Correspondence between Temporomandibular Disorder Symptoms and Clinical Examination Findings

측두하악장애 환자에서 주관적 증상과 임상검사 소견 간의 일치성

  • Im, Yeong-Gwan (Department of Oral Medicine, School of Dentistry, Chonnam National University) ;
  • Baek, Hey-Sung (Department of Pediatrics, School of Medicine, Hanyang University) ;
  • Kim, Byung-Gook (Department of Oral Medicine, School of Dentistry, Chonnam National University)
  • 임영관 (전남대학교 치의학전문대학원 구강내과학교실) ;
  • 백혜성 (한양대학교 의과대학 소아청소년과학교실) ;
  • 김병국 (전남대학교 치의학전문대학원 구강내과학교실)
  • Received : 2010.02.03
  • Accepted : 2010.02.26
  • Published : 2010.03.30

Abstract

Objectives: This study aimed to assess the characteristics of temporomandibular disorder (TMD) symptoms and to determine the correspondence between TMD symptoms and clinical examination findings. Material and methods: A total of 218 patients (143 females and 75 males; age=$31.3{\pm}14.0$) were enrolled in this study who completed a questionnaire and underwent a clinical examination and radiographic assessment. Patients were asked about all the symptoms and complaints, including onset or duration, and locations of the symptoms. Clinical examination included amounts of mouth opening, palpable temporomandibular joint (TMJ) sounds, and tenderness to palpation of the TMJ and all masticatory muscles. Tenderness scores obtained from palpation of the masticatory system were summated to define the variables for further analysis. Results: Pain was the most frequently reported symptom (78.9%), followed by joint sounds (45.4%), and limitation in mouth opening (17.0%). Jaw pain comprised 91.9% of pain complaints. The subjective intensity of jaw pain was low to medium in most patients (93.7%), but it was poorly correlated with the sum of tenderness scores of the TMJ and masticatory muscles (Kendall tau = 0.084). In contrast, the side in which pain was reported by patients was well associated with the clinical examination results (pain of the right side, p < 0.001, and left side, p < 0.001). There was moderate agreement in TMJ sounds between the side identified by patients as symptomatic and clinical examination findings (kappa = 0.482). Finally, patients who complained of restricted mouth opening showed about a 10 mm less opening in all three measurements, compared to other patients (p < 0.001). Conclusion: The most frequent symptoms reported by TMD patients were jaw pain, TMJ sounds, and mouth opening limitation. The side of jaw pain, the side of TMJ sounds, and the presence of opening limitation were highly concordant between symptom reports and examination findings.

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