The clinical assessment of TMJ sounds by means of auscultation, palpation or both
Identifieur interne : 008368 ( Main/Exploration ); précédent : 008367; suivant : 008369The clinical assessment of TMJ sounds by means of auscultation, palpation or both
Auteurs : J. J. R. Huddleston-Slater [Pays-Bas] ; M. K. A. Van Selms [Pays-Bas] ; F. Lobbezoo [Pays-Bas] ; M. Naeije [Pays-Bas]Source :
- Journal of Oral Rehabilitation [ 0305-182X ] ; 2002-09.
Descripteurs français
- Wicri :
- geographic : Pays-Bas.
English descriptors
- KwdEn :
- Academic centre, Anterior temporalis, Anticipatory activity, Apnoea, Appliance, Arbitrary moulding, Arthrogenous origin, Auscultation, Bennett movement, Bennett side shift, Bilateral, Bilateral clenching, Bilateral measurement, Blackwell, Blackwell science, Bosman department, Botulinum toxin, Bres, Bruxers, Bruxism, Bruxism time index, Central incisor, Centre, Cervical, Cervical spine, Clenching, Clinical assessment, Clinical signs, Complete dentures, Contraction episodes, Contraction time, Contralateral side, Control appliance, Control group, Corresponding amas, Craniomandibular, Craniomandibular disorders, Crown height, Daily stress, Deformation displacement, Dental research, Dentine exposure, Dentistry, Dentistry amsterdam, Denture, Diagnostic criteria, Different design, Different foods, Digastric, Disorder, Edentate people, Edentulous, Edentulous patients, Experimental muscle pain, Experimental occlusal interference, Facial pain, Flemish adolescent girls, Food resistance, Force transducer, Full dentures, Functional impression trays, Functional impressions, Glenoid fossa, Haemodynamic changes, Healthy subjects, Horizontal forces, Hospital anxiety, Hydrodynamic stimulation, Implant, Incisor, Interference period, Interobserver reliability, Interrater reliability, Item scores, Laryngeal, Laryngeal elevation, Laryngeal vibration, Lateral, Lateral pterygoid muscles, Life quality, Little modulation, Local anaesthesia, Local application, Local craniomandibular pain, Lower ridge region, Lower ridge resorption, Magnetic resonance imaging, Main complaint, Mandible, Mandibular, Mandibular contact movements, Mandibular movement, Mandibular movements, Mandibular posture, Masseter, Masseter muscle activity, Masseter muscles, Masticatory, Masticatory muscle palpation, Masticatory muscles, Masticatory performance, Masticatory system, Mcgill pain questionnaire, Molar, Mouth opening, Multiple regression analysis, Muscle activity, Myofascial pain, Myogenous, Myogenous pain, Naeije department, Narrow occlusal surface, Natural environment, Nerve responses, Netherlands, Occlusal, Occlusal anatomy, Occlusal appliance therapy, Occlusal surface, Occlusal tooth, Odds ratio, Okayama university, Oral function, Oral habits, Oral physiology, Oral rehabilitation, Other techniques, Other variables, Outcome variables, Pain intensity, Painful body areas, Palatal, Palatal appliances, Palpation, Patient group, Periodontal receptors, Personality characteristics, Physiology, Physiotherapeutic treatment modalities, Physiotherapy, Physiotherapy group, Positive effect, Posterior digastric, Posterior digastric muscle palpation, Posterior part, Posterior temporalis, Predictor variables, Premature contact, Present study, Pressure onset, Previous study, Prosthetic dentistry, Prosthodontics, Psychological characteristics, Psychological distress, Psychological factors, Psychosomatic disorders, Pulpal blood circulation, Randomized, Recent studies, Recurrent headache, Reliability, Removable prosthodontics, Replacement dentures, Ridge incisal edge, Right masseter muscle, Ring rates, Risk factors, Sagittal distance, Several types, Side mandible, Spearman correlation, Splint therapy, Stabilization appliance, Statistical analysis, Sternocleidomastoid muscles, Stimulation cavity, Stomatognathic physiology, Such treatment, Superior laryngeal nerve, Supramedullary region, Symptom, Temporal muscles, Temporalis, Temporalis muscle, Temporomandibular, Temporomandibular disorders, Temporomandibular joints, Tongue motion, Tooth plastic rims, Treatment contrast, Treatment demand, Treatment effect, Treatment group, Treatment need, Treatment outcome, Twitch force, Unilateral, Unilateral clenching, Vallon department, Vertical distance, Visual analogue scale, Visual analogue scales, Visual feedback, Younger persons.
