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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network<sup><xref ref-type="fn" rid="FN1">*</xref></sup> and Orofacial Pain Special Interest Group<sup><xref ref-type="fn" rid="FN2">†</xref></sup></title><author><name sortKey="Schiffman, Eric" sort="Schiffman, Eric" uniqKey="Schiffman E" first="Eric" last="Schiffman">Eric Schiffman</name></author><author><name sortKey="Ohrbach, Richard" sort="Ohrbach, Richard" uniqKey="Ohrbach R" first="Richard" last="Ohrbach">Richard Ohrbach</name></author><author><name sortKey="Truelove, Edmond" sort="Truelove, Edmond" uniqKey="Truelove E" first="Edmond" last="Truelove">Edmond Truelove</name></author><author><name sortKey="Look, John" sort="Look, John" uniqKey="Look J" first="John" last="Look">John Look</name></author><author><name sortKey="Anderson, Gary" sort="Anderson, Gary" uniqKey="Anderson G" first="Gary" last="Anderson">Gary Anderson</name></author><author><name sortKey="Goulet, Jean Paul" sort="Goulet, Jean Paul" uniqKey="Goulet J" first="Jean-Paul" last="Goulet">Jean-Paul Goulet</name></author><author><name sortKey="List, Thomas" sort="List, Thomas" uniqKey="List T" first="Thomas" last="List">Thomas List</name></author><author><name sortKey="Svensson, Peter" sort="Svensson, Peter" uniqKey="Svensson P" first="Peter" last="Svensson">Peter Svensson</name></author><author><name sortKey="Gonzalez, Yoly" sort="Gonzalez, Yoly" uniqKey="Gonzalez Y" first="Yoly" last="Gonzalez">Yoly Gonzalez</name></author><author><name sortKey="Lobbezoo, Frank" sort="Lobbezoo, Frank" uniqKey="Lobbezoo F" first="Frank" last="Lobbezoo">Frank Lobbezoo</name></author><author><name sortKey="Michelotti, Ambra" sort="Michelotti, Ambra" uniqKey="Michelotti A" first="Ambra" last="Michelotti">Ambra Michelotti</name></author><author><name sortKey="Brooks, Sharon L" sort="Brooks, Sharon L" uniqKey="Brooks S" first="Sharon L." last="Brooks">Sharon L. Brooks</name></author><author><name sortKey="Ceusters, Werner" sort="Ceusters, Werner" uniqKey="Ceusters W" first="Werner" last="Ceusters">Werner Ceusters</name></author><author><name sortKey="Drangsholt, Mark" sort="Drangsholt, Mark" uniqKey="Drangsholt M" first="Mark" last="Drangsholt">Mark Drangsholt</name></author><author><name sortKey="Ettlin, Dominik" sort="Ettlin, Dominik" uniqKey="Ettlin D" first="Dominik" last="Ettlin">Dominik Ettlin</name></author><author><name sortKey="Gaul, Charly" sort="Gaul, Charly" uniqKey="Gaul C" first="Charly" last="Gaul">Charly Gaul</name></author><author><name sortKey="Goldberg, Louis J" sort="Goldberg, Louis J" uniqKey="Goldberg L" first="Louis J." last="Goldberg">Louis J. Goldberg</name></author><author><name sortKey="Haythornthwaite, Jennifer A" sort="Haythornthwaite, Jennifer A" uniqKey="Haythornthwaite J" first="Jennifer A." last="Haythornthwaite">Jennifer A. Haythornthwaite</name></author><author><name sortKey="Hollender, Lars" sort="Hollender, Lars" uniqKey="Hollender L" first="Lars" last="Hollender">Lars Hollender</name></author><author><name sortKey="Jensen, Rigmor" sort="Jensen, Rigmor" uniqKey="Jensen R" first="Rigmor" last="Jensen">Rigmor Jensen</name></author><author><name sortKey="John, Mike T" sort="John, Mike T" uniqKey="John M" first="Mike T." last="John">Mike T. John</name></author><author><name sortKey="De Laat, Antoon" sort="De Laat, Antoon" uniqKey="De Laat A" first="Antoon" last="De Laat">Antoon De Laat</name></author><author><name sortKey="De Leeuw, Reny" sort="De Leeuw, Reny" uniqKey="De Leeuw R" first="Reny" last="De Leeuw">Reny De Leeuw</name></author><author><name sortKey="Maixner, William" sort="Maixner, William" uniqKey="Maixner W" first="William" last="Maixner">William Maixner</name></author><author><name sortKey="Van Der Meulen, Marylee" sort="Van Der Meulen, Marylee" uniqKey="Van Der Meulen M" first="Marylee" last="Van Der Meulen">Marylee Van Der Meulen</name></author><author><name sortKey="Murray, Greg M" sort="Murray, Greg M" uniqKey="Murray G" first="Greg M." last="Murray">Greg M. Murray</name></author><author><name sortKey="Nixdorf, Donald R" sort="Nixdorf, Donald R" uniqKey="Nixdorf D" first="Donald