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Sharma, S., Nilsson, P. M., Östergren, P.-O., Häggman-Henrikson, B., List, T. & Kallen, M. A. (2023). A new instrument for assessing work-related body mechanics and strain in the general population. Journal of Pain, 24(2), 237-250, Article ID S1526-5900(22)00409-6.
Open this publication in new window or tab >>A new instrument for assessing work-related body mechanics and strain in the general population
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2023 (English)In: Journal of Pain, ISSN 1526-5900, E-ISSN 1528-8447, Vol. 24, no 2, p. 237-250, article id S1526-5900(22)00409-6Article in journal (Refereed) Published
Abstract [en]

Clinical pain is often linked to poor body mechanics, with individuals sometimes presenting multiple painful disorders. Such disorders may be influenced by behaviors that affect the general resiliency and health of the musculoskeletal system. We aimed to develop a self-reported scale using the Malmö Diet and Cancer Study questions on work-related body mechanical exposures. An expert panel identified 41 variables having content validity for musculoskeletal problems. Exploratory factor analysis was conducted on a random selection of 50% of the cohort (n=6,789 adults); the remaining was reserved for confirmatory factor analyses (CFA), item response theory (IRT) item calibration, and differential item functioning investigations. Supported by standard measure development methods and fit criteria, the final unidimensional item bank contains 13 items. Overall CFA statistics (root mean square error of approximation=0.09; comparative fit index=0.96; Tucker-Lewis index=0.96; standardized root mean residuals=0.05) indicated excellent single-factor model fit and appropriateness of IRT modeling and calibration. Expert review and item information values (score-precision) guided selection of an 8-item short form with acceptable score-level reliabilities (≥0.70) for T-scores=39-80+. This measure provides reliable assessment of body mechanics strain in adults and can be useful when evaluating different contributions to musculoskeletal problems affecting pain-treatment success in future clinical research. Perspective: This article presents the development and psychometric properties of a new measure, "Work-related Body Mechanics and Strain Scale (WR-BMSS)." The scale has 13-items or alternatively an 8-item short form. This measure could potentially help clinicians who seek to assess how musculoskeletal problems may contribute to patient pain and disability.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Body mechanics, factor analysis, psychometrics, strain, work-place limitation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mau:diva-55423 (URN)10.1016/j.jpain.2022.09.011 (DOI)000969412300001 ()36216127 (PubMedID)2-s2.0-85143487167 (Scopus ID)
Available from: 2022-10-18 Created: 2022-10-18 Last updated: 2023-12-13Bibliographically approved
Durham, J., Ohrbach, R., Baad‐Hansen, L., Davies, S., De Laat, A., Goncalves, D. G., . . . Alstergren, P. (2023). Constructing the brief diagnostic criteria for temporomandibular disorders (bDC/TMD) for field testing. Journal of Oral Rehabilitation
Open this publication in new window or tab >>Constructing the brief diagnostic criteria for temporomandibular disorders (bDC/TMD) for field testing
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2023 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Despite advances in temporomandibular disorders' (TMDs) diagnosis, the diagnostic process continues to be problematic in non-specialist settings.

Objective: To complete a Delphi process to shorten the Diagnostic Criteria for TMD (DC/TMD) to a brief DC/TMD (bDC/TMD) for expedient clinical diagnosis and initial management.

Methods: An international Delphi panel was created with 23 clinicians representing major specialities, general dentistry and related fields. The process comprised a full day workshop, seven virtual meetings, six rounds of electronic discussion and finally an open consultation at a virtual international symposium.

Results: Within the physical axis (Axis 1), the self-report Symptom Questionnaire of the DC/TMD did not require shortening from 14 items for the bDC/TMD. The compulsory use of the TMD pain screener was removed reducing the total number of Axis 1 items by 18%. The DC/TMD Axis 1 10-section examination protocol (25 movements, up to 12 sets of bilateral palpations) was reduced to four sections in the bDC/TMD protocol involving three movements and three sets of palpations. Axis I then resulted in two groups of diagnoses: painful TMD (inclusive of secondary headache), and common joint-related TMD with functional implications. The psychosocial axis (Axis 2) was shortened to an ultra-brief 11 item assessment.

