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压力痛觉测定法对颞下颌关节紊乱病的诊断价值。

The diagnostic value of pressure algometry for temporomandibular disorders.

作者信息

Więckiewicz Włodzimierz, Woźniak Krzysztof, Piątkowska Dagmara, Szyszka-Sommerfeld Liliana, Lipski Mariusz

机构信息

Department of Prosthetic Dentistry, Faculty of Dentistry, Wroclaw Medical University, 50425 Wroclaw, Poland.

Department of Orthodontics, Pomeranian Medical University of Szczecin, Aleja Powstańców Wielkopolskich 72, 70111 Szczecin, Poland.

出版信息

Biomed Res Int. 2015;2015:575038. doi: 10.1155/2015/575038. Epub 2015 Mar 26.

Abstract

The aim of this study is to determine the diagnostic value of pressure algometry in temporomandibular disorders. Two hundred volunteers aged 19.3 to 27.8 (mean 21.50, SD 0.97) participated in this study. An analogue pressure algometer was used for the evaluation of muscle tenderness of the following masticatory muscles: superficial and deep parts of the masseter muscle; anterior and posterior parts of the temporal muscle; and the tissues adjacent to the lateral and dorsal part of the temporomandibular joint capsule. Each patient described the algometry result for the individual components of the masticatory motor system, by selecting each time the intensity of pain on a 100 mm Visual Analogue Scale (VAS) ruler. The area under the receiver operating characteristic (ROC) curve, indicating the discriminatory efficiency for asymptomatic subjects and patients with temporomandibular dysfunction according to the dysfunction Di index, was the largest for the mean pain value (AUC = 0.8572; SEM = 0.0531). The 7.4 VAS cut-off point marked 95.3% specificity for this variable in identifying healthy subjects and 58.4% sensitivity in identifying patients with symptoms of dysfunctions (accuracy 68.1%). Assuming comparable sensitivity (74.9%) and specificity (74.2%) for a diagnostic test, there was test accuracy of 74.5% at the 4.2 VAS cut-off point.

摘要

本研究的目的是确定压力觉测量法在颞下颌关节紊乱病中的诊断价值。200名年龄在19.3至27.8岁(平均21.50,标准差0.97)的志愿者参与了本研究。使用模拟压力觉测量仪评估以下咀嚼肌的肌肉压痛情况:咬肌的浅层和深层;颞肌的前部和后部;以及颞下颌关节囊外侧和背侧相邻的组织。每位患者通过每次在100毫米视觉模拟量表(VAS)标尺上选择疼痛强度,来描述咀嚼运动系统各个组成部分的压力觉测量结果。根据功能障碍Di指数,接受者操作特征(ROC)曲线下面积表明了对无症状受试者和颞下颌功能障碍患者的鉴别效率,其中平均疼痛值的曲线下面积最大(AUC = 0.8572;标准误 = 0.0531)。7.4的VAS截断点在识别健康受试者时该变量的特异性为95.3%,在识别有功能障碍症状的患者时敏感性为58.4%(准确率68.1%)。假设诊断测试具有可比的敏感性(74.9%)和特异性(74.2%),在4.2的VAS截断点时测试准确率为74.5%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb70/4391694/54dbf7318112/BMRI2015-575038.001.jpg

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