Padronização do diagnóstico em disfunções temporomandibulares: uma análise da aplicação do DC/TMD em contextos acadêmicos, clínicos e desenvolvimento tecnológico.

Abstract

This thesis comprises three interconnected studies with a shared objective: to make the application of the DC/TMD protocol more objective, accessible, and reproducible in dental clinical practice. The overarching aim is to enhance the diagnosis of temporomandibular disorders (TMD) through standardization, technological integration, and professional training. The first study investigated the prevalence of TMD in patients with Parkinson’s Disease and highlighted substantial limitations in applying the DC/TMD in this population. The need for prior administration of the Mini-Mental State Examination (MMSE), along with the requirement for trained professionals, restricts the reproducibility of the protocol in individuals with even mild cognitive impairment. This underscores the need for diagnostic approaches that are both adaptable and straightforward in neurologically affected populations. The second study evaluated the knowledge and confidence of dental students regarding TMD diagnosis and management. Although most students demonstrated solid theoretical knowledge, they reported low confidence in clinical decision-making. A key barrier identified was the limited exposure to structured diagnostic tools like DC/TMD, revealing a disconnect between academic instruction and clinical readiness. Addressing these challenges, the third study developed and validated a diagnostic software based on DC/TMD. Applied to 154 patients, the digital tool showed high agreement with manual diagnoses (Kappa > 0.8), supporting its reliability as a clinical and educational aid. The software proved capable of minimizing diagnostic variability and broadening the reach of standardized protocols, even for users still in training. General conclusion: These studies converge in their pursuit of strategies that promote more accurate, efficient, and consistent use of the DC/TMD protocol. The integration of scientific evidence, clinical education, and technological innovation emerges as a powerful path toward improving TMD diagnosis and ensuring higher quality and equity in dental care.