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Methods for Evaluating Temporomandibular Joint Sounds

Year 2023, , 600 - 604, 25.12.2023
https://doi.org/10.15311/selcukdentj.1235656

Abstract

Temporomandibular joint sounds are one of the most decisive signs of pathological changes in the temporomandibular joint. Identification and evaluation of joint sounds guides physicians to proper diagnosis and treatment. Subjective and objective approaches are initiated as evaluation methods. Subjective methods are frequently preferred due to their ease of application in the clinic. However, these methods are not reproducible and have disadvantages such as difficulty in making interobserver comparisons. Objective methods often require equipment and technical precision. On the other hand, these methods allow the recording and analysis of joint sounds, providing an objective assessment of treatment efficacy. In this review, the clinical importance of temporomandibular joint sounds, the parameters of the sound and the methods used in the evaluation of joint sounds are discussed.

References

  • 1. Aksoy S, Orhan K. Temporomandibular Eklemin Disk Deplasmanları. GÜ Diş Hek Fak Derg. 2009;27:65-73.
  • 2. Taşkıran U, Cunkaş M. A deep learning based decision support system for diagnosis of Temporomandibular joint disorder. Appl Acoust. 2021;182:1-12.
  • 3. Wilkie G, Al-Ani Z. Temporomandibular joint anatomy, function and clinical relevance. Br Dent J. 2022;233:539-46.
  • 4. Bal B, Sarak G, Oral K. Temporomandibular Rahatsızlık Alt Grupları ve Bruksizmin Kulak Çınlaması ile İlişkisinin İncelenmesi. Selcuk Dent J. 2022;9:509-12.
  • 5. Kaya N, Sarıdağ S. Redüksiyonlu Disk Dislokasyonunda Anterior Repozisyone Splint Tedavisi. Selcuk Dent J. 2022;9:259-67.
  • 6. Yapıcı Yavuz G, Keskinrüzgar A, Koparal M, Utkun M, Şimşek Kaya G. Temporomandibular eklem düzensizliği bulunan hastalarda kulak semptomları prevelansının araştırılması Selcuk Dent J. 2020;7:220-5.
  • 7. Matheson EM, Fermo JD, Blackwelder RS. Temporomandibular Disorders: Rapid Evidence Review. Am Fam Physician. 2023;107:52-8.
  • 8. Demir MG. Comparison of symptoms, signs, gender, and magnetic resonance images of temporomandibular joint disorder patients. Cranio. 2022;1:1-5.
  • 9. Zhang J, Whittle T, Wang L, Murray GM. The reproducibility of temporomandibular joint vibrations over time in the human. J Oral Rehabil. 2014;41:206-17.
  • 10. Sano T, Widmalm SE, Westesson PL, Takahashi K, Yoshida H, Michi K, et al. Amplitude and frequency spectrum of temporomandibular joint sounds from subjects with and without other signs/symptoms of temporomandibular disorders. J Oral Rehabil. 1999;26:145-50.
  • 11. Widmalm SE, Bae HEK, Djurdjanovic D, McKay DC. Inaudible Temporomandibular Joint Vibrations. Cranio. 2006;24:207-12.
  • 12. Widmalm SE, Williams WJ, Christiansen RL, Gunn SM, Park DK. Classification of temporomandibular joint sounds based upon their reduced interference distribution. J Oral Rehabil. 1996;23:35-43.
  • 13. Ulay G, Namdar Pekiner F. Temporomandibular eklem disfonksiyonlu bir grup hastada klinik bulguları. Selcuk Dent J. 2019;6:287-93.
  • 14. Sena MF, Mesquita KS, Santos FR, Silva FW, Serrano KW. Prevalence of temporomandibular dysfunction in children and adolescents. Rev Paul Pediatr. 2013;31:538-45.