Conclusion: The bDC/TMD represents a substantially reduced and likely expedited method to establish (grouping) diagnoses in TMDs. This may provide greater utility for settings requiring less granular diagnoses for the implementation of initial treatment, for example non-specialist general dental practice.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
facial pain, temporomandibular disorders, temporomandibular joint, temporomandibular joint disorders, temporomandibular joint dysfunction syndrome
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-64863 (URN)10.1111/joor.13652 (DOI)001136362000001 ()38151896 (PubMedID)2-s2.0-85180920007 (Scopus ID)
Available from: 2024-01-08 Created: 2024-01-08 Last updated: 2024-02-05Bibliographically approved
Ekberg, E., Nilsson, I.-M., Michelotti, A., Al-Khotani, A., Alstergren, P., Conti, P. C., . . . Rongo, R. (2023). Diagnostic Criteria for Temporomandibular Disorders - INfORM recommendations: Comprehensive and short-form adaptations for adolescents.. Journal of Oral Rehabilitation, 50(11), 1167-1180
Open this publication in new window or tab >>Diagnostic Criteria for Temporomandibular Disorders - INfORM recommendations: Comprehensive and short-form adaptations for adolescents.
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2023 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 50, no 11, p. 1167-1180Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for use in adults is in use worldwide. Until now, no version of this instrument for use in adolescents has been proposed.

OBJECTIVE: To present comprehensive and short-form adaptations of the adult version of DC/TMD that are appropriate for use with adolescents in clinical and research settings.

METHODS: International experts in TMDs and experts in pain psychology participated in a Delphi process to identify ways of adapting the DC/TMD protocol for physical and psychosocial assessment of adolescents.

RESULTS: The proposed adaptation defines adolescence as ages 10-19 years. Changes in the physical diagnosis (Axis I) include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for adolescents, (ii) adding two general health questionnaires, one for the adolescent patient and one for their caregivers, and (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire. Changes in the psychosocial assessment (Axis II) include (i) adapting the language of the Graded Chronic Pain Scale to be developmentally appropriate for adolescents, (ii) adding anxiety and depression assessment that have been validated for adolescents, and (iii) adding three constructs (stress, catastrophizing and sleep disorders) to assess psychosocial functioning in adolescents.

CONCLUSION: The recommended DC/TMD, including Axis I and Axis II for adolescents, is appropriate to use in clinical and research settings. This adapted first version for adolescents includes changes in Axis I and Axis II requiring reliability and validity testing in international settings. Official translations of the comprehensive and short-form to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
adolescents, diagnostic criteria, dysfunction, pain, temporomandibular disorders
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-59538 (URN)10.1111/joor.13488 (DOI)001015329500001 ()37144484 (PubMedID)2-s2.0-85173807140 (Scopus ID)
Available from: 2023-05-17 Created: 2023-05-17 Last updated: 2024-04-05Bibliographically approved
Nilsson, I.-M., Ekberg, E., Michelotti, A., Al-Khotani, A., Alstergren, P., Conti, P. C., . . . Rongo, R. (2023). Diagnostic Criteria for Temporomandibular Disorders - INfORM recommendations: Comprehensive and short-form adaptations for children. Journal of Oral Rehabilitation, 50(2), 99-112
Open this publication in new window or tab >>Diagnostic Criteria for Temporomandibular Disorders - INfORM recommendations: Comprehensive and short-form adaptations for children
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2023 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 50, no 2, p. 99-112Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) are used worldwide in adults. Until now, no adaptation for use in children has been proposed.

OBJECTIVE: To present comprehensive and short-form adaptations of Axis I and II of the DC/TMD for adults that are appropriate for use with children in clinical and research settings.

METHODS: Global Delphi studies with experts in TMDs and in pain psychology identified ways of adapting the DC/TMD for children.

