This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Wabeke, K.B. Articles by van der Zaag, J. Search for Related Content PubMed PubMed Citation Articles by Wabeke, K.B. Articles by van der Zaag, J. Social Bookmarking                         What's this?

The Reliability of Clinical Methods for Recording Temporomandibular Joint Sounds

Department of Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA Amsterdam, The Netherlands

R.J. Spruijt

Department of Social Dentistry and Dental Health Education, Academic Centre for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA Amsterdam, The Netherlands

J. van der Zaag

Department of Craniomandibular Disorders, Academic Centre for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA Amsterdam, The Netherlands

Measurement errors in recording temporomandibular joint sounds may originate from variation between observers and from variation in the phenomenon. Laboratory settings enable various procedures to be used to minimize both sources of variation. These procedures yield some excellent intra- and inter-examiner reliabilities, but this does not imply that dentists in a clinical setting are likely to evaluate temporomandibular joint sounds in a comparable way. This study was designed to evaluate clinical joint sound assessment methods (palpation and stethoscopy) without using special precautions to minimize variance. An attempt was made to quantify the signal variance. Within- and between-examiners agreement is estimated for both methods in a sample of 44 non-patients. The results show that two clinically experienced craniomandibular disorders specialists were able to reach fair to good agreement on the identification of (the number of) temporomandibular joint sounds. There was some disagreement with respect to the number of reciprocal clicks. Compared with the palpation technique, stethoscopy is more sensitive, especially with regard to crepitation. Based on the electronically recorded sounds, both examiners appeared to be overconsistent. It is concluded that the use of both palpation and stethoscopy in clinical settings can be justified but that both methods have limitations. When, in a given clinical setting, these limitations are acceptable, there appears to be no need for extra-sensitive but expensive electronic recording devices.

Key Words: Joint Sounds • Temporomandibular Joint • Measurement Reliability • Research Design • Statistics

REFERENCES

• Cohen J. (1960). A coefficient of agreement for nominal scales. Educ Psycholog Meas 20:37-46.
• Dworkin SF, LeResche L., de Rouen T. (1988). Reliability of clinical measurement. Clin J Pain 4:89-99.
• Dworkin SF, LeResche L., de Rouen T., von Korff M. (1990). Assessing clinical signs of temporomandibular disorders: reliability of clinical examiners. J Prosthet Dent 63:574-580.[CrossRef][Medline] [Order article via Infotrieve]
• Eriksson L., Westesson P-L., Sjoberg H. (1987). Observer performance in describing temporomandibular joint sounds. J Craniomandib Pract 5:32-35.
• Fricton JR, Schiffman EL (1986). Reliability of a craniomandibular index. J Dent Res 65:1359-1364.
• Goulet JP, Clark GT (1990). Clinical TMJ examination methods. J CA Dent Assoc 18:25-53.
• Hardison JD, Okeson JP (1990). Comparison of three clinical techniques for evaluating joint sounds. J Craniomandib Pract 8:307-311.
• Hunt RJ (1986). Percent agreement, Pearson's correlation, and Kappa as measures of inter-examiner reliability. J Dent Res 65:128-130. Spruijt RJ, Hoogstraten J (1991). The research on temporomandibular joint clicking: a methodological review. J Craniomandib Disord Facial Oral Pain 5:45-50.
• Spruijt RJ, Hoogstraten J (1992). Symptom reporting in temporomandibular joint clicking: some theoretical considerations. J Craniomandib Disord Facial Oral Pain 6:213-219. Truelove E, LeResche L, Sommers E, Dworkin S, Huggins K, Reay B (1987). Reliability of TMJ sounds in patients and controls (abstract). J Dent Res 66:336.
• Valachovic RW, Douglass CW, Berkey CS, McNeil BJ, Chauncey HH (1986). Examiner reliability in dental radiography. J Dent Res 65:432-436.
• Wabeke KB, Spruijt RJ (1993). Dental factors associated with temporomandibular joint sounds. J Prosthet Dent 69:401-405. Wabeke KB, Hansson TL, Hoogstraten J, van der Kuy P (1989). Temporomandibular joint clicking: a literature overview. J Craniomandib Disord Facial Oral Pain 3:163-173.
• Wabeke KB, Spruijt RJ, van der Weyden KJ, Naeije M. (1992). Evaluation of a technique for recording temporomandibular joint sounds. J Prosthet Dent 68:676-682.[Medline] [Order article via Infotrieve]
• Wabeke KB, Spruijt RJ, Habets LLMH. Spatial and morphologic aspects of temporomandibular joints with sounds. J Oral Rehabil (in press). Westling L, Helkimo E, Mattiasson A (1992). Observer variation in functional examination of the temporomandibular joint. J Craniomandib Disord Facial Oral Pain 6:202-207.

Journal of Dental Research, Vol. 73, No. 6, 1157-1162 (1994)
DOI: 10.1177/00220345940730060501


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Wabeke, K.B. Articles by van der Zaag, J. Search for Related Content PubMed PubMed Citation Articles by Wabeke, K.B. Articles by van der Zaag, J. Social Bookmarking                         What's this?