Sensitivity and specificity in a longitudinal temporomandibular disease study

Area of Science:

• Dentistry
• Orthodontics
• Radiology

Background:

• A longitudinal study from 1970-1990 investigated temporomandibular disease (TMD) development in children.
• Osteoarthrosis, defined as condylar deformity on radiographs, was a key diagnostic criterion for TMD.
• Radiographic techniques for diagnosing condylar deformity have limitations, including potential false-negative findings.

Purpose of the Study:

• To assess the diagnostic reliability of radiographic osteoarthrosis for temporomandibular disease (TMD) in children.
• To evaluate the association between objective signs, subjective symptoms of TMD, and radiographic condylar deformity.
• To determine the stability of radiographic condylar deformity over a 20-year period.

Main Methods:

• Utilized longitudinal and cross-sectional data from a 20-year prospective study (1970-1990) on children's TMD.
• Diagnosed osteoarthrosis based on radiographic evidence of 'morphological and/or structural deformity of the condyle'.
• Correlated radiographic findings with reported signs and symptoms of TMD.

Main Results:

• Signs and symptoms of TMD were poor predictors of radiographic condylar deformity.
• Thirty-seven percent of participants received a diagnosis of condylar deformity at least once during the study.
• In two-thirds of cases, condylar deformity was not consistently present over time; normal anatomy was often linked to TMD symptoms.

Conclusions:

• The diagnosis of temporomandibular disease (TMD) in children, particularly based on radiographic osteoarthrosis, exhibits questionable reliability and stability.
• Radiographic evidence of condylar deformity is not consistently associated with TMD signs and symptoms.
• Temporomandibular disease (TMD) likely represents a complex spectrum of conditions rather than a single, stable entity.