  • 15. Minervini G, D’Amico C, Cicciu M, Fiorillo L. Temporomandibular Joint Disk Displacement: Etiology, Diagnosis, Imaging, and Therapeutic Approaches. J Craniofac Surg. 2022;10:1097.
  • 16. Prinz JF, Ng KW. Characterization of sounds emanating from the human temporomandibular joints. Arch Oral Biol. 1996;41:631-9.
  • 17. Tanzilli RA, Tallents RH, Katzberg RW, Kyrkanides S, Moss ME. Temporomandibular joint sound evaluation with an electronic device and clinical evaluation. Clin Orthod Res. 2001;4:72-8.
  • 18. Prinz JF. Autocorrelation of acoustic signals from the temporomandibular joint. J Oral Rehabil. 1998;25:635-9.
  • 19. Tallents RH, Hatala M, Katzberg MD, Westesson PL. Temporomandibular joint sounds in asymptomatic volunteers. J Prosthet Dent. 1993;69:298-304.
  • 20. Widmer CG. Temporomandibular Joint Sounds: A Critique of Techniques for Recording and Analysis. J Craniomandib Disord. 1989;3:213-7.
  • 21. Muhl ZF, Sadowsky C, Sakols EI. Timing of Temporomandibular Joint Sounds in Orthodontic Patients. J Dent Res. 1987;66:1389-92.
  • 22. Oster C, Katzberg RW, Tallents RH, Morris TW, Bartholomew T, Miller TL, et al. Characterization of Temporomandibular Joint Sounds. Oral Surg Oral Med Oral Pathol. 1984;58:10-6.
  • 23. Prinz JF. Physical mechanisms involved in the genesis of temporomandibular joint sounds. J Oral Rehabil. 1998;25:706-14.
  • 24. Gay T, Bertolami CN, Donoff RB, Keith DA, Kelly JP. The acoustical characteristics of the normal and abnormal temporomandibular joint. J Oral Maxillofac Surg. 1987;45:397-407.
  • 25. Dagar SRS, Turakiya V, Pakhan AJ, Jaggi N, Kalra A, Vaidya V. Modified stethoscope for auscultation of temporomandibular joint sounds. J Int Oral Health. 2014;6:40-4.
  • 26. Öğüt F. Objektif ses analizi. Turkiye Klinikleri J ENT. 2002;2:121-6.
  • 27. Drum R, Litt M. Spectral analysis of temporomandibular joint sounds. J Prosthet Dent. 1987;58:485-94.
  • 28. Motoyoshi M, Hayashi A, Arimoto M, Ohnuma M, Namura S. Studies of Temporomandibular Joint Sounds Part 3. The Clinical Usefulness of TMJ Doppler. J Nihon Univ Sci Dent. 1995;37:209-13.
  • 29. Badwal RSS. The Application of Fractal Dimension to Temporomandibular Joint Sounds. Comput Biol Med. 1993;23:1-14.
  • 30. Wabeke KB, Spruijt RJ, Van Der Zaag J. The reliability of clinical methods for recording temporomandibular joint sounds. J Dent Res. 1994;73:1157-62.
  • 31. Widmalm SE, Williams WJ, Adams BS. The wave forms of temporomandibular joint sound clicking and crepitation. J Oral Rehabil. 1996;23:44-9.
  • 32. Leknius C, Kenyon BJ. Simple instrument for auscultation of temporomandibular joint sounds. J Prosthet Dent. 2004;92:604.
  • 33. Westling L. Occlusal interferences in retruded contact position and temporomandibular joint sounds. J Oral Rehabil. 1995;22:601-6.
  • 34. Kaymak D, Karakis D, Dogan A. Evolutionary Spectral Analysis of Temporomandibular Joint Sounds Before and After Anterior Repositioning Splint Therapy in Patients with Internal Derangement. Int J Prosthodont. 2019;32:475-81.
  • 35. Yoshida H, Sano T, Kataoka R, Takahashi K, Michi K. A Preliminary Investigation of a Method of Detecting Temporomandibular Joint Sounds. J Orofacial Pain. 1994;8:73-9.
  • 36. Widmalm SE, Williams WJ, Ang BK, McKay DC. Localization of TMJ sounds to side. J Oral Rehabil. 2002;29:911-7.
  • 37. Widmalm SE, Williams WJ, Yang KP. False localization of TMJ sounds to side is an important source of error in TMD diagnosis. J Oral Rehabil. 1999;26:213-4.
