Validation of the clinical diagnostic criteria for temporomandibular disorders for the diagnostic subgroup – disc derangement with reduction

Publisher Website
Google Scholar
Abstract
summary  Research is needed to assess the validity of the clinical diagnostic criteria for temporomandibular disorders (CDC/TMD). The purpose of this study was to test the reliability of the clinical diagnosis of temporomandibular joint (TMJ) internal derangement type (ID)‐I as compared with the magnetic resonance imaging (MRI) ‘gold standard’. The study comprised 168 TMJs in 84 patients, who were assigned a clinical TMJ‐related diagnosis of ID‐I (disc displacement with reduction) in at least one TMJ. Bilateral sagittal and coronal MR images were obtained subsequently to establish the corresponding diagnosis of the disc–condyle relationship. For the CDC/TMD interpretations, the positive predictive value (PPV) of ID‐I for disc displacement with reduction (DDR) was 44%, and for the presence of an ID 69%. The overall diagnostic agreement for ID‐I was 47·6% with a corresponding K‐value of 0·05. Most of the disagreement was the result of the false‐positive interpretations of ID‐I, and false‐negative interpretations of an ‘absence of ID’. The results suggest CDC/TMD for ID‐I to be insufficient reliable for determination of ID and/or DDR. Patients assigned a clinical TMJ‐related diagnosis of ID‐I may need to be supplemented by evidence from MRI to determine the functional ‘disc–condyle relationship’.