RESULTS: The proposed adaptation is suitable for children aged 6-9 years. Proposed changes in Axis I include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for children, (ii) adding a general health questionnaire for children and one for their parents, (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire, and (iv) modifying the clinical examination protocol. Proposed changes in Axis II include (i) for the Graded Chronic Pain Scale, to be developmentally appropriate for children, and (ii) adding anxiety and depression assessments that have been validated in children, and (iii) adding three constructs (stress, catastrophizing, and sleep disorders) to assess psychosocial functioning in children.

CONCLUSION: The recommended DC/TMD, including Axis I and Axis II, for children aged 6-9 years, is appropriate for use in clinical and research settings. This adapted first version for children includes changes in Axis I and Axis II changes requiring reliability and validity testing in international settings. Official translations to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
children, diagnostic criteria, dysfunction, pain, temporomandibular disorders
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-56161 (URN)10.1111/joor.13390 (DOI)000920751500001 ()36373958 (PubMedID)2-s2.0-85144152911 (Scopus ID)
Available from: 2022-11-22 Created: 2022-11-22 Last updated: 2024-02-05Bibliographically approved
Tegelberg, Å., Nohlert, E., List, T. & Isacsson, G. (2023). Oral appliance influence on jaw function in obstructive sleep apnea. American Journal of Orthodontics and Dentofacial Orthopedics, 164(5), 682-689, Article ID S0889-5406(23)00302-5.
Open this publication in new window or tab >>Oral appliance influence on jaw function in obstructive sleep apnea
2023 (English)In: American Journal of Orthodontics and Dentofacial Orthopedics, ISSN 0889-5406, E-ISSN 1097-6752, Vol. 164, no 5, p. 682-689, article id S0889-5406(23)00302-5Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Oral appliance (OA) therapy in obstructive sleep apnea (OSA) could be a risk factor for normal jaw function, given the prolonged effect of an OA in keeping the mandible in a protruded position away from a normal position. This study aimed to assess changes in symptoms and clinical findings related to jaw function after 1 year of treating OSA with an OA.

METHODS: In this follow-up clinical trial, 302 patients with OSA were assigned to treatment with either monobloc or bibloc OA. Baseline and 1-year follow-up assessment included using the Jaw Functional Limitation Scale, self-reported symptoms and signs related to jaw function. The clinical examination of jaw function included mandibular mobility, dental occlusion, and tenderness in the temporomandibular joints and masticatory muscles. Descriptive analyses of variables are presented for the per-protocol population. To evaluate differences between the baseline and the 1-year follow-up, paired Student t tests and the McNemar change test was used.

RESULTS: One-hundred and ninety-two patients completed the 1-year follow-up (male 73%, mean aged 55 ± 11 years). There was no change in the Jaw Functional Limitation Scale score at the follow-up (nonsignificant). The patients described no change in symptoms at the follow-up, except for improvements in morning headache (P <0.001) and increased frequency of difficulties in opening the mouth or chewing on awakening (P = 0.002). Subjectively reported changes in dental occlusion during biting/chewing increased significantly at the follow-up (P = 0.009).

CONCLUSIONS: No changes in measurements of jaw mobility, dental occlusion, or pain on palpation of the temporomandibular joints or masticatory muscles were seen at the follow-up. Thus, using an OA in treating OSA had limited influence on jaw functions and related symptoms. Moreover, the risk of developing pain and functional impairment in the masticatory system was infrequent, indicating that this treatment is safe and can be recommended.