- Teeft :
- Academic centre, Anterior temporalis, Anticipatory activity, Apnoea, Appliance, Arbitrary moulding, Arthrogenous origin, Auscultation, Bennett movement, Bennett side shift, Bilateral, Bilateral clenching, Bilateral measurement, Blackwell, Blackwell science, Bosman department, Botulinum toxin, Bres, Bruxers, Bruxism, Bruxism time index, Central incisor, Centre, Cervical, Cervical spine, Clenching, Clinical assessment, Clinical signs, Complete dentures, Contraction episodes, Contraction time, Contralateral side, Control appliance, Control group, Corresponding amas, Craniomandibular, Craniomandibular disorders, Crown height, Daily stress, Deformation displacement, Dental research, Dentine exposure, Dentistry, Dentistry amsterdam, Denture, Diagnostic criteria, Different design, Different foods, Digastric, Disorder, Edentate people, Edentulous, Edentulous patients, Experimental muscle pain, Experimental occlusal interference, Facial pain, Flemish adolescent girls, Food resistance, Force transducer, Full dentures, Functional impression trays, Functional impressions, Glenoid fossa, Haemodynamic changes, Healthy subjects, Horizontal forces, Hospital anxiety, Hydrodynamic stimulation, Implant, Incisor, Interference period, Interobserver reliability, Interrater reliability, Item scores, Laryngeal, Laryngeal elevation, Laryngeal vibration, Lateral, Lateral pterygoid muscles, Life quality, Little modulation, Local anaesthesia, Local application, Local craniomandibular pain, Lower ridge region, Lower ridge resorption, Magnetic resonance imaging, Main complaint, Mandible, Mandibular, Mandibular contact movements, Mandibular movement, Mandibular movements, Mandibular posture, Masseter, Masseter muscle activity, Masseter muscles, Masticatory, Masticatory muscle palpation, Masticatory muscles, Masticatory performance, Masticatory system, Mcgill pain questionnaire, Molar, Mouth opening, Multiple regression analysis, Muscle activity, Myofascial pain, Myogenous, Myogenous pain, Naeije department, Narrow occlusal surface, Natural environment, Nerve responses, Netherlands, Occlusal, Occlusal anatomy, Occlusal appliance therapy, Occlusal surface, Occlusal tooth, Odds ratio, Okayama university, Oral function, Oral habits, Oral physiology, Oral rehabilitation, Other techniques, Other variables, Outcome variables, Pain intensity, Painful body areas, Palatal, Palatal appliances, Palpation, Patient group, Periodontal receptors, Personality characteristics, Physiology, Physiotherapeutic treatment modalities, Physiotherapy, Physiotherapy group, Positive effect, Posterior digastric, Posterior digastric muscle palpation, Posterior part, Posterior temporalis, Predictor variables, Premature contact, Present study, Pressure onset, Previous study, Prosthetic dentistry, Prosthodontics, Psychological characteristics, Psychological distress, Psychological factors, Psychosomatic disorders, Pulpal blood circulation, Randomized, Recent studies, Recurrent headache, Reliability, Removable prosthodontics, Replacement dentures, Ridge incisal edge, Right masseter muscle, Ring rates, Risk factors, Sagittal distance, Several types, Side mandible, Spearman correlation, Splint therapy, Stabilization appliance, Statistical analysis, Sternocleidomastoid muscles, Stimulation cavity, Stomatognathic physiology, Such treatment, Superior laryngeal nerve, Supramedullary region, Symptom, Temporal muscles, Temporalis, Temporalis muscle, Temporomandibular, Temporomandibular disorders, Temporomandibular joints, Tongue motion, Tooth plastic rims, Treatment contrast, Treatment demand, Treatment effect, Treatment group, Treatment need, Treatment outcome, Twitch force, Unilateral, Unilateral clenching, Vallon department, Vertical distance, Visual analogue scale, Visual analogue scales, Visual feedback, Younger persons.