R." last="Nixdorf">Donald R. Nixdorf</name></author><author><name sortKey="Palla, Sandro" sort="Palla, Sandro" uniqKey="Palla S" first="Sandro" last="Palla">Sandro Palla</name></author><author><name sortKey="Petersson, Arne" sort="Petersson, Arne" uniqKey="Petersson A" first="Arne" last="Petersson">Arne Petersson</name></author><author><name sortKey="Pionchon, Paul" sort="Pionchon, Paul" uniqKey="Pionchon P" first="Paul" last="Pionchon">Paul Pionchon</name></author><author><name sortKey="Smith, Barry" sort="Smith, Barry" uniqKey="Smith B" first="Barry" last="Smith">Barry Smith</name></author><author><name sortKey="Visscher, Corine M" sort="Visscher, Corine M" uniqKey="Visscher C" first="Corine M." last="Visscher">Corine M. Visscher</name></author><author><name sortKey="Zakrzewska, Joanna" sort="Zakrzewska, Joanna" uniqKey="Zakrzewska J" first="Joanna" last="Zakrzewska">Joanna Zakrzewska</name></author><author><name sortKey="Dworkin, Samuel F" sort="Dworkin, Samuel F" uniqKey="Dworkin S" first="Samuel F." last="Dworkin">Samuel F. Dworkin</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24482784</idno><idno type="pmc">4478082</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478082</idno><idno type="RBID">PMC:4478082</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">001E91</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001E91</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network<sup><xref ref-type="fn" rid="FN1">*</xref></sup> and Orofacial Pain Special Interest Group<sup><xref ref-type="fn" rid="FN2">†</xref></sup></title><author><name sortKey="Schiffman, Eric" sort="Schiffman, Eric" uniqKey="Schiffman E" first="Eric" last="Schiffman">Eric Schiffman</name></author><author><name sortKey="Ohrbach, Richard" sort="Ohrbach, Richard" uniqKey="Ohrbach R" first="Richard" last="Ohrbach">Richard Ohrbach</name></author><author><name sortKey="Truelove, Edmond" sort="Truelove, Edmond" uniqKey="Truelove E" first="Edmond" last="Truelove">Edmond Truelove</name></author><author><name sortKey="Look, John" sort="Look, John" uniqKey="Look J" first="John" last="Look">John Look</name></author><author><name sortKey="Anderson, Gary" sort="Anderson, Gary" uniqKey="Anderson G" first="Gary" last="Anderson">Gary Anderson</name></author><author><name sortKey="Goulet, Jean Paul" sort="Goulet, Jean Paul" uniqKey="Goulet J" first="Jean-Paul" last="Goulet">Jean-Paul Goulet</name></author><author><name sortKey="List, Thomas" sort="List, Thomas" uniqKey="List T" first="Thomas" last="List">Thomas List</name></author><author><name sortKey="Svensson, Peter" sort="Svensson, Peter" uniqKey="Svensson P" first="Peter" last="Svensson">Peter Svensson</name></author><author><name sortKey="Gonzalez, Yoly" sort="Gonzalez, Yoly" uniqKey="Gonzalez Y" first="Yoly" last="Gonzalez">Yoly Gonzalez</name></author><author><name sortKey="Lobbezoo, Frank" sort="Lobbezoo, Frank" uniqKey="Lobbezoo F" first="Frank" last="Lobbezoo">Frank Lobbezoo</name></author><author><name sortKey="Michelotti, Ambra" sort="Michelotti, Ambra" uniqKey="Michelotti A" first="Ambra" last="Michelotti">Ambra Michelotti</name></author><author><name sortKey="Brooks, Sharon L" sort="Brooks, Sharon L" uniqKey="Brooks S" first="Sharon L." last="Brooks">Sharon L. Brooks</name></author><author><name sortKey="Ceusters, Werner" sort="Ceusters, Werner" uniqKey="Ceusters W" first="Werner" last="Ceusters">Werner Ceusters</name></author><author><name sortKey="Drangsholt, Mark" sort="Drangsholt, Mark" uniqKey="Drangsholt M" first="Mark" last="Drangsholt">Mark Drangsholt</name></author><author><name sortKey="Ettlin, Dominik" sort="Ettlin, Dominik" uniqKey="Ettlin D" first="Dominik" last="Ettlin">Dominik Ettlin</name></author><author><name sortKey="Gaul, Charly" sort="Gaul, Charly" uniqKey="Gaul C" first="Charly" last="Gaul">Charly Gaul</name></author><author><name sortKey="Goldberg, Louis J" sort="Goldberg, Louis J" uniqKey="Goldberg L" first="Louis J." last="Goldberg">Louis J. Goldberg</name></author><author><name sortKey="Haythornthwaite, Jennifer A" sort="Haythornthwaite, Jennifer A" uniqKey="Haythornthwaite J" first="Jennifer A." last="Haythornthwaite">Jennifer