Diagnostic validity of clinical protocols to assess temporomandibular disk displacement disorders: a meta-analysis

Diagnostic validity of clinical protocols to assess temporomandibular disk displacement disorders: a meta-analysis

Author Pupo, Yasmine Mendes Google Scholar
Quirino Pantoja, Leticia Lopes Google Scholar
Veiga, Flavia Fusco Google Scholar
Stechman-Neto, Jose Google Scholar
Zwir, Liete Figueiredo Autor UNIFESP Google Scholar
Farago, Paulo Vitor Google Scholar
Canto, Graziela De Luca Google Scholar
Porporatti, Andre Luis Google Scholar
Abstract Objective. To evaluate the diagnostic validity of clinical examination protocols compared with magnetic resonance imaging (MRI) in adults with temporomandibular joint disk displacement disorders. Study Design. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was undertaken using a selection process in 2 phases

283 different references were identified, and 10 articles were included for qualitative analysis and 7 for meta-analysis. Temporomandibular joint disorders were assessed through clinical diagnosis protocols with the aid of Research Diagnostic Criteria for Temporomandibular Disorders, Diagnostic Criteria for Temporomandibular Disorders, or Clinical Diagnostic Criteria for Temporomandibular Disorders. The authors searched the following electronic databases: Cochrane, LILACS, PubMed, Science Direct, SCOPUS, and Web of Science. Additional search of gray literature was performed. Selected studies were evaluated by using the Quality Assessment Tool for Diagnostic Accuracy Studies-2. Two subgroups were analyzed: Disk displacement with reduction (DDwR) and disk displacement without reduction (DDwoR). Results. The validity of clinical protocols compared with MRI performed in studies evaluating only DDwR presented sensitivity of 44% (39%-49%) and specificity 51% (46%-57%). In studies evaluating only DDwoR, sensitivity was 22% (16%-30%) and specificity 93% (85%-98%). The area under the curve value for validity of clinical protocols in all studies was 0.63, 0.56 for studies evaluating DDwR and 0.64 for studies evaluating DDwoR. Area under the curve values were considered poor. Conclusions. Clinical examination protocols have poor validity to diagnose DDwR and DDwoR compared with MRI. MRI should be used to increase the diagnostic accuracy when the information provided can influence clinical decisions.
xmlui.dri2xhtml.METS-1.0.item-coverage New York
Language English
Date 2016
Published in Oral Surgery Oral Medicine Oral Pathology Oral Radiology. New York, v. 122, n. 5, p. 572-586, 2016.
ISSN 2212-4403 (Sherpa/Romeo, impact factor)
Publisher Elsevier Science Inc
Extent 572-586
Origin http://dx.doi.org/10.1016/j.oooo.2016.07.004
Access rights Closed access
Type Article
Web of Science ID WOS:000389532400013
URI https://repositorio.unifesp.br/handle/11600/56798

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