Place, publisher, year, edition, pages
Elsevier, 2023
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-61987 (URN)10.1016/j.ajodo.2023.04.018 (DOI)001102708900001 ()37318425 (PubMedID)2-s2.0-85162059140 (Scopus ID)
Available from: 2023-08-18 Created: 2023-08-18 Last updated: 2023-12-04Bibliographically approved
Rongo, R., Ekberg, E., Nilsson, I.-M., Al-Khotani, A., Alstergren, P., Conti, P. C., . . . Michelotti, A. (2022). Diagnostic criteria for temporomandibular disorders (DC/TMD) in children and adolescents: an international Delphi study-Part 2-Development of Axis II. Journal of Oral Rehabilitation, 49(5), 541-552
Open this publication in new window or tab >>Diagnostic criteria for temporomandibular disorders (DC/TMD) in children and adolescents: an international Delphi study-Part 2-Development of Axis II
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2022 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 49, no 5, p. 541-552Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Unlike the psychosocial assessment established for adults in the diagnostic criteria for temporomandibular disorders (DC/TMD), a standardized psychosocial assessment for children and adolescents with TMD complaints has not yet been established.

OBJECTIVES: To develop a new standardized instrument set to assess the psychosocial functioning in children and adolescents by adapting the psychosocial status and pain-related disability (Axis II) of the adult DC/TMD and by including new instruments.

METHODS: A modified Delphi method was used to survey 23 international TMD experts and four international experts in pain-related psychological factors for consensus regarding assessment tools for psychosocial functioning and pain-related disability in children and adolescents. The TMD experts reviewed 29 Axis II statements at round 1, 13 at round 2, and 2 at round 3. Agreement was set at 80% for first-round consensus level and 70% for each of the second and third rounds. The psychological experts completed a complementary Delphi survey to reach a consensus on tools to use to assess more complex psychological domains in children and adolescents. For the psychological experts, the first round included 10 open-ended questions on preferred screening tools for depression, anxiety, catastrophizing, sleep problems, and stress in children (ages 6-9 years old) and adolescents (ages 10-19 years old) as well as on other domains suggested for investigation. In the second round, the psychological experts received a 9-item questionnaire to prioritize the suggested instruments from most to least recommended.

RESULTS: The TMD experts, after three Delphi rounds, reached consensus on the changes of DC/TMD to create a form to evaluate Axis II in children and adolescents with TMD complaints. The psychological experts added tools to assess depression and anxiety, sleep disorders, catastrophizing, stress, and resilience.

CONCLUSION: Through international expert consensus, this study adapted Axis II of the adult DC/TMD to assess psychosocial functioning and pain-related disability in children and adolescents. The adapted Axis II protocols will be validated in the target populations.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2022
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-49274 (URN)10.1111/joor.13301 (DOI)000759532100001 ()34951729 (PubMedID)2-s2.0-85125070022 (Scopus ID)
Available from: 2022-01-10 Created: 2022-01-10 Last updated: 2024-01-17Bibliographically approved
Häggman-Henrikson, B., Jawad, N., Acuña, X., Visscher, C., Schiffman, E. & List, T. (2022). Fear of Movement and Catastrophizing in Participants with Temporomandibular Disorders. The Journal of Oral & Facial Pain and Headache, 36(1), 59-66
Open this publication in new window or tab >>Fear of Movement and Catastrophizing in Participants with Temporomandibular Disorders
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2022 (English)In: The Journal of Oral & Facial Pain and Headache, ISSN 2333-0384 , E-ISSN 2333-0376 , Vol. 36, no 1, p. 59-66Article in journal (Refereed) Published
Abstract [en]

Aims: To assess differences in catastrophizing and kinesiophobia in relation to areas of pain and somatic symptoms among participants with temporomandibular disorders (TMDs) and controls. Methods: In total, 401 participants (333 women, 68 men, mean age: 45.8 years) in the TMJ Impact Project were examined in accordance with the Diagnostic Criteria for TMD, including clinical examination (Axis I) and psychosocial assessment (Axis II) augmented with imaging of the temporomandibular joint (TMJ). Of these, 218 participants had a painful TMD pain diagnosis, 63 had a nonpainful TMD diagnosis, and 111 had no TMD. Nine participants had missing data. Participants completed the Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, Areas of Pain figure, and the Patient Health Questionnaire-15 for assessing somatic symptoms. Results: Compared to controls, participants with TMD pain showed higher levels of catastrophizing (P = .017), kinesiophobia (P < .001), areas of pain (P < .001), and somatic symptoms (P < .001). Participants with nonpainful TMD showed a higher level of kinesiophobia (P < .001) than controls. There was a positive correlation between catastrophizing and kinesiophobia for participants with TMD pain (r = 0.33, P < .001) and nonpainful TMD (r = 0.42, P < .001). Discussion: The results suggest more fear of movement, as well as an association between catastrophizing and fear of movement, in participants with TMD pain and in participants with nonpainful TMD compared to controls. Assessment and management of fear of movement as well as catastrophizing may be useful as part of individualized treatment strategies for patients with TMD.

