Assessment of human intraoral thermal sensitivity with simple devices in the clinic: implications for orofacial pain conditions.

AIMS: To use simple thermal devices with different diameters and temperatures to investigate reliability and magnitude of human intraoral thermal sensitivity. METHODS: Sixteen healthy volunteers participated. Six thermal devices with tapered circular ends (stimulus diameter 3, 5, and 10 mm) were used. Three different temperatures (room temperature, heat, and cold) were applied with each of the three diameters, ie, nine combinations. Participants were stimulated in randomized order at nine different sites: tongue, lip, maxillary attached gingiva adjacent to the left and right central incisors (without touching the lip) and to the left and right premolars (with or without touching the lip), and the left and right cheeks extraorally. Participants rated the perceived stimulus intensity on 0-50- 100 numeric rating scales (NRS). The number of paradoxical thermal sensations was also recorded. Ten volunteers were examined twice on the same day and recalled for a second session for assessment with the 5-mm-diameter device of within- and between-session reliability (interclass correlation coefficients [ICC]). The results were analyzed using a three-way analysis of variance. RESULTS: Reliability of NRS scores ranged from poor (ICC = 0.09, with cold stimulation at the premolar region) to excellent (ICC > 0.92, with cold stimulation at the cheek or tongue). NRS values varied with stimulus diameter (P < .050), temperature (P < .001), and sites (P < .001), with significant size x site and temperature x site interactions (P < .001). The tongue was the most sensitive site (P < .001) and the gingiva was the least sensitive site (P < .050). The 10-mm-diameter device produced higher NRS scores than the 3-mm-diameter device. CONCLUSION: The reliability of intraoral thermal sensitivity recorded with the 5-mm-diameter device varied greatly between different sites. Nonetheless, with this caveat in mind, the study did document that semiquantitative assessment of intraoral thermal sensitivity is feasible and applicable for clinical studies in different intraoral pain conditions.

Validated assessment scales for the mid face.

BACKGROUND: The improvement of aesthetic treatment options for age-related mid face changes, such as volume loss, and the increase in patient expectations necessitates the development of more-complex and globally accepted assessment tools. OBJECTIVE: To develop three grading scales for objective assessment of the infraorbital hollow and upper and lower cheek fullness and to establish the reliability of these scales for clinical research and practice. METHODS AND MATERIALS: Three 5-point rating scales were developed to assess infraorbital hollow and upper and lower cheek fullness objectively. Twelve experts rated identical mid face photographs of 50 subjects in two separate rating cycles using the mid face scales. Test responses of raters were analyzed to assess intra- and interrater reliability. RESULTS: Interrater reliability was substantial for the infraorbital hollow, upper cheek fullness, and lower cheek fullness scales. Intrarater reliability was high for all three scales. Both of the cheek fullness scales yielded higher reliabilities when three rather than two views were used to assess the volume changes of the cheek. CONCLUSION: The mid face scales are reliable tools for valid and reproducible assessment of age-related mid face changes.