Abstract
Anterior disc displacements are an important diagnostic subgroup (Group II) of TM disorders according to the Research Diagnostic Criteria (RDC; Dworkin & LeResche, 1992). Although the RDC yields clear‐cut criteria for the diagnosis of a disc displacement, the interobserver reliability for the clinical recognition of joint sounds is highly variable. This high variance may be caused by the fact that the clinical assessment of joint sounds is difficult. In many previous studies, auscultation with a stethoscope was used. This technique is often claimed to be the most reliable one. However, it is unclear whether in these studies, auscultation was performed without simultaneous palpation of the contralateral joint. Therefore, the aim of the present study was to test the interobserver reliability of the clinical assessment of TMJ sounds by means of auscultation, palpation or both. A total of 220 undergraduate students (100 men; 120 women; mean age 21·9 ± 3·6 years) was examined independently by two calibrated dentists for the presence, probable presence or absence of sounds caused by anterior disc displacement, hypermobility, or another cause. The 79 students underwent auscultation only (i.e. without contralateral manual palpation); 87 students underwent bilateral palpation; the remainder (54 students) was subjected to both auscultation and palpation. The results show that the combination technique yields the highest reliability (Cohen's κ=0·53). For other techniques, κ‐values of 0·46 (auscultation) and 0·48 (palpation) were found. It was concluded that the combination of auscultation and palpation yields the highest interobserver reliability for the recognition of TMJ sounds, although the differences with other techniques were small. (Supported by the IOT)
Url:
DOI: 10.1046/j.1365-2842.2002.01026_5.x
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J. R." last="Huddleston-Slater">J. J. R. Huddleston-Slater</name><affiliation wicri:level="1"><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Oral Function, Academic Center for Dentistry Amsterdam</wicri:regionArea><wicri:noRegion>Academic Center for Dentistry Amsterdam</wicri:noRegion></affiliation></author><author><name sortKey="Van Selms, M K A" sort="Van Selms, M K A" uniqKey="Van Selms M" first="M. K. A." last="Van Selms">M. K. A. Van Selms</name><affiliation wicri:level="1"><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Oral Function, Academic Center for Dentistry Amsterdam</wicri:regionArea><wicri:noRegion>Academic Center for Dentistry Amsterdam</wicri:noRegion></affiliation></author><author><name sortKey="Lobbezoo, F" sort="Lobbezoo, F" uniqKey="Lobbezoo F" first="F." last="Lobbezoo">F. 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Naeije</name><affiliation wicri:level="1"><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Oral Function, Academic Center for Dentistry Amsterdam</wicri:regionArea><wicri:noRegion>Academic Center for Dentistry Amsterdam</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Journal of Oral Rehabilitation</title><title level="j" type="alt">JOURNAL ORAL REHABILITATION</title><idno type="ISSN">0305-182X</idno><idno type="eISSN">1365-2842</idno><imprint><biblScope unit="vol">29</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="873">873</biblScope><biblScope unit="page" to="873">873</biblScope><biblScope unit="page-count">1</biblScope><publisher>Blackwell Science Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2002-09">2002-09</date></imprint><idno type="ISSN">0305-182X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0305-182X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Academic centre</term><term>Anterior temporalis</term><term>Anticipatory activity</term><term>Apnoea</term><term>Appliance</term><term>Arbitrary moulding</term><term>Arthrogenous origin</term><term>Auscultation</term><term>Bennett movement</term><term>Bennett side shift</term><term>Bilateral</term><term>Bilateral clenching</term><term>Bilateral measurement</term><term>Blackwell</term><term>Blackwell science</term><term>Bosman department</term><term>Botulinum toxin</term><term>Bres</term><term>Bruxers</term><term>Bruxism</term><term>Bruxism time index</term><term>Central incisor</term><term>Centre</term><term>Cervical</term><term>Cervical spine</term><term>Clenching</term><term>Clinical assessment</term><term>Clinical signs</term><term>Complete dentures</term><term>Contraction episodes</term><term>Contraction time</term><term>Contralateral side</term><term>Control appliance</term><term>Control group</term><term>Corresponding