Analysis of the accuracy and reliability of the Short-Form Fonseca Anamnestic Index in the diagnosis of myogenous temporomandibular disorder in women.

BACKGROUND: The Fonseca Anamnestic Index is a questionnaire used to classify individuals with temporomandibular disorders. Previous studies have shown that the Fonseca Anamnestic Index provides a multidimensional measurement of the temporomandibular disorders construct and that the main dimension presents a good fit to the model according to the item response theory. OBJECTIVE: To evaluate the between-day reliability, accuracy, and best cut-off score of the Short-Form Fonseca Anamnestic Index for the diagnosis of myogenous temporomandibular disorders. METHODS: The sample consisted of 123 women (57 with myogenous temporomandibular disorders and 66 asymptomatic), evaluated by the Research Diagnostic Criteria for Temporomandibular Disorders. The participants answered the Short-Form Fonseca Anamnestic Index on two occasions with a seven-day interval between tests. For the analysis of between-day reliability, the intraclass correlation coefficient, the standard error of measurement and the minimum detectable change were used. The Receiver Operating Characteristic curve was used to determine the diagnostic accuracy and the best cut-off point. RESULTS: The Short-Form Fonseca Anamnestic Index demonstrated excellent reliability (intraclass correlation coefficient≥0.95) for all items and for the total Short-Form Fonseca Anamnestic Index score (intraclass correlation coefficient=0.98; standard error of measurement=3.28; minimum detectable change=9.09). The level of accuracy of the Short-Form Fonseca Anamnestic Index for the diagnosis of myogenous temporomandibular disorders was high (area under the curve of 0.97), with a better cut-off score of 17.5 points. CONCLUSION: The Fonseca Anamnestic Index should be used in its short form to classify the absence of myogenous temporomandibular disorders (scores between 0 and 15 points) or presence of myogenous temporomandibular disorders (scores between 20 and 50 points) in women.

Women with more severe degrees of temporomandibular disorder exhibit an increase in temperature over the temporomandibular joint.

AIM: The purpose of the present study was to correlate the degree of temporomandibular disorder (TMD) severity and skin temperatures over the temporomandibular joint (TMJ) and masseter and anterior temporalis muscles. MATERIALS AND METHODS: This blind cross-sectional study involved 60 women aged 18-40 years. The volunteers were allocated to groups based on Fonseca anamnestic index (FAI) score: no TMD, mild TMD, moderate TMD, and severe TMD (n = 15 each). All volunteers underwent infrared thermography for the determination of skin temperatures over the TMJ, masseter and anterior temporalis muscles. The Shapiro-Wilk test was used to determine the normality of the data. The Kruskal-Wallis test, followed by Dunn's test, was used for comparisons among groups according to TMD severity. Spearman's correlation coefficients were calculated to determine the strength of associations among variables. RESULTS: Weak, positive, significant associations were found between FAI score and skin temperatures over the left TMJ (rs = 0.195, p = 0.009) and right TMJ (rs = 0.238, p = 0.001). Temperatures over the right and left TMJ were significantly higher in groups with more severe TMD (p < 0.05). CONCLUSION: FAI score was associated with skin temperature over the TMJ, as determined by infrared thermography, in this sample. Women with more severe TMD demonstrated a bilateral increase in skin temperature.

Accuracy of two forms of infrared image analysis of the masticatory muscles in the diagnosis of myogenous temporomandibular disorder.

The aim of the present study was to assess the accuracy of two forms of infrared image analysis (area and extension) of the masseter and anterior temporalis muscles in the diagnosis of myogenous temporomandibular disorder (TMD). A cross-sectional study was carried out involving 104 female volunteers from the university community. Following the application of the Research Diagnostic Criteria for Temporomandibular Disorders, the volunteers were divided into a TMD group (n = 52) and control group (n = 52), and evaluated using infrared thermography. The area and extension of the masseter and anterior temporalis muscles were measured on the images. The receiver operating characteristic (ROC) curve was used to determine diagnostic accuracy (area under the curve), best cutoff point, sensitivity and specificity. A significant difference in skin temperature between groups was only found in the measurement of the area of the left anterior temporalis muscle (p = 0.011). The area under the ROC curve was less than the reference values for all muscles evaluated in the analyses of area and extension. Thus, neither method of infrared thermography tested for the quantification of the masseter and anterior temporalis muscles (analysis of area and extension) is consistent with the RDC/TMD for the diagnosis of myogenous TMD in women.

Accuracy and reliability of infrared thermography in the diagnosis of arthralgia in women with temporomandibular disorder.

OBJECTIVE: The purpose of this study was to determine the accuracy and reliability of infrared thermography in the diagnosis of arthralgia in women with temporomandibular disorder. METHODS: Thirty women aged between 18 and 40 years were recruited for the study. The Research Diagnostic Criteria for Temporomandibular Disorders was used to allocate the volunteers to the control group (n = 15) and arthralgia group (n = 15). Both groups were submitted to infrared thermography of the temporomandibular joint (TMJ), followed by a punctual analysis of the images. The Mann-Whitney U test was used for the comparison of skin surface temperature between groups. The intraclass correlation coefficient was calculated to determine the reliability of the infrared image analysis. The receiver operating characteristic curve was used to determine the accuracy of the diagnosis. RESULTS: Skin temperature was significantly greater over the left (P = .004) and right (P = .012) TMJ in the arthralgia group. The intraclass correlation coefficient ranged from 0.841 to 0.874. The area under the receiver operating characteristic curve ranged from 0.598 to 0.675. CONCLUSION: Excellent intrarater and interrater reliability was found in the analysis of the infrared images of the TMJ. However, infrared thermography demonstrated a low accuracy in the diagnosis of arthralgia in women with temporomandibular disorder.