Comparison of the outcomes of dynamic/static tests and palpation tests in <scp>TMD</scp>‐pain patients

Osiewicz, Magdalena; Manfredini, Daniele; Loster, Bartłomiej; Selms, M.K.A. van; Lobbezoo, Frank

doi:10.1111/joor.12600

Cited by 12 publications

(15 citation statements)

References 13 publications

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“…In order to perform data analysis, the 4-point ordinal pain scale was dichotomized into: 0 = no pain or 1 = presence of pain (independent of the rating). The pain diagnoses based on palpation tests (RDC/TMD) were compared with those based on dynamic/static tests as per the study of Osiewicz et al [20]. To that aim, the following single diagnostic outcomes were established for each diagnostic system (i.e., palpation tests and dynamic/static tests): no pain diagnosis, mainly myogenous pain, and mainly arthogenous pain.…”

Section: Discussionmentioning

confidence: 99%

“…A TMD-pain diagnosis is commonly based on oral history and the outcomes of palpation tests as per the Research Diagnostic Criteria for TMD (RDC/TMD; [15]), or the updated Diagnostic Criteria for TMD (DC/TMD; [16]). As a complimentary diagnostic option, dynamic/static tests have been proposed, based on the rationale to elicit pain in a function-dependent manner (i.e., as a result of movements of the jaw and static muscle efforts) [17][18][19][20]. In patients with TMD symptoms occurring in presence of other primary conditions, such as Lyme disease, it should be interesting to assess findings from the dynamic/static tests with respect to the possible overestimation of primary TMDs that could be drawn from palpation tests alone.…”

Section: Introductionmentioning

confidence: 99%

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Differences between palpation and static/dynamic tests to diagnose painful temporomandibular disorders in patients with Lyme disease

et al. 2019

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Objectives The aim was to determine the frequency of Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD)-based pain diagnoses and dynamic/static tests-based pain diagnoses, and to assess the agreement of palpation tests with static/dynamic tests. Materials and methods Eighty-six (N = 86) adult patients with Lyme disease (mean age 57.0 ± 14.3 years; male/female ratio was 42/44) were examined according to techniques described in the RDC/TMD. Additionally, dynamic/static tests were performed. For RDC/TMD-based pain diagnoses and dynamic/static tests-based pain diagnoses, descriptive frequencies were calculated. Differences between the frequency of palpation-based diagnoses and of dynamic/static-based diagnoses as well as the agreement between pain diagnoses established with the two diagnostic approaches were assessed. Results RDC/TMD-based pain diagnoses were made in 61 patients for myofascial pain and in 11 patients for arthralgia and/or osteoarthritis. Based on dynamic/static tests, mainly myogenous pain was diagnosed in 6 patients, and a mainly arthrogenous pain in 5. The agreement of palpation tests with static/dynamic tests in Lyme disease population was poor. Conclusion A high prevalence of TMD symptoms was found in patients with Lyme disease. The results suggest that using palpation tests alone could overestimate primary TMDs when comorbid conditions are present. Clinical relevance: Dynamic/static tests should be used as part of the routine TMD assessment. In case of Lyme disease as the actual cause of the facial pain, while the dentist might be suspecting TMD when dynamic/static TMD tests are negative, referral to an appropriate specialist for the diagnosis and treatment of Lyme disease needs to be made.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Differences between palpation and static/dynamic tests to diagnose painful temporomandibular disorders in patients with Lyme disease

et al. 2019

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“…Pain responses could be further subdivided as the following: (1) local myalgia: pain at the site of palpation; (2) myofascial pain: pain spreading beyond the site of palpation, within the boundary of the muscle being palpated; and (3) myofascial pain with referral. Intratester reliability for palpation pain of the TMJ and the masseter, respectively was .29 and .31 to .45 PPT .…”

Section: Methodsmentioning

confidence: 96%

Preclinical Signs of a Temporomandibular Disorder in Female Patients With Episodic Cervicogenic Headache Versus Asymptomatic Controls: A Cross‐Sectional Study

