Original scientific paper

Temporomandibular disorders – validity of clinical diagnostics compared to magnetic resonance imaging

TOMISLAV BADEL orcid.org/0000-0001-5872-1132 ; Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
MILJENKO MAROTTI ; Department of diagnostic and interventional Radiology, Clinical Hospital »Sestre milosrdnice«, University of Zagreb, Vinogradska cesta 29, 10000 Zagreb, Croatia
IVANA SAVIĆ PAVIČIN orcid.org/0000-0002-5210-1765 ; Department of Dental Anthropology, School of Dental Medicine, University of Zagreb, Gunduli}eva 5, 10000 Zagreb, Croatia
NIKŠA DULČIĆ orcid.org/0000-0002-8536-000X ; Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
DIJANA ZADRAVEC ; Department of diagnostic and interventional Radiology, Clinical Hospital »Sestre milosrdnice«, University of Zagreb, Vinogradska cesta 29, 10000 Zagreb, Croatia
JOSIPA KERN orcid.org/0000-0002-0896-3018 ; Department of Medical Statistics, Epidemiology and Medical Informatics, School of Public Health »Andrija Štampar«, School of Medicine, University of Zagreb, Rockefellerova 4, 10000 Zagreb, Croatia

Abstract

Background and Purpose: Orthopedic examination techniques of the
musculoskeletal system contribute to the successful diagnostics of temporomandibular disorders (TMD). The purpose of this study is to determine the validity of TMD clinical diagnostics by comparing the findings of manual functional analysis (MFA) and the results of MRI of temporomandibular joint (TMJ). The diagnostic significance of limited mouth opening and pain upon passive mouth opening were taken into consideration.

Materials and Methods: 59 patients with clinical signs and symptoms
ofTMDwere examined consecutively. There was a subgroup comprising 40 patients diagnosed with DD. Clinical diagnoses were made by means of MFA. MRI was the gold standard in the assessment of clinical diagnostics validity, in certain diagnoses of DD (partial with reduction, complete with reduction, complete without reduction), as well as in the diagnostic significance
of limited mouth opening (<40 mm) and pain upon passive mouth
opening.

Results and Conclusion: Validity of MFA in diagnostics of TMD showed
maximal sensitivity of 100% and specificity of 57%. Matching of
TMDdiagnoses between findings ofMFA and MRI was 95%. Sensitivity of MFA for certain diagnoses of DD was from 67 to 78%. Lower values were determined for active mouth opening (<40 mm) for certain diagnoses of DD (from 25 to 35%), while the sensitivity for findings of pain in the TMJ on passive mouth opening was 86%. By using compression and joint play technique, the existing clinical diagnostics for specific diagnostics of subgroups as well as for various TMD diagnoses was enhanced.

Keywords

temporomandibular disorders; magnetic resonance imaging; validity; manual functional analysis

Hrčak ID:

68992

URI

https://hrcak.srce.hr/68992

Publication date:

1.6.2011.

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