Cranio
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Randomized Controlled Trial Clinical Trial
Research diagnostic criteria for temporomandibular disorders: a calibration and reliability study.
The aim of this study was to investigate the reliability between different examiners when using the axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The hypothesis was that the standardized RDC/TMD examination protocol enables calibrated examiners to evaluate all examination items reliably. After calibration training by the RDC/TMD calibration team including the calibration of palpation pressure and the performance of the standardized examination protocol, four examiners, blinded to the patients' medical histories examined 24 subjects in a randomized sequence. ⋯ Only sub-retromandibular muscle palpation and joint sound vibration recordings on lateral excursion showed poor-results (ICC < or = 0.4). The RDC/TMD examination protocol enables calibrated examiners to perform most (87%) examination items with satisfactory reliability. Therefore multi-site studies based on the RDC/TMD examination protocol may become feasible, keeping in mind the unsatisfactory reliability of 13% of the items (clicking during laterotrusion to the ipsilateral side, palpation of the posterior and submandibular region).
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Randomized Controlled Trial Clinical Trial
Effect of parafunctional clenching on temporomandibular disorder pain and proprioceptive awareness.
This study tested the hypothesis that parafunctional clenching increases pain, can lead to a diagnosis of temporomandibular disorder (TMD) pain, and can produce reductions in proprioceptive awareness. Twenty individuals participated in EMG biofeedback training sessions on the left and right temporalis and masseter muscles. No subjects had TMD prior to training. ⋯ Three subjects assigned to the Increase group and no subjects assigned to the Decrease group were diagnosed with TMD pain following training. Self-reported pain post-training was significantly higher for the Increase group. Parafunctional clenching did not affect performance in the proprioceptive test.
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Randomized Controlled Trial Clinical Trial
Better palpation of pain: reliability and validity of a new pressure pain protocol in TMD.
The purpose of this research was to employ a double-blind placebo control design of iontophoretically administered lidocaine to assess the test-retest reliability and validity of a magnitude matching procedure using a pressure algometer. In studies in the literature on assessment of pain in temporomandibular disorders (TMD), the pressure algometer has been found to be a reliable means of measuring pressure-pain threshold and a sensitive measure of treatment-response in the laboratory. However, previous research with this apparatus has not employed more sophisticated psychophysics. ⋯ Although it was hypothesized that subjects in the anesthesia group would demonstrate reduced discriminability as compared with the control groups, no differences were found among the three groups on this measure. However, differences in response bias were found, with both the placebo control and no-treatment control groups differing from the experimental group but not from each other. Possible explanations and the implications of these findings are discussed.