A. Haythornthwaite</name></author><author><name sortKey="Hollender, Lars" sort="Hollender, Lars" uniqKey="Hollender L" first="Lars" last="Hollender">Lars Hollender</name></author><author><name sortKey="Jensen, Rigmor" sort="Jensen, Rigmor" uniqKey="Jensen R" first="Rigmor" last="Jensen">Rigmor Jensen</name></author><author><name sortKey="John, Mike T" sort="John, Mike T" uniqKey="John M" first="Mike T." last="John">Mike T. John</name></author><author><name sortKey="De Laat, Antoon" sort="De Laat, Antoon" uniqKey="De Laat A" first="Antoon" last="De Laat">Antoon De Laat</name></author><author><name sortKey="De Leeuw, Reny" sort="De Leeuw, Reny" uniqKey="De Leeuw R" first="Reny" last="De Leeuw">Reny De Leeuw</name></author><author><name sortKey="Maixner, William" sort="Maixner, William" uniqKey="Maixner W" first="William" last="Maixner">William Maixner</name></author><author><name sortKey="Van Der Meulen, Marylee" sort="Van Der Meulen, Marylee" uniqKey="Van Der Meulen M" first="Marylee" last="Van Der Meulen">Marylee Van Der Meulen</name></author><author><name sortKey="Murray, Greg M" sort="Murray, Greg M" uniqKey="Murray G" first="Greg M." last="Murray">Greg M. Murray</name></author><author><name sortKey="Nixdorf, Donald R" sort="Nixdorf, Donald R" uniqKey="Nixdorf D" first="Donald R." last="Nixdorf">Donald R. Nixdorf</name></author><author><name sortKey="Palla, Sandro" sort="Palla, Sandro" uniqKey="Palla S" first="Sandro" last="Palla">Sandro Palla</name></author><author><name sortKey="Petersson, Arne" sort="Petersson, Arne" uniqKey="Petersson A" first="Arne" last="Petersson">Arne Petersson</name></author><author><name sortKey="Pionchon, Paul" sort="Pionchon, Paul" uniqKey="Pionchon P" first="Paul" last="Pionchon">Paul Pionchon</name></author><author><name sortKey="Smith, Barry" sort="Smith, Barry" uniqKey="Smith B" first="Barry" last="Smith">Barry Smith</name></author><author><name sortKey="Visscher, Corine M" sort="Visscher, Corine M" uniqKey="Visscher C" first="Corine M." last="Visscher">Corine M. Visscher</name></author><author><name sortKey="Zakrzewska, Joanna" sort="Zakrzewska, Joanna" uniqKey="Zakrzewska J" first="Joanna" last="Zakrzewska">Joanna Zakrzewska</name></author><author><name sortKey="Dworkin, Samuel F" sort="Dworkin, Samuel F" uniqKey="Dworkin S" first="Samuel F." last="Dworkin">Samuel F. Dworkin</name></author></analytic><series><title level="j">Journal of oral & facial pain and headache</title><idno type="ISSN">2333-0384</idno><idno type="eISSN">2333-0376</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Aims</title><p id="P1">The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0.95.</p><p id="P2">Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were shown to be both reliable and valid. Working from these findings and revisions, two international consensus workshops were convened, from which recommendations were obtained for the finalization of new Axis I diagnostic algorithms and new Axis II instruments.</p></sec><sec id="S2"><title>Methods</title><p id="P3">Through a series of workshops and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel's recommendations for further revision of the Axis I diagnostic algorithms were assessed for validity by using the Validation Project's data set, and for reliability by using newly collected data from the ongoing TMJ Impact Project—the follow-up study to the Validation Project. New Axis II instruments were identified through a comprehensive search of the literature providing valid instruments that, relative to the RDC/TMD, are shorter in length, are available in the public domain, and currently are being used in medical settings.