Diagnostic value of ultrasonography for the detection of disc displacements in the temporomandibular joint: a systematic review and meta-analysis

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Abstract

Objectives

The aim was to assess the added diagnostic value of ultrasonography (US) for establishing the presence or absence of disc displacements (DDs) in temporomandibular joints (TMJs).

Materials and methods

Pubmed and EMBASE were searched electronically to identify diagnostic accuracy studies that assessed the diagnostic value of US for the diagnosis of DD, using Magnetic resonance imaging (MRI) as the reference standard. Meta-analyses were performed with Metadisc 1.4 and RevMan 5.3.

Results

A total of 16 studies qualified for meta-analyses. For the diagnosis of DD at closed mouth position (DD-CM) and DD at maximum mouth-opening position (DD-MMO), the added values of a positive result with US for ruling in DD-CM and DD-MMO were 22 and 41%, while those of a negative result with US for ruling out DD-CM and DD-MMO were 30 and 20%. For the diagnosis of DD with reduction (DDWR) and DD without reduction (DDWoR), the added values of a positive result in US for ruling in DDWR and DDWoR were 35 and 41%, while those of a negative result in US for ruling out DDWR and DDWoR were 21 and 27%.

Conclusions

Using MRI as reference standard, the added values of both positive predictive values and negative predictive values of US for ruling in and ruling out DDs are sufficient in the decision-making in dental practice.

Clinical relevance

US can be a good imaging tool to supplement clinical examination findings in patients with suspected DDs. Combined static and dynamic examinations using high-resolution US should be preferred.

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Most cited references 37

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Case-control and two-gate designs in diagnostic accuracy studies.

Anne Rutjes, Johannes Reitsma, Jan P. Vandenbroucke … (2005)

In some diagnostic accuracy studies, the test results of a series of patients with an established diagnosis are compared with those of a control group. Such case-control designs are intuitively appealing, but they have also been criticized for leading to inflated estimates of accuracy. We discuss similarities and differences between diagnostic and etiologic case-control studies, as well as the mechanisms that can lead to variation in estimates of diagnostic accuracy in studies with separate sampling schemes ("gates") for diseased (cases) and nondiseased individuals (controls). Diagnostic accuracy studies are cross-sectional and descriptive in nature. Etiologic case-control studies aim to quantify the effect of potential causal exposures on disease occurrence, which inherently involves a time window between exposure and disease occurrence. Researchers and readers should be aware of spectrum effects in diagnostic case-control studies as a result of the restricted sampling of cases and/or controls, which can lead to changes in estimates of diagnostic accuracy. These spectrum effects may be advantageous in the early investigation of a new diagnostic test, but for an overall evaluation of the clinical performance of a test, case-control studies should closely mimic cross-sectional diagnostic studies. As the accuracy of a test is likely to vary across subgroups of patients, researchers and clinicians might carefully consider the potential for spectrum effects in all designs and analyses, particularly in diagnostic accuracy studies with differential sampling schemes for diseased (cases) and nondiseased individuals (controls).

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Latent class models in diagnostic studies when there is no reference standard--a systematic review.

Ignace H. J. T. de Hingh, K. G. M. Moons, M Kerkhove … (2014)

Latent class models (LCMs) combine the results of multiple diagnostic tests through a statistical model to obtain estimates of disease prevalence and diagnostic test accuracy in situations where there is no single, accurate reference standard. We performed a systematic review of the methodology and reporting of LCMs in diagnostic accuracy studies. This review shows that the use of LCMs in such studies increased sharply in the past decade, notably in the domain of infectious diseases (overall contribution: 59%). The 64 reviewed studies used a range of differently specified parametric latent variable models, applying Bayesian and frequentist methods. The critical assumption underlying the majority of LCM applications (61%) is that the test observations must be independent within 2 classes. Because violations of this assumption can lead to biased estimates of accuracy and prevalence, performing and reporting checks of whether assumptions are met is essential. Unfortunately, our review shows that 28% of the included studies failed to report any information that enables verification of model assumptions or performance. Because of the lack of information on model fit and adequate evidence "external" to the LCMs, it is often difficult for readers to judge the validity of LCM-based inferences and conclusions reached.

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Imaging of the temporomandibular joint: An update.

Asim K Bag, Santhosh Gaddikeri, Aparna Singhal … (2014)

Imaging of the temporomandibular joint (TMJ) is continuously evolving with advancement of imaging technologies. Many different imaging modalities are currently used to evaluate the TMJ. Magnetic resonance imaging is commonly used for evaluation of the TMJ due to its superior contrast resolution and its ability to acquire dynamic imaging for demonstration of the functionality of the joint. Computed tomography and ultrasound imaging have specific indication in imaging of the TMJ. This article focuses on state of the art imaging of the temporomandibular joint. Relevant normal anatomy and biomechanics of movement of the TMJ are discussed for better understanding of many TMJ pathologies. Imaging of internal derangements is discussed in detail. Different arthropathies and common tumors are also discussed in this article.

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Author and article information

Contributors

Naichuan Su: naichuansu@hotmail.com , n.su@acta.nl

Journal

Journal ID (nlm-ta): Clin Oral Investig

Journal ID (iso-abbrev): Clin Oral Investig

Title: Clinical Oral Investigations

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 1432-6981

ISSN (Electronic): 1436-3771

Publication date (Electronic): 17 February 2018

Publication date PMC-release: 17 February 2018

Publication date (Print): 2018

Volume: 22

Issue: 7

Pages: 2599-2614

Affiliations

[1 ]ISNI 0000 0001 0807 1581, GRID grid.13291.38, State Key Laboratory of Oral Disease, West China Hospital of Stomatology, , Sichuan University, ; Chengdu, China

[2 ]ISNI 0000 0001 0807 1581, GRID grid.13291.38, Department of Prosthodontics, West China Hospital of Stomatology, , Sichuan University, ; Chengdu, China

[3 ]ISNI 0000000084992262, GRID grid.7177.6, Department of Social Dentistry, Academic Centre for Dentistry Amsterdam, , University of Amsterdam and Vrije Universiteit, ; 1081 LA, Amsterdam, The Netherlands

[4 ]ISNI 0000000084992262, GRID grid.7177.6, Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam, MOVE research Institute Amsterdam, , University of Amsterdam and Vrije Universiteit, ; Amsterdam, The Netherlands

Article

Publisher ID: 2359

DOI: 10.1007/s00784-018-2359-4

PMC ID: 6097040

PubMed ID: 29455373

SO-VID: 2a841836-cefe-4348-a171-708159450881

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Date received : 1 December 2016

Date accepted : 23 January 2018

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100004543, China Scholarship Council;

Custom metadata

ScienceOpen disciplines: Dentistry

Keywords: temporomandibular joint disorders,ultrasonography,meta-analysis,magnetic resonance imaging

Data availability:

ScienceOpen disciplines: Dentistry

Keywords: temporomandibular joint disorders, ultrasonography, meta-analysis, magnetic resonance imaging

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Diagnostic value of ultrasonography for the detection of disc displacements in the temporomandibular joint: a systematic review and meta-analysis

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Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

Related collections

Karger: Neurology and Neuroscience

Most cited references 37

Case-control and two-gate designs in diagnostic accuracy studies.

Latent class models in diagnostic studies when there is no reference standard--a systematic review.

Imaging of the temporomandibular joint: An update.

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Cited by 7

Most referenced authors 890