amas</term><term>Craniomandibular</term><term>Craniomandibular disorders</term><term>Crown height</term><term>Daily stress</term><term>Deformation displacement</term><term>Dental research</term><term>Dentine exposure</term><term>Dentistry</term><term>Dentistry amsterdam</term><term>Denture</term><term>Diagnostic criteria</term><term>Different design</term><term>Different foods</term><term>Digastric</term><term>Disorder</term><term>Edentate people</term><term>Edentulous</term><term>Edentulous patients</term><term>Experimental muscle pain</term><term>Experimental occlusal interference</term><term>Facial pain</term><term>Flemish adolescent girls</term><term>Food resistance</term><term>Force transducer</term><term>Full dentures</term><term>Functional impression trays</term><term>Functional impressions</term><term>Glenoid fossa</term><term>Haemodynamic changes</term><term>Healthy subjects</term><term>Horizontal forces</term><term>Hospital anxiety</term><term>Hydrodynamic stimulation</term><term>Implant</term><term>Incisor</term><term>Interference period</term><term>Interobserver reliability</term><term>Interrater reliability</term><term>Item scores</term><term>Laryngeal</term><term>Laryngeal elevation</term><term>Laryngeal vibration</term><term>Lateral</term><term>Lateral pterygoid muscles</term><term>Life quality</term><term>Little modulation</term><term>Local anaesthesia</term><term>Local application</term><term>Local craniomandibular pain</term><term>Lower ridge region</term><term>Lower ridge resorption</term><term>Magnetic resonance imaging</term><term>Main complaint</term><term>Mandible</term><term>Mandibular</term><term>Mandibular contact movements</term><term>Mandibular movement</term><term>Mandibular movements</term><term>Mandibular posture</term><term>Masseter</term><term>Masseter muscle activity</term><term>Masseter muscles</term><term>Masticatory</term><term>Masticatory muscle palpation</term><term>Masticatory muscles</term><term>Masticatory performance</term><term>Masticatory system</term><term>Mcgill pain questionnaire</term><term>Molar</term><term>Mouth opening</term><term>Multiple regression analysis</term><term>Muscle activity</term><term>Myofascial pain</term><term>Myogenous</term><term>Myogenous pain</term><term>Naeije department</term><term>Narrow occlusal surface</term><term>Natural environment</term><term>Nerve responses</term><term>Netherlands</term><term>Occlusal</term><term>Occlusal anatomy</term><term>Occlusal appliance therapy</term><term>Occlusal surface</term><term>Occlusal tooth</term><term>Odds ratio</term><term>Okayama university</term><term>Oral function</term><term>Oral habits</term><term>Oral physiology</term><term>Oral rehabilitation</term><term>Other techniques</term><term>Other variables</term><term>Outcome variables</term><term>Pain intensity</term><term>Painful body areas</term><term>Palatal</term><term>Palatal appliances</term><term>Palpation</term><term>Patient group</term><term>Periodontal receptors</term><term>Personality characteristics</term><term>Physiology</term><term>Physiotherapeutic treatment modalities</term><term>Physiotherapy</term><term>Physiotherapy group</term><term>Positive effect</term><term>Posterior digastric</term><term>Posterior digastric muscle palpation</term><term>Posterior part</term><term>Posterior temporalis</term><term>Predictor variables</term><term>Premature contact</term><term>Present study</term><term>Pressure onset</term><term>Previous study</term><term>Prosthetic dentistry</term><term>Prosthodontics</term><term>Psychological characteristics</term><term>Psychological distress</term><term>Psychological factors</term><term>Psychosomatic disorders</term><term>Pulpal blood circulation</term><term>Randomized</term><term>Recent studies</term><term>Recurrent headache</term><term>Reliability</term><term>Removable prosthodontics</term><term>Replacement dentures</term><term>Ridge incisal edge</term><term>Right masseter muscle</term><term>Ring rates</term><term>Risk factors</term><term>Sagittal distance</term><term>Several types</term><term>Side mandible</term><term>Spearman correlation</term><term>Splint therapy</term><term>Stabilization appliance</term><term>Statistical analysis</term><term>Sternocleidomastoid muscles</term><term>Stimulation cavity</term><term>Stomatognathic physiology</term><term>Such treatment</term><term>Superior laryngeal nerve</term><term>Supramedullary region</term><term>Symptom</term><term>Temporal muscles</term><term>Temporalis</term><term>Temporalis muscle</term><term>Temporomandibular</term><term>Temporomandibular disorders</term><term>Temporomandibular joints</term><term>Tongue