</p></sec><sec id="S3"><title>Results</title><p id="P4">The newly recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for detecting any pain-related TMD as well as valid diagnostic criteria for differentiating the most common pain-related TMD (sensitivity ≥ 0.86, specificity ≥ 0.98) and for one intra-articular disorder (sensitivity of 0.80 and specificity of 0.97). Diagnostic criteria for other common intra-articular disorders lack adequate validity for clinical diagnoses but can be used for screening purposes. Inter-examiner reliability for the clinical assessment associated with the validated DC/TMD criteria for pain-related TMD is excellent (kappa ≥ 0.85). Finally, a comprehensive classification system that includes both the common and less common TMD is also presented. The Axis II protocol retains selected original RDC/TMD screening instruments augmented with new instruments to assess jaw function as well as behavioral and additional psychosocial factors. The Axis II protocol is divided into screening and comprehensive self-report instrument sets. The screening instruments’ 41 questions assess pain intensity, pain-related disability, psychological distress, jaw functional limitations, and parafunctional behaviors, and a pain drawing is used to assess locations of pain. The comprehensive instruments, composed of 81 questions, assess in further detail jaw functional limitations and psychological distress as well as additional constructs of anxiety and presence of comorbid pain conditions.</p></sec><sec id="S4"><title>Conclusion</title><p id="P5">The recommended evidence-based new DC/TMD protocol is appropriate for use in both clinical and research settings. More comprehensive instruments augment short and simple screening instruments for Axis I and Axis II. These validated instruments allow for identification of patients with a range of simple to complex TMD presentations.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">101624698</journal-id><journal-id journal-id-type="pubmed-jr-id">42177</journal-id><journal-id journal-id-type="nlm-ta">J Oral Facial Pain Headache</journal-id><journal-id journal-id-type="iso-abbrev">J Oral Facial Pain Headache</journal-id><journal-title-group><journal-title>Journal of oral & facial pain and headache</journal-title></journal-title-group><issn pub-type="ppub">2333-0384</issn><issn pub-type="epub">2333-0376</issn></journal-meta><article-meta><article-id pub-id-type="pmid">24482784</article-id><article-id pub-id-type="pmc">4478082</article-id><article-id pub-id-type="manuscript">NIHMS695420</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network<sup><xref ref-type="fn" rid="FN1">*</xref></sup> and Orofacial Pain Special Interest Group<sup><xref ref-type="fn" rid="FN2">†</xref></sup></article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Schiffman</surname><given-names>Eric</given-names></name><degrees>DDS, MS</degrees><role>Associate Professor</role><aff id="A1">Department of Diagnostic and Biological Sciences School of Dentistry University of Minnesota Minneapolis, Minnesota, USA</aff></contrib><contrib contrib-type="author"><name><surname>Ohrbach</surname><given-names>Richard</given-names></name><degrees>DDS, PhD</degrees><role>Associate Professor</role><aff id="A2">Department of Oral Diagnostic Sciences School of Dental Medicine University at Buffalo New York, New York USA</aff></contrib><contrib contrib-type="author"><name><surname>Truelove</surname><given-names>Edmond</given-names></name><degrees>DDS, MSD</degrees><role>Professor</role><aff id="A3">Department of Oral Medicine School of Dentistry University of Washington Seattle, Washington, USA</aff></contrib><contrib contrib-type="author"><name><surname>Look</surname><given-names>John</given-names></name><degrees>DDS, PhD</degrees><role>Senior Research Associate</role><aff id="A4">Department of Diagnostic and Biological Sciences School of Dentistry University of Minnesota Minneapolis, Minnesota, USA</aff></contrib><contrib contrib-type="author"><name><surname>Anderson</surname><given-names>Gary</given-names></name><degrees>DDS, MS</degrees><role>Associate Professor</role><aff id="A5">Department of Developmental and Surgical Sciences School of Dentistry University of Minnesota Minneapolis, Minnesota, USA</aff></contrib><contrib contrib-type="author"><name><surname>Goulet</surname><given-names>Jean-Paul</given-names></name><degrees>DDS, MSD</degrees><role>Professor</role><aff id="A6">Section of Stomatology Faculty of Dentistry Laval University Quebec, Canada</aff></contrib><contrib contrib-type="author"><name><surname>List</surname><given-names>Thomas</given-names><suffix>Odont