Clinical Exam and Electrovibratography Detecting Articular Disk Displacement: A Comparative Study

Abstract

The complete evaluation of the stomatognathic system is essential for orthodontic diagnosis and treatment planning. The evaluation should not only include the occlusal static aspects, but also the functional aspects. This is because the latter could be altered and one or more components of the stomatognathic system could be involved, including the temporomandibular joint (TMJ). The most usual alteration found is articular disk displacement, which can affect the prognosis, and eventually the result in the need for orthodontic treatment. In order to add to the literature on recognition of these alterations, the purpose of this study was to compare the findings of two calibrated examiners on disk displacement clinical diagnosis, and the possible matching between the clinical examination and the electrovibratography (EVG) as methods of disk displacement detection. The sample was composed of 60 patients, divided equally into four groups of 15 participants each, depending on the presence or absence of disk displacement determined by a clinical examination performed by two trained examiners and according to gender. One of the trained operators used EVG and SonoPAK (BioResearch, Inc., Brown Deer, WI) software. The results of the two examiners' findings, one using clinical examination and the other using EVG and SonoPak software. The results were analyzed by applying the kappa coefficient. The findings of the two examiners were very close, resulting in an excellent agreement, and the comparison between the clinical examination and EVG findings resulted in satisfactory agreement between the methods.

The reproducibility of temporomandibular joint vibrations over time in the human

“…Although some studies reported that the Axis I criterion procedures of RDC/TMD had developed content validity and acceptable reliability, there was still some inherent variability in the clinical signs and symptoms and systematic error in the examiners' subjective measurements that were difficult to distinguish in the clinic . Some investigators have used electronic recording techniques such as JVA in an attempt to obtain more objective measurements that could link the sound characteristics produced during jaw movements to a specific pathologic state in the TMJ . Moreover, the aetiology of joint sounds is not clear and there is no consensus on treatment necessary and effective treatment method.…”

Diagnostic concordance between MRI and electrovibratography of the temporomandibular joint of subjects with disc displacement disorders

“…27 Abrão et al described an excellent statistical agreement in the comparison between the clinical diagnosis of disc disorders and EVG findings. 28 However, they did not perform an MRI investigation of the analysed joints; therefore, their conclusions should be interpreted with caution. Naeije et al confirmed the fact that clinically, even under the guide of the RDC/TMD, it is a challenge to discriminate between the two most prevalent internal derangements: ADDwR and symptomatic hypermobility.…”

Comparison of TMJ vibration frequencies under different joint conditions

“…Many different systems, equipments and methods have been used in the past to accomplish the recording and analysis of TMJ vibration data. 5,10,13,18,20,21 More recent results from studies of electrovibratography, [23][24][25][26][27] joint vibration analysis (JVA), [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] sonography, [44][45][46] electro-sonography [47][48][49][50] and doppler auscultation [51][52][53][54] have been mixed, although far more successful classifications have been published than failures. However, a few dentists have been skeptical of the usefulness of TMJ vibration measurements.…”