title: Smallest detectable difference of maximal mouth opening in patients with painfully restricted temporomandibular joint function.
abstract: Changes in maximal mouth opening reflect the impact of temporomandibular disorders and the effect of a therapeutic intervention. No information about the amount of change in maximal mouth opening with regard to reasoned decision-making is available. The smallest detectable difference, as a measure of reliability assessment, provides this information and is expressed in the unit of the measurement instrument. Twenty-five consecutive patients (5 males, 20 females) with a painfully restricted temporomandibular joint participated in this study. Measurements of maximal mouth opening were performed by two well-trained observers on two separate measurement days, one week apart. The maximal mouth opening measurements were repeated three times. Inter-observer, intra-observer, and test-retest reliability varied between 0.90 and 0.96. Inconsistency in measurement results analyzed in terms of absolute error variance, i.e. the measurement facets plus all the interactions, represented 11% of total variance. The smallest detectable difference of maximal mouth opening varied from 9 to 6 mm. For being successful in painfully restricted temporomandibular joint patients, statistically as well as clinically, the clinician has to measure at least 9 mm of improvement in maximal mouth opening. To reduce the smallest detectable difference from 9 to 6 mm, repeated measurement is necessary.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Groningen University Hospital, The Netherlands. T.J.B.Kropmans@rev.azg.nl
authors.forename: T
authors.initials: T
authors.lastname: Kropmans
authors.forename: P
authors.initials: P
authors.lastname: Dijkstra
authors.forename: B
authors.initials: B
authors.lastname: Stegenga
authors.forename: R
authors.initials: R
authors.lastname: Stewart
authors.forename: L
authors.initials: L
authors.lastname: de Bont
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D010147:Pain Measurement; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology* / Q000628:therapy*