Abstract
This study aimed at validating the MBGR Orofacial Myofunctional Assessment Protocol (MBGR Protocol) for adults with Temporal Mandibular Disorders (TMD). The study sample was composed of 30 adults: 15 with TMD (disc displacement with reduction according to the Research Diagnostic Criteria for Temporomandibular Disorders) and 15 control individuals. The validation process encompassed the content, criterion, and construct of the protocol, as well as its inter- and intra-rater agreement levels and sensitivity and specificity values, considering a 5% statistical significance level. The following validities were confirmed: of content, as the MBGR Protocol covers all functional issues present in patients with TMD; of criterion, with significant correlations between the MBGR and Orofacial Myofunctional Evaluation with Scores (OMES) protocols; of construct, differentiating individuals with and without Orofacial Myofunctional Disorders (OMD) as for pain on palpation and mandible range of motion, with significant correlation between the MBGR clinical evaluation and that using a digital algometer, as well as confirmation of the instrumental assessment for the breathing mode classification. Agreement ranged from poor to very good and from reasonable to very good for the inter- and intra-rater power analyses, respectively. High sensitivity and specificity values were observed. The MBGR Protocol proved to be valid for use in adults presented with TMD with disc displacement with reduction and controls, covering all aspects that enable the analysis of OMD in these individuals.
Highlights
Temporomandibular disorders (TMD) are considered a complex musculoskeletal dysfunction of multifactorial etiology[1] and are the leading cause of non-odontogenic-related orofacial pain
The Study Group (SG) was composed of individuals with good general and oral health, a diagnosis of disc displacement with reduction (DDWR) according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/Temporal Mandibular Disorders (TMD)) Axis I(4) adapted to Portuguese[12], and who were not undergoing treatment for this condition
It was possible to verify that the MBGR Orofacial Myofunctional Assessment Protocol (MBGR Protocol) includes the aspects described in the literature to identify Orofacial Myofunctional Disorders (OMD) in individuals with Temporal Mandibular Disorders (TMD), and the extraoral/postural characteristics, orofacial mobility, mastication pattern and time, mastication efficiency, characteristics of the oral phase of deglutition, as well as phonetic and general aspects of speech
Summary
Temporomandibular disorders (TMD) are considered a complex musculoskeletal dysfunction of multifactorial etiology[1] and are the leading cause of non-odontogenic-related orofacial pain. Signs and symptoms are diverse and may include difficulties associated with mastication and other orofacial functions[2], in addition to pain in the face, temporomandibular joint (TMJ) and cervical region, as well as joint noises and limited mandibular range of motion, and are more frequently observed in women[3]. The functional assessment has been listed as an essential step in the diagnostic process, with a view to planning and establishing the appropriate treatment for these individuals[5]. For clinical evaluation of the orofacial functions, there are protocols in the literature that include the attribution of scores, providing a quantitative analysis of the clinical examination and facilitating the follow-up of case evolution throughout the treatment process[6,7,8]. Assessment protocols enable standardization of the examinations by different professionals, contributing to academic qualification and favoring comparison between the results from different study centers[9]
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