Diagnostic Accuracy of Clinical Tests and Signs of Temporomandibular Joint Disorders: A Systematic Review of the Literature

Reneker, Jennifer C.; Paz, Jaime C.; Petrosino, Christopher; Cook, Chad

doi:10.2519/jospt.2011.3644

Cited by 22 publications

(16 citation statements)

References 35 publications

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“…In an attempt to obtain greater diagnostic precision, researchers have investigated correlations among different assessment methods (De Felício et al, 2012) and have analyzed the sensitivity and specificity of these methods (Reneker et al, 2011). According to Mohl (1993), the gold standard for the diagnosis of TMD should be based on an evaluation of the patient's history as well as a clinical exam.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of the Fonseca anamnestic index in the identification of myogenous temporomandibular disorder in female community cases

Berni

Dibai‐Filho

Rodrigues-Bigaton

2015

Journal of Bodywork and Movement Therapies

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Section: Introductionmentioning

confidence: 99%

Accuracy of the Fonseca anamnestic index in the identification of myogenous temporomandibular disorder in female community cases

Berni

Dibai‐Filho

Rodrigues-Bigaton

2015

Journal of Bodywork and Movement Therapies

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“…Palpation revealed depressions anterior to the lobules of the ears and tenderness to palpation of the masseters and the lateral TMJs. 21,36 Interrater reliability of masticatory muscle and joint palpation for reproduction of pain is reported to be moderate (k50.51) and fair (k50.33), respectively.…”

Section: Examinationmentioning

confidence: 99%

Automobilization intervention and exercise for temporomandibular joint open lock

Hoglund

Scott

2012

Journal of Manual & Manipulative Therapy

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Temporomandibular joint disorders (TMDs) are common and may cause temporomandibular joint (TMJ) locking, pain, and disability. Evidence supports use of manual therapy and exercise for treatment of TMDs including disk displacement limiting full mouth opening, TMJ 'closed lock'. Only limited case studies describe management of TMJ 'open lock', a condition due to posterior disk displacement (PDD) or TMJ anterior dislocation (TMJ-AD). Reported treatment for open lock includes splinting and intraoral joint manipulation. This case report describes a novel extraoral automobilization using the mandibular elevator muscles to treat TMJ open lock in a 22-year-old male after intraoral joint mobilization failed. The exercise program used to restore neuromuscular control for post-reduction management is described. Short term results of automobilization were excellent with restored ability to swallow, speak normally, and achieve occlusion. Long term results at 14 months were good: the patient was pain-free, could swallow and speak normally, had no recurrence of TMJ locking, and minimal disability. Limited right lateral excursion range and left mandibular deviation during mouth opening indicated possible persistence of PDD. This case suggests that mandibular elevator automobilization and masticatory muscle exercise may be useful to treat TMJ open lock and should be considered to treat PDD and TMJ-AD.

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“…67 For people with TMDs of joint origin (disc or joint surface or structure), physical therapists will focus intervention on the impairments of joint pain and reduced joint range of motion, because conservative management will not substantially alter disc displacement or joint surface degeneration.…”

mentioning

confidence: 99%

“…16,47 These facts and the multifactorial nature of the disorder result in problems when trying to use more traditional gold standards, such as imaging, to validate the clinical exam among those presenting with orofacial pain. 67 For people with TMDs of joint origin (disc or joint surface or structure), physical therapists will focus intervention on the impairments of joint pain and reduced joint range of motion, because conservative management will not substantially alter disc displacement or joint surface degeneration.…”

mentioning

confidence: 99%

A Proposed Diagnostic Classification of Patients With Temporomandibular Disorders: Implications for Physical Therapists

Harrison¹,

Thorp²,

Ritzline³

2014

J Orthop Sports Phys Ther

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Researchers and expert clinicians in orofacial pain have long acknowledged the Differential DiagnosisIn addition to the musculoskeletal structures (TMJ and the masticatory muscles) and the psychological factors discussed, orofacial pain may result from or be exacerbated by (1) primary HAs (migraine, cluster, tension type, other primary); (2) secondary HAs related to systemic problems such as cardiovascular and rheumatoid disorders and disorders related to the cervical spine, ears, sinuses, eyes, medications, and dental structures; and (3) cranial and peripheral neuralgias and central nervous system disorders.The following provides an overview of the physical therapy examination for people presenting with HAs and/or orofacial pain. The examination will consist of the history, screens for contributing psychological factors, a systems screen, cervical spine screen, and specific examination of the TMJ and masticatory muscles. PHYSICAL THERAPY EXAMINATION HistoryA thorough history will help identify the possible source(s) of the orofacial pain and provide a screen for other causative or contributing factors. 17,22,61,74,75 Red flags related to cardiac history (eg, angina or history of myocardial infarction) and brain function (eg, sudden-onset severe HAs, weakness, or slurred speech) must be investigated early in the history taking. Information about the nature of the pain will be critical in determining the possibility of primary HAs (migraine, cluster) (TABLE 3) and secondary HAs related to the eyes, ears, sinus, dental structures, medication complications, and/or neurologic types of pain. Unrelenting pain unrelated to musculoskeletal function is an indication for referral. Information about cervical dysfunction is essential to determine whether the cervical spine is causing or exacerbating the HA/facial pain. Medication history is important to determine potential negative interactions, rebound HAs from overuse (as occurs with nonsteroidal anti-inflammatory drugs), or withdrawal.Key questions have been examined and determined to have strong sensitivity and specificity in incriminating TMDs as the source of pain. 22,29 The initiating question is, "Have you had pain or stiffness in the face, jaw, temple, in front of the ear, or in the ear in the past month?" A positive response should be followed with a question about whether the symptoms are altered by any of the following jaw activities: chewing, talking, singing, yawning, kissing, moving the jaw. 22,29,74,75 The other key inquiry is directed toward identifying the presence of a disc displacement 22,74 : "Have you ever had your jaw lock or catch so that it would not open all the way? If so, was this limitation in jaw opening severe enough to interfere with your ability to eat? Have you ever noticed clicking, popping, or other sounds in your joint?" 74 importance of the psychological domain in causing and/or maintaining pain, and in upregulating peripheral and central neural structures involved in nociception. 22,32,74,75 Central nervous system differences in the t...

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Diagnostic Accuracy of Clinical Tests and Signs of Temporomandibular Joint Disorders: A Systematic Review of the Literature

Cited by 22 publications

References 35 publications

Accuracy of the Fonseca anamnestic index in the identification of myogenous temporomandibular disorder in female community cases

Accuracy of the Fonseca anamnestic index in the identification of myogenous temporomandibular disorder in female community cases

Automobilization intervention and exercise for temporomandibular joint open lock

A Proposed Diagnostic Classification of Patients With Temporomandibular Disorders: Implications for Physical Therapists

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