  • 38. Mohl ND, Lund JP, Widmer CG, McCall Jr. WD. Devices for the diagnosis and treatment of temporomandibular disorders. Part II: Electromyography and sonography. J Prosthet Dent. 1990;63:332-6.
  • 39. Okeson JP. Management of Temporomandibular Disorders and Occlusion, 7th edn. St. Louis: Elsevier Mosby, 2013.
  • 40. Bracco P, Deregibus A, Piscetta R, Giaretta GA. TMJ clicking: a comparison of clinical examination, sonography, and axiography. Cranio. 1997;15:121-6.
  • 41. Prinz JF. Subjective assessment of temporomandibular joint sounds. J Oral Rehabil. 1998;25:765-9.
  • 42. Heffez L, Blaustein D. Advances in sonography of the temporomandibular joint. Oral Surg Oral Med Oral Pathol. 1986;62:486-95.
  • 43. Öğütcen-Toller M. Sound analysis of temporomandibular joint internal derangements with phonographic recordings. J Prosthet Dent. 2003;89:311-8.
  • 44. Gay T, Bertolami CN. The spectral properties of temporomandibular joint sounds. J Dent Res. 1987;66:1189-94.
  • 45. Mazzetto MO, Hotta TH, Carrasco TG, Mazzetto RG. Characteristics of TMD noise analyzed by electrovibratography. Cranio. 2008;26:222-8.
  • 46. Goiato MC, dos Santos DM, Monteiro DR. Joint Sounds in Complete Denture Wearers. NY State Dent J. 2010;76:46-9.
  • 47. Ishigaki S, Bessette RW, Maruyama T. Vibration analysis of the temporomandibular joints with meniscal displacement with and without reduction. J Craniomandib Pract. 1993;11:192-201.
  • 48. Christensen LV, Donegan SJ, McKay DC, Lewin A. Temporomandibular joint vibration analysis in a sample of non-patients. Cranio. 1992;10:35-42.
  • 49. Sharma S, Crow HC, McCall WD, Jr., Gonzalez YM. Systematic review of reliability and diagnostic validity of joint vibration analysis for diagnosis of temporomandibular disorders. J Orofac Pain. 2013;27:51-60.
  • 50. Güleç M, Taşsöker M, Özcan S. Tıpta ve Diş Hekimliğinde Fraktal Analiz. EÜ Dişhek Fak Derg. 2019;40:17-31.
  • 51. Eriksson L, Westesson PL, Rohlin M. Temporomandibular joint sounds in patients with disc displacement. Int J Oral Surg. 1985;14:428-36.
  • 52. Widmalm SE, Westesson PL, Brooks SL, Hatala MP, Paesani D. Temporomandibular joint sounds: correlation to joint structure in fresh autopsy specimens. Am J Orthod Dentofacial Orthop. 1992;101:60-9.
  • 53. Isberg A, Widmalm SE, Ivarsson R. Clinical, radiographic, and electromyographic study of patients with internal derangement of the temporomandibular joint. Am J Orthod. 1985;88:453-60.
  • 54. Motoyoshi M, Matsumoto Y, Ohnuma M, Arimoto M, Takahashi K, Namura S. A Study of Temporomandibular Joint Sounds Part 2. Acoustic Characteristics of Joint Sounds. J Nihon Univ Sch Dent. 1995;37:47-54.
  • 55. Djurdjanovic D, Widmalm SE, Williams WJ, Koh CK, Yang KP. Computerized classification of temporomandibular joint sounds. IEEE Trans Biomed Eng. 2000;47:977-84.
  • 56. Gallo LM, Airoldi R, Ernst B, Palla S. Power spectral analysis of temporomandibular joint sounds in asymptomatic subjects. J Dent Res. 1993;72:871-5.
  • 57. Sano T, Widmalm SE, Westesson PL, Yamaga T, Yamamoto M, Takahashi K, et al. Acoustic characteristics of sounds from temporomandibular joints with and without effusion: An MRI study. J Oral Rehabil. 2002;29:161-6.
  • 58. Kimoto K. A three dimensional display for TMJ sounds using STFT. Bull Kanagawa Dent Coll. 1996;24:19-20.