Dr</suffix></name><degrees>DDS</degrees><role>Professor and Chair</role><aff id="A7">Department of Stomatognathic Physiology Faculty of Odontology Malmö University Malmö, Sweden</aff></contrib><contrib contrib-type="author"><name><surname>Svensson</surname><given-names>Peter</given-names><suffix>Dr Odont</suffix></name><degrees>DDS, PhD</degrees><role>Professor</role><aff id="A8">Department of Clinical Oral Physiology School of Dentistry Aarhus University and Professor Center for Functionally Integrative Neuroscience MindLab Aarhus University Hospital Aarhus, Denmark</aff></contrib><contrib contrib-type="author"><name><surname>Gonzalez</surname><given-names>Yoly</given-names></name><degrees>DDS, MS, MPH</degrees><role>Assistant Professor</role><aff id="A9">Department of Oral Diagnostic Sciences School of Dental Medicine University at Buffalo Buffalo, New York, USA</aff></contrib><contrib contrib-type="author"><name><surname>Lobbezoo</surname><given-names>Frank</given-names></name><degrees>DDS, PhD</degrees><role>Professor</role><aff id="A10">Department of Oral Kinesiology Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and VU University Amsterdam MOVE Research Institute Amsterdam Amsterdam, The Netherlands</aff></contrib><contrib contrib-type="author"><name><surname>Michelotti</surname><given-names>Ambra</given-names></name><degrees>DDS</degrees><role>Associate Professor</role><aff id="A11">Department of Orthodontics and Gnathology School of Dentistry University of Naples Federico II Naples, Italy</aff></contrib><contrib contrib-type="author"><name><surname>Brooks</surname><given-names>Sharon L.</given-names></name><degrees>DDS, MS</degrees><role>Professor Emerita</role><aff id="A12">Department of Periodontics and Oral Medicine School of Dentistry University of Michigan Ann Arbor, Michigan, USA</aff></contrib><contrib contrib-type="author"><name><surname>Ceusters</surname><given-names>Werner</given-names></name><degrees>MD</degrees><role>Professor</role><aff id="A13">Department of Psychiatry School of Medicine and Biomedical Sciences University at Buffalo Director of Research of the Institute for Healthcare Informatics and Director of the Ontology Research Group New York State Center of Excellence in Bioinformatics and Life Sciences Buffalo, New York, USA</aff></contrib><contrib contrib-type="author"><name><surname>Drangsholt</surname><given-names>Mark</given-names></name><degrees>DDS, PhD</degrees><role>Professor and Chair</role><aff id="A14">Department of Oral Medicine School of Dentistry University of Washington Seattle, Washington, USA</aff></contrib><contrib contrib-type="author"><name><surname>Ettlin</surname><given-names>Dominik</given-names></name><degrees>MD, DDS</degrees><role>Privatdozent</role><aff id="A15">University of Zurich Zurich, Switzerland</aff></contrib><contrib contrib-type="author"><name><surname>Gaul</surname><given-names>Charly</given-names></name><degrees>MD</degrees><role>Neurologist and Head of Department</role><aff id="A16">Migraine and Headache Clinic Königstein, Germany</aff></contrib><contrib contrib-type="author"><name><surname>Goldberg</surname><given-names>Louis J.</given-names></name><degrees>DDS, PhD</degrees><role>Professor</role><aff id="A17">Department of Oral Diagnostic Sciences School of Dental Medicine University at Buffalo Buffalo, New York, USA</aff></contrib><contrib contrib-type="author"><name><surname>Haythornthwaite</surname><given-names>Jennifer A.</given-names></name><degrees>PhD</degrees><role>Professor</role><aff id="A18">Department of Psychiatry & Behavioral Sciences School of Medicine Johns Hopkins University Baltimore, Maryland, USA</aff></contrib><contrib contrib-type="author"><name><surname>Hollender</surname><given-names>Lars</given-names><suffix>Odont Dr</suffix></name><degrees>DDS</degrees><role>Professor (emeritus)</role><aff id="A19">Division of Oral Radiology Department of Oral Medicine School of Dentistry University of Washington Seattle, Washington, USA</aff></contrib><contrib contrib-type="author"><name><surname>Jensen</surname><given-names>Rigmor</given-names></name><degrees>MD, PhD</degrees><role>Professor</role><aff id="A20">Danish Headache Center Department of Neurology Glostrup Hospital University of Copenhagen Copenhagen, Denmark</aff></contrib><contrib contrib-type="author"><name><surname>John</surname><given-names>Mike T.