Cranio
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Comparative Study
Palpation and pressure pain threshold: reliability and validity in patients with temporomandibular disorders.
This study assessed the interexaminer reliability and validity of palpation (PA) and pressure pain threshold (PPT) of the temporomandibular joint (TMJ) and the masseter and temporalis muscles in patients with temporomandibular disorders (TMD) and asymptomatic controls. Eighty (80) subjects were distributed into two groups: Group 1 consisted of 40 TMD patients with muscular and joint pain selected by RDC/TMD Axis I; and Group 2 (control) with 40 asymptomatic individuals. Training and calibration of examiners was undertaken prior to testing. ⋯ Results showed statistically significant differences (p<0.001), for PA and PPT among TMD patients compared with the control. The results also showed acceptable specificity values (above 0.90), although sensitivity had low values. The tests had low diagnostic validity to discriminate between patients and controls, with low positive predictive values (PPV).
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Studying joint noise is an important parameter for diagnosing temporomandibular dysfunction. In this study, eight groups (n=9) were formed according to joint dysfunction classification, provided by employing vibration analysis equipment. Parameters for analyzing joint noise were: total vibration energy, peak amplitude, and peak frequency. ⋯ The patient group with normal condyle/disk relationship always presented the lowest values. The type of joint noise was characterized by analyzing total integral noise, peak amplitude, peak frequency, and mouth opening. Analyzing joint noise using electrovibratography suggests the type of joint dysfunction and may help to establish a diagnosis, as well as a treatment plan.