Gomes Marden B, Guimarães Josemar P, Guimarães Franceane C, Neves Ana Cristina C
School of Dentistry, Juiz de Fora Federal University, Brazil.
Cranio. 2008 Jul;26(3):202-10. doi: 10.1179/crn.2008.027.
This study assessed the interexaminer reliability and validity of palpation (PA) and pressure pain threshold (PPT) of the temporomandibular joint (TMJ) and the masseter and temporalis muscles in patients with temporomandibular disorders (TMD) and asymptomatic controls. Eighty (80) subjects were distributed into two groups: Group 1 consisted of 40 TMD patients with muscular and joint pain selected by RDC/TMD Axis I; and Group 2 (control) with 40 asymptomatic individuals. Training and calibration of examiners was undertaken prior to testing. Mean reliability values were 0.64 and 0.78 (PPT), and 0.59 and 0.75 (PA), for patients and controls, respectively. Results showed statistically significant differences (p<0.001), for PA and PPT among TMD patients compared with the control. The results also showed acceptable specificity values (above 0.90), although sensitivity had low values. The tests had low diagnostic validity to discriminate between patients and controls, with low positive predictive values (PPV).
本研究评估了颞下颌关节紊乱病（TMD）患者和无症状对照者颞下颌关节（TMJ）以及咬肌和颞肌触诊（PA）和压痛阈（PPT）的检查者间可靠性和有效性。80名受试者分为两组：第1组由40名根据RDC/TMD轴I选择的有肌肉和关节疼痛的TMD患者组成；第2组（对照组）有40名无症状个体。在测试前对检查者进行了培训和校准。患者组和对照组的平均可靠性值分别为：PPT为0.64和0.78，PA为0.59和0.75。结果显示，与对照组相比，TMD患者的PA和PPT有统计学显著差异（p<0.001）。结果还显示，特异性值可接受（高于0.90），尽管敏感性值较低。这些测试在区分患者和对照组方面诊断有效性较低，阳性预测值（PPV）也较低。