Place, publisher, year, edition, pages
Quintessence, 2022
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-54217 (URN)10.11607/ofph.3060 (DOI)000841407000008 ()35298576 (PubMedID)2-s2.0-85127468485 (Scopus ID)
Available from: 2022-08-02 Created: 2022-08-02 Last updated: 2023-10-02Bibliographically approved
John, M. T., Omara, M., Su, N., List, T., Sekulic, S., Häggman-Henrikson, B., . . . Larsson, P. (2022). Recommendations for use and scoring of oral health impact profile versions. Journal of Evidence-Based Dental Practice, 22(1), Article ID 101619.
Open this publication in new window or tab >>Recommendations for use and scoring of oral health impact profile versions
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2022 (English)In: Journal of Evidence-Based Dental Practice, ISSN 1532-3382, E-ISSN 1532-3390, Vol. 22, no 1, article id 101619Article in journal (Refereed) Published
Abstract [en]

Background: OHIP's original seven-domain structure does not fit empirical data, but a psychometrically sound and clinically more plausible structure with the four OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact has emerged. Consequently, use and scoring of available OHIP versions need to be revisited. Aim: We assessed how well the overall construct OHRQoL and its four dimensions were measured with several OHIP versions (20, 19, 14, and 5 items) to derive recommendations which instruments should be used and how to score them. Methods: Data came from the “Dimensions of OHRQoL Project” and used the project's learning sample (5,173 prosthodontic patients and general population subjects with 49-item OHIP data). We computed correlations among OHIP versions’ summary scores. Correlations between OHRQoL dimensions, on one hand, and OHIP versions’ domain scores or OHIP-5′s items, on the other hand, were also computed. OHIP use and scoring recommendations were derived for psychometrically solid but also practical OHRQoL assessment. Results: Summary scores of 5-, 14-, 19- and 49-item versions correlated highly (r = 0.91–0.98), suggesting similar OHRQoL construct measurement across versions. The OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact were best measured by the OHIP domain scores for Physical Disability, Physical Pain, Psychological Discomfort, and Handicap, respectively. Conclusion: Recommendations were derived which OHIP should be preferably used and how OHIP versions should be scored to capture the overall construct and the dimensions of OHRQoL. Psychometrically solid and practical OHRQoL assessment in all settings across all oral health conditions can be achieved with the 5-item OHIP. 

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
OHIP, Oral Function, Oral health-related quality of life, Orofacial Appearance, Orofacial Pain, Psychosocial Impact
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-49018 (URN)10.1016/j.jebdp.2021.101619 (DOI)000820710900001 ()35219460 (PubMedID)2-s2.0-85088389695 (Scopus ID)
Available from: 2021-12-27 Created: 2021-12-27 Last updated: 2023-10-02Bibliographically approved
Häggman-Henrikson, B., Lobbezoo, F., Durham, J., Peck, C. & List, T. (2022). THE VOICE OF THE PATIENT IN OROFACIAL PAIN MANAGEMENT: The Voice of the Patient in Orofacial Pain Management. Journal of Evidence-Based Dental Practice, 22(1), 1-7, Article ID 101648.
Open this publication in new window or tab >>THE VOICE OF THE PATIENT IN OROFACIAL PAIN MANAGEMENT: The Voice of the Patient in Orofacial Pain Management
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2022 (English)In: Journal of Evidence-Based Dental Practice, ISSN 1532-3382, E-ISSN 1532-3390, Vol. 22, no 1, p. 1-7, article id 101648Article in journal (Refereed) Published
Abstract [en]

