Table 6.
From RDC/TMD to DC/TMD: Comparison of Diagnostic Procedures for Disc Displacements and Degenerative Joint Disease with New History-Based Diagnosis of Subluxation
| RDC/TMD | DC/TMD | |
|---|---|---|
| HISTORY | ||
| “In last 30 days, any noise present” applicable to disc displacement with reduction with and without intermittent locking, and degenerative joint disease | ✓ | |
| “In last 30 days, jaw locks with limited mouth opening and then unlocks” applicable to disc displacement with reduction with intermittent locking | ✓ | |
| “Ever have jaw lock or catch so that it would not open all the way” and “interfered with eating” applicable to disc displacement without reduction with and without limited opening | ✓ | ✓ |
| “In last 30 days, when you opened your mouth wide, jaw locked or caught so that it would not close all the way” applicable to subluxation | ✓ | |
| EXAMINATION | ||
| Disc displacement with reduction | ||
| Report by patient of any joint noise (click or crepitus) | ✓ | |
| Click detection (# of opening/closing cycles required for click) | 2 of 3 | 1 of 3 |
| Click detection during lateral and protrusive movements | ✓ | ✓ |
| 5mm vertical distance between reciprocal clicks | ✓ | |
| Elimination of click in protrusive position | ✓ | |
| Disc displacement with reduction with intermittent locking | ✓ | |
| Disc displacement without reduction with limited opening | ||
| Unassisted opening* ≤ 35mm and assisted opening ≤ 4mm more than unassisted opening | ✓ | |
| Assisted opening* < 40mm | ✓ | |
| Contralateral movements < 7mm and/or uncorrected deviation to the ipsilateral side on opening | ✓ | |
| Absence of noise, or noise not meeting criteria for disc displacement with reduction | ✓ | |
| Disc displacement without reduction without limited opening | ||
| Unassisted opening* > 35mm and assisted opening > 4mm more than unassisted opening | ✓ | |
| Assisted opening* ≥ 40mm | ✓ | |
| Contralateral and protrusive movements ≥ 7mm | ✓ | |
| Noise not meeting criteria for disc displacement with reduction | ✓ | |
| Degenerative joint disease | ||
| Report by patient of any joint noise (click or crepitus) | ✓ | |
| Crepitus (only coarse) with palpation | ✓ | |
| Crepitus (either fine or coarse) with palpation | ✓ | |
*
Measurement of opening includes interincisal opening plus vertical incisal overlap.