Comparison of instruments used to select and classify patients with temporomandibular disorder

The aim of the present study was to identify the relationship among instruments used to screen and diagnose temporomandibular disorders (TMD). A retrospective study was conducted using medical records of patients with temporomandibular disorder who had visited the institution for initial assessment between January and December 2015. Medical history and physical examination data were collected, particularly those focusing on the diagnosis of TMD and TMJ (temporomandibular joint) function. The following instruments were used to assess the severity of the TMD signs and symptoms: the Fonseca Anamnestic index (FAI), the Helkimo index (HI), the American Association of Orofacial Pain Questionnaire (AAOPQ) and the Jaw Symptom & Oral Habit Questionnaire (JSOHQ). Thirty-eight patient records were included, with prevalence of women (84. 6%) and mean age 37. 42 ± 14. 32 years. The patients who were classified as having severe TMD by the FAI exhibited more positive responses on the AAOPQ (6. 25 ±1. 42; one-way ANOVA F= 15. 82), with a statistically significant difference when compared to patients with mild TMD (3. 0 ±1. 22; p<0. 01). A positive correlation (r=0. 78; p<0. 01) was found between the number of positive responses on the AAOPQ and the sum of the JSOHQ scores. Patients who were classified with severe TMD on the FAI exhibited higher scores on the JSOHO (18. 58 ±4. 96/oneway ANOVA F=14. 43), with a statistically significant difference when compared to patients with moderate (12. 08 ±5. 64; p<0. 01) and mild TMD (7. 46 ±4. 89; p<0. 01).

In the study sample, there was consistency among the instruments used to differentiate patients with severe and mild TMD. The selection of instruments should be rational, in order to improve the quality of the results.