As pain cannot be measured objectively, the use of patient reported outcomes (PROs), and specifically dental PROs (dPROs), is essential for adequate assessment and management of the patient with orofacial pain. For orofacial pain conditions, some of the suitable PROs are specific to dentistry and hence can be labelled dPROs, whereas others are not. There is also a need to understand which outcomes and domains are most relevant to the patient with pain complaints within the context of the biopsychosocial model. Acute pain in the orofacial area is most often related to toothache, whereas the most common chronic orofacial pain are temporomandibular disorders. Other chronic pains in the orofacial area include neuropathic pain and unknown or idiopathic pain. PROs have been fundamental in the development of both screening procedures and diagnostic criteria in temporomandibular disorders. PROs are now often a prerequisite for the most common temporomandibular disorder pain diagnoses. Furthermore, PROs form the basis for decision-making with regard to treatment, prognostics, and referrals. Future areas of development include the standardized use of PROs in the screening and diagnostics of the less common orofacial pain conditions, together with development of core outcomes sets and standardized protocols for the use of PROs in evaluation of treatment including efficacy, compliance, adherence, and side-effects. © 2021 The Author(s)

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Orofacial pain, Patient reported outcome measures, Patient reported outcomes, Temporomandibular disorders, Temporomandibular joint disorder
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-48593 (URN)10.1016/j.jebdp.2021.101648 (DOI)000773906400002 ()35063175 (PubMedID)2-s2.0-85119614944 (Scopus ID)
Available from: 2021-12-29 Created: 2021-12-29 Last updated: 2023-07-05Bibliographically approved
Rongo, R., Ekberg, E., Nilsson, I.-M., Al‐Khotani, A., Alstergren, P., Conti, P. C., . . . Michelotti, A. (2021). Diagnostic criteria for temporomandibular disorders (DC/TMD) for children and adolescents: An international Delphi study—Part 1‐Development of Axis I. Journal of Oral Rehabilitation, 48(7), 836-845
Open this publication in new window or tab >>Diagnostic criteria for temporomandibular disorders (DC/TMD) for children and adolescents: An international Delphi study—Part 1‐Development of Axis I
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2021 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 48, no 7, p. 836-845Article in journal (Refereed) Published
Abstract [en]

AIM: To develop new instruments and to adapt the diagnostic criteria for temporomandibular disorders (DC/TMD) for the evaluation of TMD in children and adolescents.

METHOD: A modified Delphi method was used to seek international consensus among TMD experts. Fourteen clinicians and researchers in the field of orofacial pain and TMD worldwide were invited to participate in a workshop initiated by the International Network for Orofacial Pain and Related Disorders Methodology (INfORM scientific network) at the General Session of the International Association for Dental Research (IADR, London 2018), as the first step in the Delphi process. Participants discussed the protocols required to make physical diagnoses included in the Axis I of the DC/TMD. Thereafter, nine experts in the field were added, and the first Delphi round was created. This survey included 60 statements for Axis I, and the experts were asked to respond to each statement on a five-item Likert scale ranging from "Strongly disagree" to "Strongly agree". Consensus level was set at 80% agreement for the first round, and at 70% for the next.

RESULTS: After three rounds of the Delphi process, a consensus among TMD experts was achieved and two adapted DC/TMD protocols for Axis I physical diagnoses for children and adolescents were developed.

CONCLUSION: Through international consensus among TMD experts, this study adapted the Axis I of the DC/TMD for use in evaluating TMD in children and adolescents.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
Delphi study, adolescents, children, diagnostic criteria, temporomandibular disorders
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-62961 (URN)10.1111/joor.13175 (DOI)000651992600001 ()33817818 (PubMedID)2-s2.0-85105916851 (Scopus ID)
Available from: 2023-10-05 Created: 2023-10-05 Last updated: 2024-01-17Bibliographically approved
Projects
Malmö Offspring Pain Study - MOPS
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-9638-4648

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