A Comparative Evaluation of Malocclusion and Associated Risk Factors in Patients Suffering with Temporomandibular Disorders: A Systematic Review and Meta-analysis of Observational Studies

Abstract

An association of malocclusion as potent risk factor to temporomandibular disorders (TMDs) has been under question since ages. A systematic review and meta-analysis of case-control and cohort studies was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses)guidelines to compare the prevalence of TMDs in subjects with malocclusion to patients with normocclusion. The study was registered on the PROSPERO database (identifier: CRD42022315863). An elaborate electronic database (PubMed, DOAJ, and Google Scholar) and manual search resulted in 325 articles, among which 7 and 3 articles were shortlisted for qualitative and quantitative review, respectively, for articles published from January 2000 until December 2021. A total of 4,183 participants were included in this review with age range of 5 to 75 years. New-Castle Ottawa tool was employed for quality assessment, while I 2 statistical value for meta-analysis was interpreted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. Fixed effect model was applied as, I 2 = 0. Pooled odds ratio with 95% confidence interval for all three studies was 14.64 [4.43, 48.36] suggesting that TMDs were 14.64 times more associated in patients with malocclusion (cases) than patients without malocclusion (controls). Within the limitations and fair quality of evidence of the current review and analysis, TMDs and associated symptoms are more prevalent in patients with malocclusion with or without more associated factors.