</given-names></name><degrees>DDS, PhD</degrees><role>Associate Professor</role><aff id="A21">Department of Diagnostic and Biological Sciences 6-320 Moos Tower University of Minnesota Minneapolis, Minnesota, USA</aff></contrib><contrib contrib-type="author"><name><surname>De Laat</surname><given-names>Antoon</given-names></name><degrees>DDS, PhD</degrees><role>Professor</role><aff id="A22">Department of Oral Health Sciences KU Leuven and Dentistry, University Hospital Leuven Leuven, Belgium</aff></contrib><contrib contrib-type="author"><name><surname>de Leeuw</surname><given-names>Reny</given-names></name><degrees>DDS, PhD</degrees><role>Associate Professor</role><aff id="A23">Department of oral Health Science College of Dentistry University of Kentucky Lexington, Kentucky, USA</aff></contrib><contrib contrib-type="author"><name><surname>Maixner</surname><given-names>William</given-names></name><degrees>DDS, PhD</degrees><aff id="A24">Mary Lily Kenan Flagler Bingham Distinguished Professor and Director Center for Neurosensory Disorders University of North Carolina at Chapel Hill Chapel Hill, North Carolina, USA</aff></contrib><contrib contrib-type="author"><name><surname>van der Meulen</surname><given-names>Marylee</given-names></name><degrees>PhD</degrees><role>Assistant Professor</role><aff id="A25">Department of Oral Kinesiology Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and VU University Amsterdam MOVE Research Institute Amsterdam Amsterdam, The Netherlands</aff></contrib><contrib contrib-type="author"><name><surname>Murray</surname><given-names>Greg M.</given-names></name><degrees>MDS, PhD</degrees><role>Professor Faculty of Dentistry</role><aff id="A26">University of Sydney Sydney, Australia</aff></contrib><contrib contrib-type="author"><name><surname>Nixdorf</surname><given-names>Donald R.</given-names></name><degrees>DDS, MS</degrees><role>Associate Professor</role><aff id="A27">Department of Diagnostic and Biological Sciences and Adjunct Assistant Professor Department of Neurology University of Minnesota, Minneapolis and Research Investigator HealthPartners Institute for Education and Research Bloomington, Minnesota, USA</aff></contrib><contrib contrib-type="author"><name><surname>Palla</surname><given-names>Sandro</given-names><suffix>Dr Med Dent</suffix></name><role>Professor</role><aff id="A28">Emeritus University of Zurich Zurich, Switzerland</aff></contrib><contrib contrib-type="author"><name><surname>Petersson</surname><given-names>Arne</given-names><suffix>Odont Dr</suffix></name><degrees>DDS</degrees><role>Professor Emeritus</role><aff id="A29">Department of Oral and Maxillofacial Radiology Faculty of Odontology Malmö University Malmö, Sweden</aff></contrib><contrib contrib-type="author"><name><surname>Pionchon</surname><given-names>Paul</given-names></name><degrees>DDS, PhD</degrees><role>Associate Professor</role><aff id="A30">Department of Orofacial Pain and Department of Psychology Faculty of Odontology Université d'Auvergne Clermont Ferrand, France</aff></contrib><contrib contrib-type="author"><name><surname>Smith</surname><given-names>Barry</given-names></name><degrees>PhD</degrees><role>Professor</role><aff id="A31">Departments of Philosophy, Neurology, and Computer Science University at Buffalo Buffalo, New York, USA</aff></contrib><contrib contrib-type="author"><name><surname>Visscher</surname><given-names>Corine M.</given-names></name><degrees>PT, PhD</degrees><role>Associate Professor</role><aff id="A32">Department of Oral Kinesiology Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and VU University Amsterdam MOVE Research Institute Amsterdam Amsterdam, The Netherlands</aff></contrib><contrib contrib-type="author"><name><surname>Zakrzewska</surname><given-names>Joanna</given-names></name><degrees>MD, FDSRCSI</degrees><role>Professor</role><aff id="A33">Division of Diagnostic, Surgical and Medical Sciences Eastman Dental Hospital UCLH NHS Foundation Trust London, UK</aff></contrib><contrib contrib-type="author"><name><surname>Dworkin</surname><given-names>Samuel F.