motion</term><term>Tooth plastic rims</term><term>Treatment contrast</term><term>Treatment demand</term><term>Treatment effect</term><term>Treatment group</term><term>Treatment need</term><term>Treatment outcome</term><term>Twitch force</term><term>Unilateral</term><term>Unilateral clenching</term><term>Vallon department</term><term>Vertical distance</term><term>Visual analogue scale</term><term>Visual analogue scales</term><term>Visual feedback</term><term>Younger persons</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Academic centre</term><term>Anterior temporalis</term><term>Anticipatory activity</term><term>Apnoea</term><term>Appliance</term><term>Arbitrary moulding</term><term>Arthrogenous origin</term><term>Auscultation</term><term>Bennett movement</term><term>Bennett side shift</term><term>Bilateral</term><term>Bilateral clenching</term><term>Bilateral measurement</term><term>Blackwell</term><term>Blackwell science</term><term>Bosman department</term><term>Botulinum toxin</term><term>Bres</term><term>Bruxers</term><term>Bruxism</term><term>Bruxism time index</term><term>Central incisor</term><term>Centre</term><term>Cervical</term><term>Cervical spine</term><term>Clenching</term><term>Clinical assessment</term><term>Clinical signs</term><term>Complete dentures</term><term>Contraction episodes</term><term>Contraction time</term><term>Contralateral side</term><term>Control appliance</term><term>Control group</term><term>Corresponding amas</term><term>Craniomandibular</term><term>Craniomandibular disorders</term><term>Crown height</term><term>Daily stress</term><term>Deformation displacement</term><term>Dental research</term><term>Dentine exposure</term><term>Dentistry</term><term>Dentistry amsterdam</term><term>Denture</term><term>Diagnostic criteria</term><term>Different design</term><term>Different foods</term><term>Digastric</term><term>Disorder</term><term>Edentate people</term><term>Edentulous</term><term>Edentulous patients</term><term>Experimental muscle pain</term><term>Experimental occlusal interference</term><term>Facial pain</term><term>Flemish adolescent girls</term><term>Food resistance</term><term>Force transducer</term><term>Full dentures</term><term>Functional impression trays</term><term>Functional impressions</term><term>Glenoid fossa</term><term>Haemodynamic changes</term><term>Healthy subjects</term><term>Horizontal forces</term><term>Hospital anxiety</term><term>Hydrodynamic stimulation</term><term>Implant</term><term>Incisor</term><term>Interference period</term><term>Interobserver reliability</term><term>Interrater reliability</term><term>Item scores</term><term>Laryngeal</term><term>Laryngeal elevation</term><term>Laryngeal vibration</term><term>Lateral</term><term>Lateral pterygoid muscles</term><term>Life quality</term><term>Little modulation</term><term>Local anaesthesia</term><term>Local application</term><term>Local craniomandibular pain</term><term>Lower ridge region</term><term>Lower ridge resorption</term><term>Magnetic resonance imaging</term><term>Main complaint</term><term>Mandible</term><term>Mandibular</term><term>Mandibular contact movements</term><term>Mandibular movement</term><term>Mandibular movements</term><term>Mandibular posture</term><term>Masseter</term><term>Masseter muscle activity</term><term>Masseter muscles</term><term>Masticatory</term><term>Masticatory muscle palpation</term><term>Masticatory muscles</term><term>Masticatory performance</term><term>Masticatory system</term><term>Mcgill pain questionnaire</term><term>Molar</term><term>Mouth opening</term><term>Multiple regression analysis</term><term>Muscle activity</term><term>Myofascial pain</term><term>Myogenous</term><term>Myogenous pain</term><term>Naeije department</term><term>Narrow occlusal surface</term><term>Natural environment</term><term>Nerve responses</term><term>Netherlands</term><term>Occlusal</term><term>Occlusal anatomy</term><term>Occlusal appliance therapy</term><term>Occlusal surface</term><term>Occlusal tooth</term><term>Odds ratio</term><term>Okayama university</term><term>Oral function</term><term>Oral habits</term><term>Oral physiology</term><term>Oral rehabilitation</term><term>Other techniques</term><term>Other variables</term><term>Outcome variables</term><term>Pain intensity</term><term>Painful body areas</term><term>Palatal</term><term>Palatal appliances</term><term>Palpation</term><term>Patient group</term><term>Periodontal receptors</term><term>Personality characteristics</term><term>Physiology</term><term>Physiotherapeutic treatment modalities</term><term>Physiotherapy</term><term>Physiotherapy