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J Oral Rehabil. 2019 Aug 8. doi: 10.1111/joor.12870. [Epub ahead of print]

Tactile trigeminal region acuity in temporomandibular disorders: A reliability and cross-sectional study.

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Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.
Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.
Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain.
Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain.
Department of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain.



Two-point discrimination (2-PD) is a valuable test for measuring tactile acuity that provides relevant information about cortical reorganisation and somatosensory function.


The main objectives of the present study were to assess intra- and interexaminer reliability of the 2-PD test in the trigeminal region in asymptomatic individuals and only intra-examiner reliability in patients with temporomandibular disorders (TMD). The secondary objective was to observe the correlations of the 2-PD test with regard to pain intensity and psychological and disability variables.


Intra- and interexaminer reliability of 2-PD in the trigeminal region was assessed in 40 asymptomatic individuals and 54 patients with TMD. Each clinician received training in the assessment of 2-PD using an esthesiometer and following a standardised protocol for the three branches of trigeminal nerve.


In the asymptomatic participants, interexaminer (intra-class correlation coefficient (ICC .64-.88) and test-retest (ICC .70-.87) values were obtained. Given similar test-retest values were shown in the group of patients with TMD (ICC .72-.86), the reliability were considered good-moderate. Statistically significant differences (P < .001) were obtained between the asymptomatic participants and the patients with TMD regarding the mean values from trials of the three trigeminal branch measurements, with a large effect size.


Reliability of the 2-PD test was considered good-moderate. Patients with TMD showed greater distances in the 2-PD test, suggesting that tactile acuity in the trigeminal region is impaired in patients with TMD. Assessment of tactile acuity with 2-PD test in patients with TMD should be considered clinically.


reliability; somatosensory function; tactile acuity; temporomandibular disorders; trigeminal nerve; two-point discrimination


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