Exploring the link between temporomandibular disorders and infectious diseases: A systematic review of comorbidities and underlying mechanisms.

Abstract

Temporomandibular disorders (TMD) are often linked with a variety of comorbidities, which can complicate their diagnosis and management. A systematic literature review (SLR) was conducted to investigate the association between the occurrence of TMD signs and symptoms in patients with infectious diseases.The present SLR was carried out in PubMed®. The eligibility criteria were established to include patients presenting with TMD signs and symptoms associated with an infection. The search identified 258 records, of which 27, involving 20,489 patients, were included in the qualitative analysis. Three types of associations were identified between the onset of TMD signs and symptoms and the type of infection. The first association is TMD arising from hematogenous spread of the pathogen to the temporomandibular joint (TMJ), the predominant symptoms of which are related to impaired TMJ function. The infection varies in severity and is occasionally asymptomatic, making it challenging to establish a clear connection between pathogen spread and symptoms in the temporomandibular region. Second, TMD resulting from the local spread of pathogens to adjacent tissues within the temporomandibular area were examined. This category included odontogenic infections, upper respiratory tract infections and otogenic infections. Thirdly, TMD associated with chronic systemic infection without arthritis were analyzed, which develop as a consequence of systemic changes due to prolonged illness and/or psychological disorders arising from limited treatment options.The relationship between the onset of TMD and infectious diseases is complex and multifaceted. A careful differential diagnosis is essential, as TMD can mask an underlying infection, leading to delays in accurate diagnosis and timely anti-infective treatment.