Abstract
The aim of this study is to determine the diagnostic value of pressure algometry in temporomandibular disorders. Two hundred volunteers aged 19.3 to 27.8 (mean 21.50, SD 0.97) participated in this study. An analogue pressure algometer was used for the evaluation of muscle tenderness of the following masticatory muscles: superficial and deep parts of the masseter muscle; anterior and posterior parts of the temporal muscle; and the tissues adjacent to the lateral and dorsal part of the temporomandibular joint capsule. Each patient described the algometry result for the individual components of the masticatory motor system, by selecting each time the intensity of pain on a 100 mm Visual Analogue Scale (VAS) ruler. The area under the receiver operating characteristic (ROC) curve, indicating the discriminatory efficiency for asymptomatic subjects and patients with temporomandibular dysfunction according to the dysfunction Di index, was the largest for the mean pain value (AUC = 0.8572; SEM = 0.0531). The 7.4 VAS cut-off point marked 95.3% specificity for this variable in identifying healthy subjects and 58.4% sensitivity in identifying patients with symptoms of dysfunctions (accuracy 68.1%). Assuming comparable sensitivity (74.9%) and specificity (74.2%) for a diagnostic test, there was test accuracy of 74.5% at the 4.2 VAS cut-off point.
Highlights
The high universal prevalence of temporomandibular dysfunction among the population means that it is important to look for methods of early diagnosis
The aim of this study is to determine the diagnostic value of pressure algometry in temporomandibular disorders
In order to limit the negative consequences of adaptive compensation and to prevent prospective decompensation, it is essential to detect pain-free functional disorders in the masticatory system early and to apply therapeutic procedures, which are often simple in nature
Summary
The high universal prevalence of temporomandibular dysfunction among the population means that it is important to look for methods of early diagnosis. Modern instrumental diagnostic methods make it possible to record the dynamics of the symptomatology of functional disorders objectively and quantitatively, as well as enabling the monitoring of therapeutic procedures [1,2,3]. The diagnosis of temporomandibular dysfunction includes a detailed and focused anamnesis and scrupulous clinical investigation. The main symptoms of masticatory motor system dysfunctions such as tenderness, restriction of mandibular movement, or temporomandibular joint noises are evaluated during a routine examination which includes methods characterised by low objectivity [4]. For many parameters of functional significance, the margin between physiology and pathology is often difficult to observe during a clinical examination. Differentiation between physiology and pathology relies to a greater extent
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