{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T09:46:42Z","timestamp":1781344002972,"version":"3.54.1"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T00:00:00Z","timestamp":1665532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Swedish Public Dental Services, Folktandv\u00e5rden Stockholm AB"},{"name":"Steering Group for Collaborative Odontological Research at Karolinska Institutet and Stockholm City County"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Temporomandibular disorders (TMD) are comprised by a heterogenous group of diagnoses with multifaceted and complex etiologies. Although diseases of the musculoskeletal system and connective tissue (MSD) have been reported as risk factors for developing TMD, no nationwide population-based registry studies have been conducted to investigate this possible link. The aim of this study was to investigate the association between MSD and TMD in a population-based sample using Swedish registry data, and to further investigate the difference in such association between patients diagnosed with TMD in a hospital setting and patients surgically treated for the condition.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>Population based case-control study using Swedish nationwide registry data. Data was collected between 1998 and 2016 from 33 315 incident cases and 333 122 controls aged \u226518, matched for sex, age, and living area. Cases were stratified into non-surgical (NS), surgically treated once (ST1) and surgically treated twice or more (ST2). Information on MSD exposure (ICD-10 M00-M99) was collected between 1964 and 2016. Odds ratios were calculated using conditional logistic regression, adjusted for country of birth, educational level, living area, and mental health comorbidity.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A significant association between MSD and the development of TMD was found for all diagnostic categories: arthropathies (OR 2.0, CI 1.9\u20132.0); systemic connective tissue disorders (OR 2.3, CI 2.1\u20132.4); dorsopathies (OR 2.2, CI 2.1\u20132.2); soft tissue disorders (OR 2.2, CI 2.2\u20132.3); osteopathies and chondropathies (OR 1.7, CI 1.6\u20131.8); and other disorders of the musculoskeletal system and connective tissue (OR 1.9, CI 1.8\u20132.1). The associations were generally much stronger for TMD requiring surgical treatment. The diagnostic group with the strongest association was inflammatory polyarthropathies, M05-M14 (OR 11.7, CI 8.6\u201315.9), which was seen in the ST2 group.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Patients with MSD diagnoses have a higher probability of being diagnosed with TMD, in comparison to individuals without MSD. This association is even stronger for TMD that requires surgery. The results are in line with earlier findings, but present new population-based evidence of a possible causal relationship between MSD and TMD, even after adjusting for known confounders. Both dentists and physicians should be aware of this association and be wary of early signs of painful TMD among patients with MSD, to make early referral and timely conservative treatment possible.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0275930","type":"journal-article","created":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T17:30:44Z","timestamp":1665595844000},"page":"e0275930","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Diseases of the musculoskeletal system and connective tissue in relation to temporomandibular disorders\u2014A SWEREG-TMD nationwide case-control study"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7930-348X","authenticated-orcid":true,"given":"Adrian","family":"Salinas Fredricson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron","family":"Naimi-Akbar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Adami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bodil","family":"Lund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Ros\u00e9n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britt","family":"Hedenberg-Magnusson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Fredriksson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carina","family":"Kr\u00fcger Weiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,10,12]]},"reference":[{"issue":"7","key":"pone.0275930.ref001","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1177\/0333102416686302","article-title":"Temporomandibular disorders: Old ideas and new concepts","volume":"37","author":"T List","year":"2017","journal-title":"Cephalalgia"},{"issue":"1","key":"pone.0275930.ref002","doi-asserted-by":"crossref","first-page":"6","DOI":"10.11607\/jop.1151","article-title":"Diagnostic Criteria for Temporomandibular Disorders (DC\/TMD) for Clinical and Research Applications: recommendations of the International RDC\/TMD Consortium Network* and Orofacial Pain Special Interest Groupdagger","volume":"28","author":"E Schiffman","year":"2014","journal-title":"J Oral Facial Pain Headache"},{"issue":"3","key":"pone.0275930.ref003","doi-asserted-by":"crossref","first-page":"273","DOI":"10.14219\/jada.archive.1990.0043","article-title":"Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls","volume":"120","author":"SF Dworkin","year":"1990","journal-title":"J Am Dent Assoc"},{"issue":"1","key":"pone.0275930.ref004","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1186\/s12889-022-13329-z","article-title":"Sick leave and disability pension in a cohort of TMD-patients\u2014The Swedish National Registry Studies for Surgically Treated TMD (SWEREG-TMD)","volume":"22","author":"A Salinas Fredricson","year":"2022","journal-title":"BMC Public Health"},{"issue":"10","key":"pone.0275930.ref005","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1177\/0022034516653743","article-title":"Painful Temporomandibular Disorder: Decade of Discovery from OPPERA Studies","volume":"95","author":"GD Slade","year":"2016","journal-title":"J Dent Res"},{"issue":"1","key":"pone.0275930.ref006","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1002\/ejp.1472","article-title":"Premorbid and concurrent predictors of TMD onset and persistence","volume":"24","author":"R Ohrbach","year":"2020","journal-title":"Eur J Pain"},{"issue":"1","key":"pone.0275930.ref007","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.oooo.2019.02.023","article-title":"Comorbidity between fibromyalgia and temporomandibular disorders: a systematic review","volume":"128","author":"I Ayouni","year":"2019","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"issue":"5","key":"pone.0275930.ref008","doi-asserted-by":"crossref","first-page":"2475","DOI":"10.1007\/s00784-018-2664-y","article-title":"Prevalence of degenerative joint disease of the temporomandibular joint: a systematic review","volume":"23","author":"LLQ Pantoja","year":"2019","journal-title":"Clin Oral Investig"},{"issue":"Suppl 1","key":"pone.0275930.ref009","doi-asserted-by":"crossref","first-page":"S79","DOI":"10.1111\/adj.12593","article-title":"Management of temporomandibular joint disorders: A surgeon\u2019s perspective","volume":"63","author":"G. 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