Evaluation of the Validity of TMD Examination Procedures

Objectives: The aim of this study was to evaluate the validity of clinical TMD examination protocols. Material & methods: 149 TMD patients and 43 symptom-free subjects were examined using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), additional examination procedures (compression etc.) and magnetic resonance imaging (MRI). The importance of each variable of the clinical examination with respect to the correct joint-related diagnosis was assessed using the MRI diagnoses. The statistical assessment was performed using a °¥random tree' software (based on classification trees). Results: Maximum unassisted mouth-opening, stretch, a history of a locked jaw, joint sound with and without compression, joint pain, presence of facial pain, pain on palpation of the lateral pterygoid area and the overjet proofed to be suited to distinguish between healthy joints and different subtypes of joint related TMD (z-scores differences >=5). The measurement of the excursion, protrusion and midline deviation were less important (z-score differences <5). Conclusion: The validity of clinical TMD examination protocols may be enhanced using variables of high importance which were identified in the present study.