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Quality of clinical tests for temporomandibular disorders

Based on the lack of knowledge about methodological quality of clinical tests used by clinicians examining patients with TMD, the purpose of this study is to explore reliability and validity of such tests and compare findings with MRI results.

About the project

Treatment-seeking patients with temporomandibular pain and limited mouth-opening were recruited among patients from health-professionals in the region of Oslo in 2012.  Thirty-five persons, aged 18–70 years, with 58 symptomatic joints or pain in surrounding area were included. The examinations were performed by two experienced manual therapist. Magnetic resonance imaging (MRI) was used as reference standard. Reliability and validity are examined for single and cluster of tests.

The project is based on, and is a continuation of Elisabeth Heggem Julsvolls work with her master thesis


To evaluate the reliability and validity of single clinical tests and cluster of tests used to identify examine the TMD joint and especially the condition involving anterior disc displacement without reduction (ADDWOR).


  • The main result is that a cluster of 7 clinical tests (5 positive) can be used to diagnose ADDWOR with an accuracy of 71%.
  • The “dental stick test” was the best single test with equal sensitivity as the cluster, but with lower specificity.
  • The tests require no advanced equipment, they are easy to perform and suitable for use in clinical settings.
  • MRI can be sees as more of a supplement to the clinical tests than a necessity to start a clinical intervention.


Elisabeth Heggem Julsvoll has received two grants on this projects: "Formidlingsstipend fra Fysiofondet"

Start - finish

2012 -


Julsvoll, EH, Vøllestad, NK, Robinson HS, Kan smerte og funksjon bidra til å diagnostisere temporomandibulær dysfunksjon? Fysioterapeuten 3/2017

Julsvoll EH, Vollestad NK, Robinson HS: Validation of clinical tests for patients with long-lasting painful temporomandibular disorders with anterior disc displacement without reduction.  Man Ther 21/2016.

Julsvoll, EH, Vøllestad, Nk, Opseth, G, Robinson HS, Intertester relibility of selected clinical tests for long-lasting temporomandibular disorders. JMMT 14.5.2017



Published Aug. 24, 2017 2:15 PM - Last modified Aug. 25, 2017 2:27 PM