Temporomandibular Eklem Seslerini Değerlendirme Yöntemleri

Year 2023, , 600 - 604, 25.12.2023
https://doi.org/10.15311/selcukdentj.1235656

Abstract

Temporomandibular eklem sesleri, temporomandibular eklemdeki patolojik değişikliklere işaret eden en önemli bulgulardan biridir. Eklem seslerinin doğru bir şekilde tanımlanması ve değerlendirilmesi, hekimleri uygun tanı ve tedavi seçeneklerine yönlendirmektedir. Eklem seslerinin değerlendirilmesi için öznel ve nesnel yöntemler uygulanmaktadır. Palpasyon, oskültasyon ve stetoskop ile dinleme gibi öznel yöntemler, klinikte uygulama kolaylıkları nedeniyle sıklıkla tercih edilmelerine rağmen bu yöntemlerin tekrarlanabilir olmamaları ve gözlemciler arası karşılaştırmalar yapmaya izin vermemeleri gibi dezavantajları bulunmaktadır. Nesnel yöntemler ise sıklıkla ekipman ve teknik hassasiyet gerektirmektedirler. Bununla birlikte, eklem seslerinin kaydı ve analizine izin veren bu yöntemler, tedavi süreçlerinin nesnel bir şekilde değerlendirilmesine olanak tanımaktadır. Bu derlemede, eklem seslerinin klinik açıdan önemi, sesin parametreleri ve eklem seslerinin değerlendirilmesinde kullanılan öznel ve nesnel yöntemler ele alınmıştır.

