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. 2024 Dec 31;29(1):35.
doi: 10.1007/s00784-024-06095-2.

When trauma bites back: a systematic review on direct orofacial macrotrauma and temporomandibular disorders

Loreine M L Helmer  1   2   3 , Sebastiaan W R Dalmeijer  4   5 , Michail Koutris  6 , Ralph de Vries  7 , Leander Dubois  5 , Jan de Lange  5 , Frank Lobbezoo  6
Affiliations

When trauma bites back: a systematic review on direct orofacial macrotrauma and temporomandibular disorders

Loreine M L Helmer et al. Clin Oral Investig. .

Abstract

Objectives: Temporomandibular disorders (TMD) are musculoskeletal conditions with a multifactorial aetiology. The predictive role of direct orofacial macrotrauma in the development of TMD is considered controversial. This systematic review aims to elucidate the association between direct orofacial macrotrauma and TMD, and to identify potential factors involved in this relationship.

Materials and methods: A comprehensive literature search of PubMed, Embase, and Web of Science databases up to November 1, 2023, was performed in collaboration with a medical information specialist, identifying 2,047 unique studies. Of these, 139 met the inclusion criteria of this investigation.

Results: Our synthesis of the literature indicates a consistent association between TMD and direct orofacial macrotrauma in adults, while this relationship appears less defined in paediatric and adolescent populations. The association shows robustness across various TMD diagnoses and trauma locations, remaining not only immediately following the direct orofacial macrotrauma but also after long time, despite other interventions. These outcomes could be due to the physical effect of the trauma, but they might be associated with the psychosocial effect of the trauma as well.

Conclusions: The evidence supports a robust, but complex, association between direct orofacial macrotrauma and TMD.

Clinical relevance: This finding underscores the importance of considering both physical and psychosocial sequelae of trauma in the clinical management of direct orofacial macrotrauma and TMD.

Keywords: Condylar fracture; Direct orofacial macrotrauma; Psychosocial sequelae; Review; TMD.

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Conflict of interest statement

Declarations. Consent to participate: As it is a review of literature, no individual participants were included in this study. Statement of clinical relevance: An association between TMD and direct orofacial macrotrauma has been assumed to exist. However, a comprehensive synthesis of the evidence on this topic has never been performed. In this review, the possible association and the different factors of influence on this association are discussed. Competing interests: The authors declare no competing interests.

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