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Review

Diagnostics of Temporomandibular Disorders [Internet]

Vegard Strøm, Kjetil G. Brurberg, Kristin Thuve Dahm, Ingvild Kirkehei
Oslo, Norway: Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH); 2013 Jun. Report from Norwegian Knowledge Centre for the Health Services (NOKC) No. 10-2013.
NIPH Systematic Reviews: Executive Summaries.
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Review

Diagnostics of Temporomandibular Disorders [Internet]

Vegard Strøm et al.
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Excerpt

Temporomandibular disorder (TMD) is a term used to describe a number of related disorders affecting the temporomandibular joints, masticatory muscles, and associated structures. To diagnose subgroups of TDM, numerous tests are available. The aim of this overview of systematic reviews is to summarize scientific research on accuracy of different diagnostic tests for the presence of TMD. In the absence of a methodological gold standard for the diagnosis of TMD, it is to be emphasized that the findings of this review does not provide a basis for deciding which tests best detect or rule out TMD, but rather whether and to what extent various diagnostic tests lead to the same conclusion.

Main findings Results from six systematic reviews, comprising 67 primary studies and about 5400 participants demonstrate that:

  1. MRI, especially sagittal + coronal images, appears to have acceptable accuracy to detect or exclude disc displacement, disc configuration and osseous changes of the temopromandibular joint compared with cryosections (postmortem) or biopsies.

  2. Ultrasonography seems to have acceptable accuracy to detect, but not exclude, disc displacement compared with MRI.

  3. Clinical tests of joint sounds, pain and movements do not seem to have satisfactory accuracy to detect or exclude TMD when compared with MRI.

  4. Electromyography does not seem to have sufficient accuracy to detect or rule out myofascial TMD compared with clinical tests.

  5. The results must be interpreted with caution, because the primary studies included in the systematic reviews may have methodological weaknesses, the results show great variation, and confidence intervals in accuracy measures are wide or not reported.

Keywords: Temporomandibular Joint Disorders; Temporomandibular Joint; Craniomandibular Disorders; Diagnosis; TMD.

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