Background & Aims
The temporal tendon is a structure often compromised in patients suffering of temporomandibular disorders (TMD). When painful, it can generate great impairment in mastication, oral food processing and normal jaw function. In a previous study, a device called the Palpeter[11] was introduced for testing mechanical sensitivity of muscles and joints, proving low variability and good accuracy compared to manual palpation. Yet, the intraoral location of the temporal tendon makes a standardized assessment difficult. The aims of this study were to assess the test-retest variability and accuracy to target force of an intraoral extension for the temporal tendon, when compared to the Palpeter without the extension (reference) and manual palpation (experiment 1). In addition, to run a proof of concept clinical study to show that the extension can be used intraorally to reliably assess mechanical sensitivity and referred sensations of the temporal tendon in healthy participants (experiment 2).
Methods
In experiment 1, 12 individuals were asked to target on a scale 0.5 kg, 1 kg and 2 kg, for 2 and 5 seconds by using five different methods (Palpeter, Palpeter with 3 different extension shapes and manual palpation). To assess differences between methods, repeated measures analysis of variance (ANOVA) was used with duration, force and method as factors. Subsequently in experiment 2, 10 healthy participants were recruited for a randomized double-blinded assessment by applying pressure of 0.5, 1 and 2 kg to the right temporal tendon with the 3 extensions and manual palpation. Participants rated the intensity of their sensation/pain on a 0-50-100 numeric rating scale (NRS), unpleasantness on a 0-100 NRS, and if present, they rated and drew the location of referred sensations. Repeated measures ANOVA were used to test for differences in both, mechanical sensitivity and unpleasantness scores, between the three different extension shapes with force, repetition, and method as factors.
Results
The extensions showed no significant differences between them regarding reliability and accuracy. The manual method was significantly less reliable and accurate when compared to the other methods (p<0.05). There were no significant differences between the Palpeter extensions regarding pain intensity or unpleasantness NRS scores (p>0.05), but all of them were significantly increased when compared to manual palpation (p<0.05). Similarly, frequency of referred sensations was similar between extensions but increased when compared to manual palpation.
Conclusions
The new Palpeter extensions proved to be significantly more accurate and have lower test-retest variability than the manual method when tested in a laboratory setting. Clinically, the different Palpeter extensions showed no significant differences in NRS scores for pain intensity nor unpleasantness, with no major differences in referred sensations, making any of the extensions suitable for clinical testing of the temporal tendon in future studies. Referred pain was a rather common finding upon standardized palpation of the temporal tendon with a 2 kg force in healthy participants.
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Presenting Author
Nicole Renner
Poster Authors
Nicole Renner
OTHR
Aarhus University
Lead Author
Yuri M. Costa. DDS
Ph.D
University of Campinas
Lead Author
Eduardo E. Castrillon. DDS
MSc
Aarhus University
Lead Author
Peter Svensson
DDS
Department of Dentistry and Oral Health, Aarhus University
Lead Author
Fernando Exposto
Section of Orofacial Pain and Jaw Function, Aarhus University
Lead Author
Topics
- Models: Musculoskeletal