References

  • 1. Aksoy S, Orhan K. Temporomandibular Eklemin Disk Deplasmanları. GÜ Diş Hek Fak Derg. 2009;27:65-73.
  • 2. Taşkıran U, Cunkaş M. A deep learning based decision support system for diagnosis of Temporomandibular joint disorder. Appl Acoust. 2021;182:1-12.
  • 3. Wilkie G, Al-Ani Z. Temporomandibular joint anatomy, function and clinical relevance. Br Dent J. 2022;233:539-46.
  • 4. Bal B, Sarak G, Oral K. Temporomandibular Rahatsızlık Alt Grupları ve Bruksizmin Kulak Çınlaması ile İlişkisinin İncelenmesi. Selcuk Dent J. 2022;9:509-12.
  • 5. Kaya N, Sarıdağ S. Redüksiyonlu Disk Dislokasyonunda Anterior Repozisyone Splint Tedavisi. Selcuk Dent J. 2022;9:259-67.
  • 6. Yapıcı Yavuz G, Keskinrüzgar A, Koparal M, Utkun M, Şimşek Kaya G. Temporomandibular eklem düzensizliği bulunan hastalarda kulak semptomları prevelansının araştırılması Selcuk Dent J. 2020;7:220-5.
  • 7. Matheson EM, Fermo JD, Blackwelder RS. Temporomandibular Disorders: Rapid Evidence Review. Am Fam Physician. 2023;107:52-8.
  • 8. Demir MG. Comparison of symptoms, signs, gender, and magnetic resonance images of temporomandibular joint disorder patients. Cranio. 2022;1:1-5.
  • 9. Zhang J, Whittle T, Wang L, Murray GM. The reproducibility of temporomandibular joint vibrations over time in the human. J Oral Rehabil. 2014;41:206-17.
  • 10. Sano T, Widmalm SE, Westesson PL, Takahashi K, Yoshida H, Michi K, et al. Amplitude and frequency spectrum of temporomandibular joint sounds from subjects with and without other signs/symptoms of temporomandibular disorders. J Oral Rehabil. 1999;26:145-50.
  • 11. Widmalm SE, Bae HEK, Djurdjanovic D, McKay DC. Inaudible Temporomandibular Joint Vibrations. Cranio. 2006;24:207-12.
  • 12. Widmalm SE, Williams WJ, Christiansen RL, Gunn SM, Park DK. Classification of temporomandibular joint sounds based upon their reduced interference distribution. J Oral Rehabil. 1996;23:35-43.
  • 13. Ulay G, Namdar Pekiner F. Temporomandibular eklem disfonksiyonlu bir grup hastada klinik bulguları. Selcuk Dent J. 2019;6:287-93.
  • 14. Sena MF, Mesquita KS, Santos FR, Silva FW, Serrano KW. Prevalence of temporomandibular dysfunction in children and adolescents. Rev Paul Pediatr. 2013;31:538-45.
  • 15. Minervini G, D’Amico C, Cicciu M, Fiorillo L. Temporomandibular Joint Disk Displacement: Etiology, Diagnosis, Imaging, and Therapeutic Approaches. J Craniofac Surg. 2022;10:1097.
  • 16. Prinz JF, Ng KW. Characterization of sounds emanating from the human temporomandibular joints. Arch Oral Biol. 1996;41:631-9.
  • 17. Tanzilli RA, Tallents RH, Katzberg RW, Kyrkanides S, Moss ME. Temporomandibular joint sound evaluation with an electronic device and clinical evaluation. Clin Orthod Res. 2001;4:72-8.
  • 18. Prinz JF. Autocorrelation of acoustic signals from the temporomandibular joint. J Oral Rehabil. 1998;25:635-9.
  • 19. Tallents RH, Hatala M, Katzberg MD, Westesson PL. Temporomandibular joint sounds in asymptomatic volunteers. J Prosthet Dent. 1993;69:298-304.
  • 20. Widmer CG. Temporomandibular Joint Sounds: A Critique of Techniques for Recording and Analysis. J Craniomandib Disord. 1989;3:213-7.
  • 21. Muhl ZF, Sadowsky C, Sakols EI. Timing of Temporomandibular Joint Sounds in Orthodontic Patients. J Dent Res. 1987;66:1389-92.
  • 22. Oster C, Katzberg RW, Tallents RH, Morris TW, Bartholomew T, Miller TL, et al. Characterization of Temporomandibular Joint Sounds. Oral Surg Oral Med Oral Pathol. 1984;58:10-6.
  • 23. Prinz JF. Physical mechanisms involved in the genesis of temporomandibular joint sounds. J Oral Rehabil. 1998;25:706-14.
  • 24. Gay T, Bertolami CN, Donoff RB, Keith DA, Kelly JP. The acoustical characteristics of the normal and abnormal temporomandibular joint. J Oral Maxillofac Surg. 1987;45:397-407.
  • 25. Dagar SRS, Turakiya V, Pakhan AJ, Jaggi N, Kalra A, Vaidya V. Modified stethoscope for auscultation of temporomandibular joint sounds. J Int Oral Health. 2014;6:40-4.
  • 26. Öğüt F. Objektif ses analizi. Turkiye Klinikleri J ENT. 2002;2:121-6.
  • 27. Drum R, Litt M. Spectral analysis of temporomandibular joint sounds. J Prosthet Dent. 1987;58:485-94.
  • 28. Motoyoshi M, Hayashi A, Arimoto M, Ohnuma M, Namura S. Studies of Temporomandibular Joint Sounds Part 3. The Clinical Usefulness of TMJ Doppler. J Nihon Univ Sci Dent. 1995;37:209-13.
  • 29. Badwal RSS. The Application of Fractal Dimension to Temporomandibular Joint Sounds. Comput Biol Med. 1993;23:1-14.
  • 30. Wabeke KB, Spruijt RJ, Van Der Zaag J. The reliability of clinical methods for recording temporomandibular joint sounds. J Dent Res. 1994;73:1157-62.
  • 31. Widmalm SE, Williams WJ, Adams BS. The wave forms of temporomandibular joint sound clicking and crepitation. J Oral Rehabil. 1996;23:44-9.
