Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Health, Aarhus University, Aarhus, Denmark.
Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark.
J Oral Rehabil. 2024 Sep;51(9):1848-1861. doi: 10.1111/joor.13743. Epub 2024 May 20.
The temporal tendon is a structure often compromised in patients suffering from temporomandibular disorders (TMD), yet its intraoral location makes a standardised assessment difficult.
To evaluate the variability and accuracy to target force of a newly designed intraoral extension for a palpometer device (Palpeter, Sunstar Suisse) when compared to manual palpation, in addition to clinically assessing the mechanical sensitivity and referred sensations of the temporal tendon in healthy individuals.
Experiment 1: 12 individuals were asked to target on a scale 0.5, 1 and 2 kg, for 2 and 5 s by using five different methods (Palpeter, Palpeter with three different extension shapes and manual palpation). Experiment 2: 10 healthy participants were recruited for a randomised double-blinded assessment by applying pressure of 0.5, 1 and 2 kg to the right temporal tendon with the three extensions and manual palpation. Participants rated the intensity of their sensation/pain on a 0-50-100 numeric rating scale (NRS), unpleasantness on a 0-100 NRS, and if present, they rated and drew the location of referred sensations. Repeated measures analysis of variance (ANOVA) was used in both experiments to compare differences between palpation methods. Tukey's HSD tests were used for the post hoc comparisons, and p values below .05 were considered significant.
Experiment 1: The extensions showed no significant differences between them regarding reliability and accuracy for all forces and durations (p > .05). The manual method was significantly less reliable and accurate when compared to the other methods (p < .05). Experiment 2: There were no significant differences between the Palpeter extensions regarding pain intensity or unpleasantness NRS scores (p > .05), but all the extensions had significantly increased pain intensity and unpleasantness when compared to manual palpation (p < .05). Similarly, the frequency of referred sensations was similar between extensions but increased when compared to manual palpation.
The new Palpeter extensions proved to be significantly more accurate and have lower test-retest variability than the manual method in a non-clinical setting. Clinically, they showed no significant differences in NRS scores for pain intensity nor unpleasantness, with no major differences in referred sensations, making any of the extensions suitable for clinical testing of the temporal tendon in future studies.
颞肌腱在患有颞下颌关节紊乱症（TMD）的患者中经常受损，但由于其位于口腔内，因此难以进行标准化评估。
评估新型口腔内延伸装置对触诊器（Palpeter，Sunstar Suisse）目标力的可变性和准确性，与手动触诊相比，并在健康个体中临床评估颞肌腱的机械敏感性和牵涉感觉。
实验 1：12 名参与者被要求使用五种不同的方法（Palpeter、带有三种不同延伸形状的 Palpeter 和手动触诊）在 2 秒和 5 秒内将目标设定在 0.5、1 和 2kg 的量表上。实验 2：10 名健康参与者被招募进行随机双盲评估，方法是使用三种延伸装置和手动触诊对右侧颞肌腱施加 0.5、1 和 2kg 的压力。参与者使用 0-50-100 数字评定量表（NRS）对其感觉/疼痛强度进行评分，使用 0-100 NRS 对其不愉快程度进行评分，如果存在牵涉感觉，则对其进行评分并画出其位置。在两个实验中均使用重复测量方差分析（ANOVA）比较触诊方法之间的差异。使用 Tukey 的 HSD 检验进行事后比较，p 值小于.05 被认为具有统计学意义。
实验 1：在所有力和持续时间方面，延伸装置之间在可靠性和准确性方面均无显著差异（p>.05）。与其他方法相比，手动方法的可靠性和准确性显著降低（p<.05）。实验 2：在疼痛强度或不愉快 NRS 评分方面，Palpeter 延伸装置之间没有显著差异（p>.05），但与手动触诊相比，所有延伸装置的疼痛强度和不愉快度均显著增加（p<.05）。同样，牵涉感觉的频率在延伸装置之间相似，但与手动触诊相比有所增加。
在非临床环境中，新型 Palpeter 延伸装置在准确性方面明显优于手动方法，且测试-重测变异性更低。临床上，它们在疼痛强度和不愉快度的 NRS 评分方面没有显著差异，牵涉感觉也没有明显差异，这使得任何一种延伸装置都适合未来研究中对颞肌腱进行临床测试。