Mingels

Dankaerts

Granitzer

2019

PM&R

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Background: The International Classification of Headache Disorders, 3rd Edition, accepted "headache attributed to temporomandibular disorders" as a valid headache. The neurophysiologic interplay between cervical structures and the temporomandibular joint, however, might also suggest that a temporomandibular disorder could develop in patients with cervicogenic headache. Objective: To compare the presence of preclinical temporomandibular signs between female patients with episodic cervicogenic headache and a control group. Design: Case-controlled cross-sectional design. Setting: Institutional setting: Hasselt University. Participants: Twenty-two women (mean age AE SD: 20.7 AE 2.5 years) with episodic cervicogenic headache, without temporomandibular signs and 22 matched (gender, age, level of education, occupation) asymptomatic controls (21 AE 2.3 years). Methods: (Un)assisted temporomandibular range of motion, pressure pain thresholds, painful palpations were examined and the level of perceived stress was measured. Main Outcome Measurements: Temporomandibular range of motion (mm), pressure pain thresholds (kPa/cm²), painful palpations (yes/no), and level of perceived stress (Perceived Stress Scale). Results: Maximal mouth-opening was significantly smaller in the headache group (P <.05; effect size [ES] −0.45). Palpation of the masseter resulted in significantly more positive pain responses in the headache group at the left (P = .009; ES ∞) and right (P = .002;ES 17.5) origin, left (P = .004; ES 14.54) and right (P = .03; ES 5.71) body and left (P < .001; ES 12) insertion. Significantly lower pressure pain thresholds on the left and right anterior (P = .03; ES −0.33 resp. P = .02; ES −0.35), central (P = .003; ES 1.02 resp. P = .02; ES 0.79) and right posterior (P = .03; ES 0.62) temporalis and right tibialis anterior (P = .03; ES −0.33) were measured in the headache group. The level of perceived stress was significantly higher (P = .02) in the headache group. Conclusions: Patients with episodic cervicogenic headache present with signs of a preclinical temporomandibular disorder and sensitization. The smaller range of motion, lower pressure pain thresholds, and higher levels of stress accentuate the multidimensionality of the problem.

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“…The control group was composed of asymptomatic volunteers who were referred to the department of plastic surgery for aesthetic procedures. All participants were asked to complete a version of the Diagnostic Criteria for Temporomandibular Disorders questionnaire (Osiewicz et al 2018) and underwent clinical examination conducted by a maxillofacial surgeon with 5 y experience in the evaluation of TMJ pathologic conditions, to ultimately confirm (TMD group) or exclude (control group) the presence of TMDs.…”

Section: Participantsmentioning

confidence: 99%

Shear Wave Elastography in the Evaluation of Temporomandibular Joint Disorders

Paluch¹,

Maj

Pietruski

et al. 2020

Ultrasound in Medicine & Biology

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We aimed at verifying the usefulness of shear wave elastography in determining the temporomandibular disc stiffness in patients with a temporomandibular disorders (TMDs). The study included 37 patients with confirmed TMDs and 208 healthy volunteers. Patients presented with significantly greater stiffness of the intermediate zone of the disc (region of interest [ROI] 1) and significantly lower stiffness of its anteriorly displaced portion (ROI 3). A receiver operating characteristics analysis indicated that a decrease in the stiffness in ROI 3 less than 8.667 KPa provided 100% sensitivity, 97.3% specificity, 100% positive predictive value (PPV) and 99.5% negative predictive value (NPV) in distinguishing between patients with TMDs and without. Whereas an increase in ROI 1 stiffness to at least 54.33 KPa provided high specificity and NPV, both the sensitivity and the PPV of this predictor equaled zero. Findings suggest that a decrease in anteriorly dislocated disc stiffness less than 8.667 kPa can accurately identify patients with TMDs.

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Comparison of the outcomes of dynamic/static tests and palpation tests in TMD‐pain patients

Cited by 12 publications

References 13 publications

Differences between palpation and static/dynamic tests to diagnose painful temporomandibular disorders in patients with Lyme disease

Differences between palpation and static/dynamic tests to diagnose painful temporomandibular disorders in patients with Lyme disease

Preclinical Signs of a Temporomandibular Disorder in Female Patients With Episodic Cervicogenic Headache Versus Asymptomatic Controls: A Cross‐Sectional Study

Shear Wave Elastography in the Evaluation of Temporomandibular Joint Disorders

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