  • 32. Leknius C, Kenyon BJ. Simple instrument for auscultation of temporomandibular joint sounds. J Prosthet Dent. 2004;92:604.
  • 33. Westling L. Occlusal interferences in retruded contact position and temporomandibular joint sounds. J Oral Rehabil. 1995;22:601-6.
  • 34. Kaymak D, Karakis D, Dogan A. Evolutionary Spectral Analysis of Temporomandibular Joint Sounds Before and After Anterior Repositioning Splint Therapy in Patients with Internal Derangement. Int J Prosthodont. 2019;32:475-81.
  • 35. Yoshida H, Sano T, Kataoka R, Takahashi K, Michi K. A Preliminary Investigation of a Method of Detecting Temporomandibular Joint Sounds. J Orofacial Pain. 1994;8:73-9.
  • 36. Widmalm SE, Williams WJ, Ang BK, McKay DC. Localization of TMJ sounds to side. J Oral Rehabil. 2002;29:911-7.
  • 37. Widmalm SE, Williams WJ, Yang KP. False localization of TMJ sounds to side is an important source of error in TMD diagnosis. J Oral Rehabil. 1999;26:213-4.
  • 38. Mohl ND, Lund JP, Widmer CG, McCall Jr. WD. Devices for the diagnosis and treatment of temporomandibular disorders. Part II: Electromyography and sonography. J Prosthet Dent. 1990;63:332-6.
  • 39. Okeson JP. Management of Temporomandibular Disorders and Occlusion, 7th edn. St. Louis: Elsevier Mosby, 2013.
  • 40. Bracco P, Deregibus A, Piscetta R, Giaretta GA. TMJ clicking: a comparison of clinical examination, sonography, and axiography. Cranio. 1997;15:121-6.
  • 41. Prinz JF. Subjective assessment of temporomandibular joint sounds. J Oral Rehabil. 1998;25:765-9.
  • 42. Heffez L, Blaustein D. Advances in sonography of the temporomandibular joint. Oral Surg Oral Med Oral Pathol. 1986;62:486-95.
  • 43. Öğütcen-Toller M. Sound analysis of temporomandibular joint internal derangements with phonographic recordings. J Prosthet Dent. 2003;89:311-8.
  • 44. Gay T, Bertolami CN. The spectral properties of temporomandibular joint sounds. J Dent Res. 1987;66:1189-94.
  • 45. Mazzetto MO, Hotta TH, Carrasco TG, Mazzetto RG. Characteristics of TMD noise analyzed by electrovibratography. Cranio. 2008;26:222-8.
  • 46. Goiato MC, dos Santos DM, Monteiro DR. Joint Sounds in Complete Denture Wearers. NY State Dent J. 2010;76:46-9.
  • 47. Ishigaki S, Bessette RW, Maruyama T. Vibration analysis of the temporomandibular joints with meniscal displacement with and without reduction. J Craniomandib Pract. 1993;11:192-201.
  • 48. Christensen LV, Donegan SJ, McKay DC, Lewin A. Temporomandibular joint vibration analysis in a sample of non-patients. Cranio. 1992;10:35-42.
  • 49. Sharma S, Crow HC, McCall WD, Jr., Gonzalez YM. Systematic review of reliability and diagnostic validity of joint vibration analysis for diagnosis of temporomandibular disorders. J Orofac Pain. 2013;27:51-60.
  • 50. Güleç M, Taşsöker M, Özcan S. Tıpta ve Diş Hekimliğinde Fraktal Analiz. EÜ Dişhek Fak Derg. 2019;40:17-31.
  • 51. Eriksson L, Westesson PL, Rohlin M. Temporomandibular joint sounds in patients with disc displacement. Int J Oral Surg. 1985;14:428-36.
  • 52. Widmalm SE, Westesson PL, Brooks SL, Hatala MP, Paesani D. Temporomandibular joint sounds: correlation to joint structure in fresh autopsy specimens. Am J Orthod Dentofacial Orthop. 1992;101:60-9.
  • 53. Isberg A, Widmalm SE, Ivarsson R. Clinical, radiographic, and electromyographic study of patients with internal derangement of the temporomandibular joint. Am J Orthod. 1985;88:453-60.
  • 54. Motoyoshi M, Matsumoto Y, Ohnuma M, Arimoto M, Takahashi K, Namura S. A Study of Temporomandibular Joint Sounds Part 2. Acoustic Characteristics of Joint Sounds. J Nihon Univ Sch Dent. 1995;37:47-54.
  • 55. Djurdjanovic D, Widmalm SE, Williams WJ, Koh CK, Yang KP. Computerized classification of temporomandibular joint sounds. IEEE Trans Biomed Eng. 2000;47:977-84.
  • 56. Gallo LM, Airoldi R, Ernst B, Palla S. Power spectral analysis of temporomandibular joint sounds in asymptomatic subjects. J Dent Res. 1993;72:871-5.
  • 57. Sano T, Widmalm SE, Westesson PL, Yamaga T, Yamamoto M, Takahashi K, et al. Acoustic characteristics of sounds from temporomandibular joints with and without effusion: An MRI study. J Oral Rehabil. 2002;29:161-6.
  • 58. Kimoto K. A three dimensional display for TMJ sounds using STFT. Bull Kanagawa Dent Coll. 1996;24:19-20.
There are 58 citations in total.

Details

Primary Language Turkish
Subjects Dentistry
Journal Section Review
Authors

Mevsim Yayman 0000-0003-1669-6834

Prof. Dr. Serhan Akman 0000-0001-7362-6619

Publication Date December 25, 2023
Submission Date January 18, 2023
Published in Issue Year 2023

Cite

Vancouver Yayman M, Akman PDS. Temporomandibular Eklem Seslerini Değerlendirme Yöntemleri. Selcuk Dent J. 2023;10(3):600-4.