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Abstract: Aim The abbreviation TMD (temporomandibular disorders) has
been used to signify the variety of symptoms, signs and
combinations that have often been assigned to the TMJ
(temporomandibular joint) and its related structures (muscles,
bone and facial structures). The prevalence of temporomandibular
disorders in children and adolescents varies widely
in literature. The most common signs and symptoms of TMD
are: temporomandibular joint sounds, impaired movement of
the mandible, limitation in mouth opening, preauricolar pain,
facial pain, headaches and jaw tenderness on function. Many
studies have shortcomings in their method of assessing or
measuring TMD: the problem is probably due to the fact that
temporomandibular disorders have multiple aetiological factors.
The aim of this article is a review of the literature about the
diagnostic procedures used to assess signs and symptoms of
temporomandibular disorders in children and adolescents.
Materials and methods Literature was searched using
Medline, Embase, and Cochrane Library from 1992 to February
2008. Only articles written in English were included in the study.
The key words and mesh used were: temporomandibular
disorders, mandibular dysfunction, children, adolescents. The
inclusion criteria were: symptoms and signs of TMD,
questionnaire, clinical protocol examination. Clinical studies as
well as cross-sectional studies, longitudinal and epidemiological
researches were considered. The articles reviewed were
grouped according to the diagnostic procedure used.
Results Out of the 37 articles selected, the Helkimo Clinical
Dysfunction Index was used in 6 studies (16.22%), the CMI
Index in 1 (2.70%), the RCD/TMD in 9 (24.33%) and a clinical
protocol examination in 21 (56.75%) articles. Conclusion The
review of the literature shows that clinical examination
protocols without reproducible items and a measurable and
reproducible classification into diagnostic subgroups was the
type of investigation used in most of the cases. This ended in a
multitude of different results depending on the criteria used
and the method of data collection. Such methodological
problems should be acknowledged in studies relating to TMD in
order to obtain a reliable diagnostic procedure. |