group</term><term>Positive effect</term><term>Posterior digastric</term><term>Posterior digastric muscle palpation</term><term>Posterior part</term><term>Posterior temporalis</term><term>Predictor variables</term><term>Premature contact</term><term>Present study</term><term>Pressure onset</term><term>Previous study</term><term>Prosthetic dentistry</term><term>Prosthodontics</term><term>Psychological characteristics</term><term>Psychological distress</term><term>Psychological factors</term><term>Psychosomatic disorders</term><term>Pulpal blood circulation</term><term>Randomized</term><term>Recent studies</term><term>Recurrent headache</term><term>Reliability</term><term>Removable prosthodontics</term><term>Replacement dentures</term><term>Ridge incisal edge</term><term>Right masseter muscle</term><term>Ring rates</term><term>Risk factors</term><term>Sagittal distance</term><term>Several types</term><term>Side mandible</term><term>Spearman correlation</term><term>Splint therapy</term><term>Stabilization appliance</term><term>Statistical analysis</term><term>Sternocleidomastoid muscles</term><term>Stimulation cavity</term><term>Stomatognathic physiology</term><term>Such treatment</term><term>Superior laryngeal nerve</term><term>Supramedullary region</term><term>Symptom</term><term>Temporal muscles</term><term>Temporalis</term><term>Temporalis muscle</term><term>Temporomandibular</term><term>Temporomandibular disorders</term><term>Temporomandibular joints</term><term>Tongue motion</term><term>Tooth plastic rims</term><term>Treatment contrast</term><term>Treatment demand</term><term>Treatment effect</term><term>Treatment group</term><term>Treatment need</term><term>Treatment outcome</term><term>Twitch force</term><term>Unilateral</term><term>Unilateral clenching</term><term>Vallon department</term><term>Vertical distance</term><term>Visual analogue scale</term><term>Visual analogue scales</term><term>Visual feedback</term><term>Younger persons</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Pays-Bas</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Anterior disc displacements are an important diagnostic subgroup (Group II) of TM disorders according to the Research Diagnostic Criteria (RDC; Dworkin & LeResche, 1992). Although the RDC yields clear‐cut criteria for the diagnosis of a disc displacement, the interobserver reliability for the clinical recognition of joint sounds is highly variable. This high variance may be caused by the fact that the clinical assessment of joint sounds is difficult. In many previous studies, auscultation with a stethoscope was used. This technique is often claimed to be the most reliable one. However, it is unclear whether in these studies, auscultation was performed without simultaneous palpation of the contralateral joint. Therefore, the aim of the present study was to test the interobserver reliability of the clinical assessment of TMJ sounds by means of auscultation, palpation or both. A total of 220 undergraduate students (100 men; 120 women; mean age 21·9 ± 3·6 years) was examined independently by two calibrated dentists for the presence, probable presence or absence of sounds caused by anterior disc displacement, hypermobility, or another cause. The 79 students underwent auscultation only (i.e. without contralateral manual palpation); 87 students underwent bilateral palpation; the remainder (54 students) was subjected to both auscultation and palpation. The results show that the combination technique yields the highest reliability (Cohen's κ=0·53). For other techniques, κ‐values of 0·46 (auscultation) and 0·48 (palpation) were found. It was concluded that the combination of auscultation and palpation yields the highest interobserver reliability for the recognition of TMJ sounds, although the differences with other techniques were small. (Supported by the IOT)</div></front></TEI><affiliations><list><country><li>Pays-Bas</li></country></list><tree><country name="Pays-Bas"><noRegion><name sortKey="Huddleston Later, J J R" sort="Huddleston Later, J J R" uniqKey="Huddleston Later J" first="J. J. R." last="Huddleston-Slater">J. J. R. Huddleston-Slater</name></noRegion><name sortKey="Lobbezoo, F" sort="Lobbezoo, F" uniqKey="Lobbezoo F" first="F." last="Lobbezoo">F. Lobbezoo</name><name sortKey="Naeije, M" sort="Naeije, M" uniqKey="Naeije M" first="M." last="Naeije">M. Naeije</name><name sortKey="Van Selms, M K A" sort="Van Selms, M K A" uniqKey="Van Selms M" first="M. K. A." last="Van Selms">M. K. A. Van Selms</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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