Determination of a pressure pain threshold cut-off value for the diagnosis of temporomandibular joint arthralgia

Author(s)

Cunha, C. O. ^[1] ; Pinto-Fiamengui, L. M. S. ^[1] ; Castro, A. C. P. C. ^[2] ; Lauris, J. R. P. ^[3] ; Conti, P. C. R. ^[1]

Affiliation

^[1] Univ Sao Paulo, Bauru Sch Dent, Dept Prosthodont, BR-17012901 Bauru - Brazil

^[2] State Hosp Bauru, Bauru - Brazil

^[3] Univ Sao Paulo, Bauru Sch Dent, Dept Publ Hlth, BR-17012901 Bauru - Brazil

• Document type: Journal article
• Source: Journal of Oral Rehabilitation; v. 41, n. 5, p. 323-329, MAY 2014.
• Web of Science Citations: 4

Abstract

Temporomandibular joint (TMJ) disorders are divided by the American Academy of Orofacial Pain into five categories. The most common ones are joint pain, as arthralgia and joint disorders, as disc displacements. An important clinical presentation of arthralgia is the painful tenderness to manual palpation or decreased pressure pain threshold (PPT). The authors conducted a study to determine the appropriate PPT value to discriminate asymptomatic TMJ individuals from those with moderate to severe arthralgia. Forty-nine individuals was evaluated and divided into groups: TMJ arthralgia, asymptomatic disc displacement and control group. Magnetic resonance images were obtained for all the groups, and algometry was performed on the TMJ lateral pole. Patients with arthralgia filled out a visual analogue scale (VAS). anova test with 1% of significance analysed the data. Specificity, sensitivity and ROC curve were also determined. Arthralgia group had significant lower PPT (mean of 1 center dot 07kgf cm(-2)) than the others. Asymptomatic disc displacement group (mean of 1 center dot 64kgf cm(-2)) has shown significant lower PPT than the control (mean of 2 center dot 35kgf cm(-2)). 89 center dot 66% of specificity and 70% of sensitivity were obtained when 1 center dot 36kgf cm(-2) was applied to the TMJ (ROC area =0 center dot 90). This value was considered to be the most appropriate to detected moderate to severe TMJ arthralgia. Indeed, the presence of disc displacement seems to significantly decrease PPT levels in asymptomatic subjects. The PPT value of 1 center dot 36kgf cm(-2) can be used in the calibration procedures of the professionals involved with temporomandibular disorders and orofacial pain. (AU)

• FAPESP's process: 09/08045-8 - Determination of temporomandibular joint (TMJ) pressure pain threshold (PPT) in patients with articular disc displacement and/or arthralgia when compared to an asymptomatic control group: an algometer-based study
• Grantee: Paulo César Rodrigues Conti
• Support Opportunities: Regular Research Grants