recovering from temporomandibular disorder symptoms. PMID:39922904 | 2025 | this review only | not stated | not extracted yet |
| Meloto 2019 Clinical predictors of persistent temporomandibular disorder in people with first-onset temporomandibular disorder: A prospective… PMID:31248483 | 2019 | this review only | Pain intensity/course of TMD pain over follow-up (adjusted analysis); PM41760141-P3-O2; PM41760141-P4-O2 | not extracted yet |
| Rammelsberg 2003 Longitudinal outcome of temporomandibular disorders: a 5-year epidemiologic study of muscle disorders defined by research diagnostic… PMID:12756926 | 2003 | this review only | Pain intensity course (worse pain prognosis), adjusted analysis; Pain intensity/course of TMD pain over follow-up (adjusted analysis) | not extracted yet |
| Rollman 2013 Improvement in patients with a TMD-pain report. A 6-month follow-up study. PMID:23062033 | 2013 | this review only | Pain intensity/course of TMD pain over follow-up (adjusted analysis); PM41760141-P2-O2 | not extracted yet |
| Slade 2014 Pressure pain thresholds fluctuate with, but do not usefully predict, the clinical course of painful temporomandibular disorder. PMID:25130428 | 2014 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Individuals of any age or sex with TMD (articular, myogenic, arthrogenic or mixed), acute or chronic | Adults with TMD (n=99,051 in total; n=4282 in quantitative analyses) |
| Intervention | Prognostic factors for TMD course | 56 candidate prognostic factors after standardization (80 initially identified); 7 pooled for pain (gender, age, depression, somatization, number of disability days, pain intensity, self-efficacy) and 3 pooled for function (pain intensity, number of disability days, self-efficacy) |
| Comparison | Not specified | Not specified |
| Outcomes | Longitudinal change in pain intensity and functional status; secondary: symptom progression, subsequent treatment needs, psychosocial outcomes | Pain intensity course and mandibular function; secondary outcomes could not be analyzed |
| Study designs | Prospective and retrospective observational studies; case-control studies and RCTs also considered | 9 prospective longitudinal studies (6 cohort, 1 case-control, 2 described as prospective longitudinal) |
| Timing | Short-term (up to 3 months) or long-term (over 3 months) follow-up | Follow-up from 6 months to 11 years |