Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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EVALUATION OF CLINICAL METHODS IN THE DIAGNOSIS OF TEMPOROMANDIBULAR JOINT DISORDERS: A COMPARISON STUDY WITH MAGNETIC RESONANCE IMAGING

측두하악관절 장애에 대한 임상진단의 유효성 연구

  • Kim, Hyung-Wook (Department of Oral & Maxillofacial Surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Shin, Sung-Soo (Su-Mi-Haeng Dental Clinic) ;
  • Kim, Jong-Sik (Department of Oral & Maxillofacial Surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Kim, Ki-Young (Department of Oral & Maxillofacial Surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Kim, Yoon-Ji (Department of Orthodontics, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Hong, Soon-Min (Department of Oral & Maxillofacial Surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Cheon, Se-Hwan (Department of Orthodontics, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Park, Yang-Ho (Department of Orthodontics, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Choi, Won-Cheul (Department of Orthodontics, College of Medicine, Chung-Ang University) ;
  • Park, Jun-Woo (Department of Oral & Maxillofacial Surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University)
  • 김형욱 (한림대학교 강동성심병원 구강악안면외과) ;
  • 신성수 (수미행 치과) ;
  • 김종식 (한림대학교 강동성심병원 구강악안면외과) ;
  • 김기영 (한림대학교 강동성심병원 구강악안면외과) ;
  • 김윤지 (한림대학교 강동성심병원 치과교정과) ;
  • 홍순민 (한림대학교 강동성심병원 구강악안면외과) ;
  • 천세환 (한림대학교 강동성심병원 치과교정과) ;
  • 박양호 (한림대학교 강동성심병원 치과교정과) ;
  • 최원철 (중앙대학교 치과센터 치과교정과) ;
  • 박준우 (한림대학교 강동성심병원 구강악안면외과)
  • Published : 2007.08.31
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Abstract

Purpose: The diagnostic relevancies and characteristics and of clinical methods in the diagnosis of internal derangement(ID) were tested by comparing the results of them with those of magnetic resonance imaging(MRI). Methods: 75 patients(150 temporomandibular joints; TMJs), who were suspected to have ID by clinical diagnoses, were included. Clinical diagnoses including mouth opening pathway and TMJ sound were conducted and MRI takings were done. Accuracies, sensitivities, specificities, positive predictive values, and negative predictive values of clinical diagnosis, mouth opening pathway, and TMJ sound were calculated by comparing with diagnoses with MRIs. Results: Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis were 59.3%, 83%, 49%, 81%, and 51%. They were 59%, 82%, 25%, 73%, and 35% for mouth opening pathways. Although deviation was somewhat accurate for representing disc displacement with reduction(ADDWR), other discrepancies on opening pathways were not clinically relevant. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clicking sounds were 85%, 49%, 78%, 85%, and 37%. TMJs with crepitus were only three. But all TMJs with crepitus were diagnosed to have disc displacement without reduction(ADDWOR). Conclusion: When compared with diagnoses with MRIs, clinical diagnoses for ID were not so accurate. But they were suitable for screening tests for ID. Opening pathways and TMJ sounds were not so relevant in the diagnoses of IDs and so it was concluded that considerations for other factors must be included in the diagnoses of IDs.

Keywords

References

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