Temporomandibular joint disorders are common in the community. Identifying the relationship between specific painful examination sites and the choice of conservative treatment methods may have predictive value in determining treatment guidelines. This study aims to investigate the possible effect of pain findings at specific examination sites on determining the selection of clinical decision rules. Data were retrospectively analyzed from 1020 patients who presented to a specialty clinic with complaints of pain, movement restrictions, or joint sounds in the temporomandibular joint, temple, and facial regions. Examination findings from 12 palpation sites and administered conservative treatment methods were extracted from diagnostic and treatment records. The binary logistic regression model using a backward stepwise method was constructed to evaluate the contribution of each pain site to each treatment choice. Canonical correlation analysis, based on the optimal scaling approach examined the relationships between two sets of dichotomous variables. Strong correlation was not found between the distribution of painful palpation sites and the selection of conservative treatments sufficient to establish clinical treatment guidelines. Pain at certain examination sites significantly influenced the cold-hot application, interocclusal splint, and pharmacological treatment recommendations (p < 0.05). The odds of receiving these treatments varied concerning specific pain sites. While palpation findings are crucial for diagnosis, they do not reliably guide the selection of conservative treatment methods. Although essential for diagnosis, palpation-induced pain findings are not predictive in determining treatment methods. Further studies are needed to elucidate evidence-based clinical decision-making mechanisms for temporomandibular joint disorders.
Özcivelek et al. (2026) studied this question.