Clinical Validity of the Protocol for Multi-Professional Centers for the Determination of Signs and Symptoms of Temporomandibular Disorders. Part II

Abstract

The aims of this study were to analyze the criterion and construct validity of Part II of the protocol for multi-professional centers for the determination of signs and symptoms of temporomandibular disorders (ProTMDMulti) as a measure of TMD severity. The study was conducted on eight asymptomatic subjects (CG) and 30 subjects with articular TMD (TMDG), according to the Research Diagnostic Criteria for TMD (RDC/TMD). The ProTMDMulti-Part II was validated using the Helkimo Clinical Dysfunction Index (Di). The construct validity was tested using the analysis of the ability of ProTMDMulti-part II to differentiate the CG from the TMDG and to measure the changes that occurred in the TMDG between the period before and after TMD treatment. Correlations between the Di and the ProTMDMulti-Part II scores were calculated using the Spearman test. Inter- and intragroup comparisons were made (p<0.05). There was a statistically significant correlation between the Helkimo Clinical Dysfunction Index (Di) and the severity scores of the ProTMDMulti-Part II. There was a significant difference between TMDG and CG regarding the severity of signs and symptoms. The present study provides statistical evidence of the clinical validity of the ProTMDmulti-Part II as a measure of the severity of TMD symptoms.

Orofacial myofunctional disorder, a possible complicating factor in the management of painful temporomandibular disorder. Case report

“…This indicates that the speech therapy approach, combined with other dental and selfmanagement modalities, proved to be effective for the orofacial myofunctional balance, and consequently for the reduction of musculoskeletal overload, for the patient's perception and education regarding changes in myofunctional habits and behaviors and therefore contributing to the treatment/management of TMD in the way recommended by the current literature. The number of speech therapy sessions was higher than that reported in the literature, which is usually a total of 12 or 13 sessions 18,19 . In this case, the OMD presented important aspects related to TMD such as marked mandibular deviations during speech with exaggerated ceceo, swallowing with many cervical and tongue compensations, mandibular rest without free functional space, that is, in a state of teeth clenching with the tongue compressed most of the time; in some moments with the tongue interposed between the arches, causing strong marks on its sides.…”

Relationship between temporomandibular disorder symptoms signs and Burnout syndrome among dentistry students

“…Our results have shown decrease in ProDTMMulti scores along the years for females, however, they remained always higher as compared to males, which indicates that females have higher perception of TMD signs and symptoms 3,31 . ProDTMMulti points to self-perception with regard to TMD signs and symptoms 12,13 , being relevant for professionals when deciding the therapeutic approach. In this sense, there has been correlation between total ProDTMMulti score and EE only for females in the years 2013 and 2014, when signs and symptoms perception was more evident, reinforcing the idea that such factors are associated.…”

“…All participants have signed the Free and Informed Consent Term (FICT). Students were submitted to MBI -student survey (MBI-SS) and ProDTMMulti questionnaires, and investigators were previously trained to apply the evaluation tools 13,22 . The first questionnaire is made up of three investigating items: emotional exhaustion (EE), cynicism (CI) and professional effectiveness (PE).…”

“…In each situation, individuals shall answer to 10 questions investigating signs and symptoms commonly observed in TMD, based on a numerical scale from zero (absence of sign or symptom) to 10 (most severe possible). Scores may vary, considering the sum of each sign and symptom in the four situations, from zero to 400 12,13 . Students were gathered in a room where explanations were given about the objective of the study and the way they should answer the questionnaires.…”

“…Its multifactorial etiology is influenced by biopsychosocial aspects and for such it is important to quantify the frequency and severity of signs and symptoms, based on patients' perception. De Felicio, Melchior & Da Silva 13 have developed a protocol called Protocol for Multiprofessional Centers to Determine Temporomandibular Disorders Signs and Symptoms (ProDTMMulti), based on symptoms most frequently found in the literature and on situations causing the worst discomfort 12 . This protocol was validated based on the Helkimo Clinical Disorder Index and aims at complementing clinical evaluation with information given by patients themselves in a measurable way.…”