Validity of Clinical Diagnostic Signs in the Examination of Individuals Suspected of Temporomandibular Disorders Using the Hamburg Protocol
DOI:
https://doi.org/10.33295/1992-576X-2025-4-37Keywords:
temporomandibular disorders, clinical and diagnostic signs, examination, Hamburg ProtocolAbstract
Purpose. To determine the validity of clinical diagnostic signs in the examination of individuals suspected of temporomandibular disorders using the Hamburg Protocol.
Materials and Methods. The study included 60 patients with temporomandibular disorders (TMD) aged 20–69 years, among whom 80% were women, and 63% were individuals aged 30–49 years. Diagnosis encompassed general dental examination, the Hamburg Protocol, panoramic radiography, CT, MRI (as indicated), and axiography. Patients were stratified into groups with muscular, articular, and combined disorders.
Results. It was found that 51.67% of patients had muscular disorders, 16.67% had articular disorders, and 31.67% had combined disorders. Among patients with muscular disorders, 77.4% exhibited only two symptoms, whereas in combined disorders, symptoms were more numerous (36.8% had three, 31.6% had four, and 26.3% had five). The most frequent symptoms were pain on palpation of the masticatory muscles (100% in muscular disorders, 94.7% in combined disorders) and the presence of joint noises and impaired opening trajectory (80% each in particular disorders, 78.9% each in combined disorders). The symptom “premature contacts” was observed in over 50% of patients across all groups.
Conclusions. The Hamburg Protocol is considered a suitable diagnostic test for the preliminary rapid diagnosis of temporomandibular disorders, even in cases with only two symptoms.
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References
Costen, J. B. (1934). Syndrome of ear and sinus symptoms dependent upon disturbed function of the temporomandibular joint.
World Health Organization. (1978). International classification of diseases: [9th] ninth revision, basic tabulation list with alphabetic index. ISBN 9241541334. URL: https://iris.who.int/handle/10665/39473
World Health Organization. (1993). The ICD-10 classification of mental and behavioural disorders. World Health Organization. URL: https://iris.who.int/handle/10665/42980.
International classification of diseases 11th revision. 2022. Available at: https://icd.who.int/browsel1/l-m/en. Accessed April 10, 2022.
Kent, M. L., Tighe, P. J., Belfer, I., et al. (2017). The ACTION-APS-AAPM pain taxonomy (AAAPT) multidimensional approach to classifying acute pain conditions. Pain Med, 18(5), 479–58. DOI: https://doi.org/10.1093/pm/pnx019.
International classification of orofacial pain, 1st edition (ICOP). (2020). Cephalalgia, 40(2), 129–221. DOI: https://doi.org/10.1177/0333102419893823.
Okeson, J. P. (2019). Management of temporomandibular disorders and occlusion. 8th edition. St. Louis: Mosby.
Dworkin, S. F, Le Resche, L. (1992). Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord, 6(4), 301–55. PMID: 1298767.
Schiffman, E., Ohrbach, R., Truelove, E., et al. (2014). Diagnostic criteria for temporomandibular disorders (DC/CHP) for clinical and research applications: recommendations of the international RDC/CHP consortium network* and orofacial pain special interest. J Oral Facial Pain Headache, 28(1), 6–27. DOI: https://doi.org/10.11607/jop.1151.
Freeman, R., Edwards, R., Baron, R., et al. (2019). AAPT diagnostic criteria for peripheral neuropathic pain: focal and segmental disorders. J Pain, 20(4), 369–93. DOI: https://doi.org/10.1016/j.jpain.2018.10.002.
Marc Schmitter, Bodo Kress, Michael Leckel, Volkmar Henschel, Brigitte Ohlmann, Peter Rammelsberg. (2028). Validity of temporomandibular disorder examination procedures for assessment of temporomandibular joint status. Am J Orthod Dentofacial Orthop, 133(6), 796–803. DOI: https://doi.org/10.1016/j.ajodo.2006.06.022.
Jennifer Reneker, Jaime Paz, Christopher Petrosino, Chad Cook. (2011). Diagnostic Accuracy of Clinical Tests and Signs of Temporomandibular Joint Disorders: A Systematic Review of the Literature. J Orthop Sports Phys Ther, 41(6), 408–16. DOI: https://doi.org/10.2519/jospt.2011.3644.
Semchyshyn, Ya. O., Shybinska, M. V. (2024). Familiarization of dentists with the problems of temporomandibular disorders on the example of the Lviv region of Ukraine. Actual Dentistry, 1, 111–117. [ Семчишин, Я. О., Шибінська, М. В. (2024). Ознайомлення стоматологів з проблемами скронево-нижньощелепних розладів на прикладі Львівської області України. Сучасна стоматологія, 1, 111–117. ]. DOI: https://doi.org/10.33295/1992-576X-2024-1-112
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