Diagnostic accuracy of the Fonseca anamnestic index for temporomandibular disorders: a systematic review and meta-analysis

This study aimed to comprehensively evaluate the diagnostic accuracy and performance of the Fonseca Anamnestic Index (FAI) in screening for temporomandibular disorders (TMD) through a systematic review and meta-analysis approach. A systematic literature search was conducted in PubMed, Cochrane Library, Web of Science, and Embase from database inception to September 2025, using the keywords “Fonseca Anamnestic Index” and “temporomandibular disorders.” The included studies were assessed for risk of bias using QUADAS-2 tool. Threshold effects were examined with Meta-DiSc 1.4 software. Pooled sensitivity, specificity, diagnostic odds ratio (DOR)and area under receiver operating characteristic curve (AUC) were calculated via Stata 15.0. Subgroup analyses, sensitivity analyses, and publication bias assessments were also performed. Out of 571 records identified, nine studies involving 2,381 patients met the inclusion criteria. Spearman correlation coefficient for threshold effect was 0.376 (P = 0.332 > 0.05), indicating no significant threshold effect. Pooled sensitivity and specificity were 0.89 (95% CI: 0.82–0.94) and 0.76 (95% CI: 0.57–0.88), respectively. Positive and negative likelihood ratios were 3.28 (95% CI: 2.46–4.10) and 0.14(95% CI:0.07–0.27), respectively. The pooled DOR was 26.51 (95%CI: 11.66–60.23), and the summary AUC was 0.91 (95% CI: 0.88–0.93). Subgroup analyses indicated no notable fluctuation in diagnostic performance across populations, regions, or sample sizes, while sensitivity analyses confirmed the stability of the results. No significant publication bias was detected by Deeks’ funnel plot asymmetry test (P = 0.41 > 0.05). The FAI exhibits high diagnostic accuracy in TMD screening and may serve as a reliable clinical adjunct tool, facilitating early detection of TMD in evidence-based practices.