Validity of Diagnostic and Monitoring Tests Used for Temporomandibular Disorders

Abstract

Currently, diagnosis of temporomandibular disorders (TMD) depends on a comprehensive history and physical examination, supplemented, when indicated, by images of hard and soft tissues. However, there are electronic diagnostic devices being marketed to acquire other measures described as relevant to TMD and to use these for diagnosis of TMD and for monitoring the effects of treatment. This paper reviews the capacity of several devices to measure these variables accurately and reliably and to assess the theoretical basis of each of these tests. Diagnostic ability was established, when possible, according to the commonly accepted measures of sensitivity, specificity, and positive predictive values. It was found that many tests lack theoretical validity, that measurement validity tends to be poor, and that diagnostic ability can be even worse than chance, because of a high percentage of false-positive diagnoses. Based on these findings, the use of these instruments in clinical practice is inappropriate at this time and may lead to the treatment of large numbers of subjects who have no disorder.

Мandibular range of motion and its relation to temporomandibular disorders

“…An advantage of the incisal edge distance measurement is that the measuring point is relatively more permanent and more easily determined. (1,22,25) Measurements using a millimeter ruler have been used for assessment of mandibular mobility in large population studies, and measurement reliability has been shown to be very good (21).…”

Eletromiografia de superfície em disfunção temporomandibular: revisão sistemática

“…Such findings are in line with the pain adaptation model and its further integration, since pain leads to individual muscle activity changes aiming at limiting movements and at protecting the system against new injuries, by decreasing agonist muscles activity 13,14 . The literature suggests that SEto diagnose TMD has a much lower accuracy than was is proposed by the manufacturers of such devices 15,16 . In addition, recent systematic literature reviews argue that selected studies corresponded to low relevance and low impact trials, in addition to having conflicting final results, possibly due to the summation of many variables such as: inadequate sample and control group selection, insufficient clinical conditions and incorrect use of equipment 17,18 .…”

JVA, Mastication and Digital Occlusal Analysis in Diagnosis and Treatment of Temporomandibular Disorders

“…For many years, clinicians have employed various mechanical tools for diagnosis and to understand the reasons for the problem [7]. Due to the development of the chipset technology and software programming, we have now device-based diagnostic tools, joint vibration analysis, joint tracking measuring mastication analysis, computer-based occlusal analysis devices, and so on [8][9][10] available. However, there are still many questions and discussion points about some of the device-based diagnostic techniques [9].…”