</given-names></name><degrees>DDS, PhD</degrees><role>Professor</role><aff id="A34">Emeritus Department of Oral Medicine School of Dentistry and Department of Psychiatry and Behavioral Sciences School of Medicine University of Washington Seattle, Washington, USA</aff></contrib></contrib-group><author-notes><corresp id="CR1">Correspondence to: Dr Eric Schiffman Department of Diagnostic and Biological Sciences 6-320 Moos Tower School of Dentistry University of Minnesota Minneapolis, MN, USA 55455 Fax: (612) 626-0138 <email>schif001@umn.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>4</day><month>6</month><year>2015</year></pub-date><pub-date pub-type="ppub"><season>Winter</season><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>23</day><month>6</month><year>2015</year></pub-date><volume>28</volume><issue>1</issue><fpage>6</fpage><lpage>27</lpage><abstract><sec id="S1"><title>Aims</title><p id="P1">The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0.95.</p><p id="P2">Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were shown to be both reliable and valid. Working from these findings and revisions, two international consensus workshops were convened, from which recommendations were obtained for the finalization of new Axis I diagnostic algorithms and new Axis II instruments.</p></sec><sec id="S2"><title>Methods</title><p id="P3">Through a series of workshops and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel's recommendations for further revision of the Axis I diagnostic algorithms were assessed for validity by using the Validation Project's data set, and for reliability by using newly collected data from the ongoing TMJ Impact Project—the follow-up study to the Validation Project. New Axis II instruments were identified through a comprehensive search of the literature providing valid instruments that, relative to the RDC/TMD, are shorter in length, are available in the public domain, and currently are being used in medical settings.</p></sec><sec id="S3"><title>Results</title><p id="P4">The newly recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for detecting any pain-related TMD as well as valid diagnostic criteria for differentiating the most common pain-related TMD (sensitivity ≥ 0.86, specificity ≥ 0.98) and for one intra-articular disorder (sensitivity of 0.80 and specificity of 0.97). Diagnostic criteria for other common intra-articular disorders lack adequate validity for clinical diagnoses but can be used for screening purposes. Inter-examiner reliability for the clinical assessment associated with the validated DC/TMD criteria for pain-related TMD is excellent (kappa ≥ 0.85). Finally, a comprehensive classification system that includes both the common and less common TMD is also presented. The Axis II protocol retains selected original RDC/TMD screening instruments augmented with new instruments to assess jaw function as well as behavioral and additional psychosocial factors. The Axis II protocol is divided into screening and comprehensive self-report instrument sets. The screening instruments’ 41 questions assess pain intensity, pain-related disability, psychological distress, jaw functional limitations, and parafunctional behaviors, and a pain drawing is used to assess locations of pain. The comprehensive instruments, composed of 81 questions, assess in further detail jaw functional limitations and psychological distress as well as additional constructs of anxiety and presence of comorbid pain conditions.</p></sec><sec id="S4"><title>Conclusion</title><p id="P5">The recommended evidence-based new DC/TMD protocol is appropriate for use in both clinical and research settings. More comprehensive instruments augment short and simple screening instruments for Axis I and Axis II. These validated instruments allow for identification of patients with a range of simple to complex TMD presentations.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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