Validation of the Modified Helkimo Clinical Index for Diagnosing Temporomandibular Disorders in a Romanian Patient Sample

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Abstract

Background and objectives: Temporomandibular disorders (TMDs) are common but challenging to diagnose in routine practice due to the complexity of the DC/TMD protocol. The study assesses the diagnostic validity and reliability of the modified Helkimo Index (mHI) in a Romanian patient cohort. Methods: A cross-sectional study of 164 participants (82 TMD patients, 82 controls) evaluated the diagnostic performance and reliability of the mHI against the DC/TMD protocol. Results: The mHI demonstrated high diagnostic accuracy (sensitivity 86%, specificity 84%, AUC = 0.89) and strong agreement with DC/TMD diagnoses (r = 0.83, p < 0.001). Reliability was excellent (inter-examiner ICC = 0.87; intra-examiner ICC = 0.91). Application time was significantly shorter (5–10 min) than the DC/TMD protocol (16–20 min). Conclusions: The mHI is a valid, reliable, and time-efficient tool for TMD diagnosis, supporting its integration into general dental practice and broader screening initiatives.

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