ORIGINAL RESEARCH
Year : 2022 | Volume
: 14 | Issue : 5 | Page : 468--474
Design and calibration of infrared thermography therapeutic device for temporomandibular disorder: An instrument accuracy study
Liana Rahmayani1, Mustanir Yahya2, Cut Soraya3, Saumi Syahreza4,
1 Graduate School of Mathematics and Applied Science, Banda Aceh, Indonesia; Faculty of Dentistry, Banda Aceh, Indonesia
2 Department of Chemistry, Faculty of Mathematics and Natural Sciences, Banda Aceh, Indonesia
3 Faculty of Dentistry, Banda Aceh, Indonesia
4 Department of Physics, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh, Indonesia
Correspondence Address:
Dr. Saumi Syahreza
Department of Physics, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Kopelma Darussalam, Banda Aceh 23111
Indonesia
Abstract
Aim: To design a modification and calibration of the therapy device that is expected to be used in relieving the symptoms of temporomandibular disorders. Materials and Methods: The research type was an experimental study; the method was carried out by designing the addition of some modified components to the therapy device for the calibration of the sensors in terms of measuring the increase and decrease in the temperature repeatedly three times. The temperature increase and decrease time recorded was the duration every 30 min for each session. The data obtained were then processed using the interrater reliability statistical test with interclass correlation coefficient (ICC), to see whether a measuring instrument (device) has adequate and accurate stability. Results: The results of measurements were analyzed using interrater reliability statistical tests with ICC and measuring from the mean value of both the increase and decrease in temperature with the analysis of the Mann–Whitney test Asymp Sig. 2 (tailed) of 0.860, which means it can be assumed to be the same or not different. The result showed that the ICC single measures on the LM35 was 0.894, whereas the ICC single measures on the thermocouple was 0.887. The ICC value of single measures on the LM35 was 0.999, whereas the ICC value for single measures on thermocouples was 0.993. Conclusions: It can be concluded that there was no difference between the value of increased and decreased temperature using the LM35 sensor or thermocouple. It can be assumed that the results are the same and that the ICC value category for the LM35 sensor and the thermocouple is very reliable and has high stability.
How to cite this article:
Rahmayani L, Yahya M, Soraya C, Syahreza S. Design and calibration of infrared thermography therapeutic device for temporomandibular disorder: An instrument accuracy study.J Int Oral Health 2022;14:468-474
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How to cite this URL:
Rahmayani L, Yahya M, Soraya C, Syahreza S. Design and calibration of infrared thermography therapeutic device for temporomandibular disorder: An instrument accuracy study. J Int Oral Health [serial online] 2022 [cited 2023 Jun 1 ];14:468-474
Available from: https://www.jioh.org/text.asp?2022/14/5/468/359972 |
Full Text
Introduction
Infrared is an electromagnetic radiation with a wavelength longer than visible light but shorter than radio wave radiation. Besides being widely used as medical devices to detect disease, infrared applications are also used for disease therapy. The infrared light emitted by certain waves can be believed to help the healing process of many diseases, including diabetes, anemia, aches, rheumatism, back pain, and high blood pressure.[1],[2],[3]
The characteristics of infrared rays are invisible to humans, unable to penetrate invisible materials, and can be generated by components that generate heat. The wavelength in infrared is opposite to or inversely proportional to temperature. When the temperature increases, the wavelength will decrease.[4]
Temporomandibular disorder (TMD) causes signs and symptoms that can be felt by sufferers. Signs and symptoms that are felt tend to be chronic. Common symptoms complained of are specific pain, pain in the head and neck, tinnitus, jaw muscle pain, limited jaw movement, and feeling locked in the jaw. In order to reduce the symptoms of TMD disease, infrared light therapy can also be an option because it is noninvasive, easy to apply, relatively short time, and minimally contraindicated. Although infrared is starting to be of interest in the world of health, the use of infrared is also known to be very limited, especially in the detection and therapy of diseases related to the temporomandibular joint condition. Generally, infrared therapy also can generate superficial heat around the treated skin area; therefore, it is expected to provide physiological effects needed for healing in the joints of the human body, as well as the temporomandibular joint. A study by Khairnar et al. (2019) showed the use of low-level IR rays in patients with TMD and found a reduction in pain and a decrease in temperature in the joint area detected by infrared thermography, with the wavelength used was 660 nm.[5],[6],[7],[8]
Some of the physiological effects that occur are the activation of superficial heat receptors in the skin, which will change the conduction transmission of sensory nerves in delivering pain; therefore, the pain will be felt less. Mouli et al. (2012) said that the heating effect could also cause vasodilation of blood vessels and increase blood flow around the painful area. Therefore, it will provide sufficient oxygen to the treated joint area.[9],[10],[11],[12]
Until recently, infrared therapy has not been widely used in therapeutic measures in dental practice, whereas patients with TMDs have recently increased, reaching 60%–70% of the population. Meanwhile, according to Karthik et al. (2017), the prevalence of TMD is known from several studies, showing a fairly high percentage of 69.4%–71.4% in myofascial pain disorders and 55.5%–85.7% found in disc displacement.[13],[14],[15] Valesan et al. showed that the overall prevalence of TMD was approximately 31% for adults/elderly and 11% for children/adolescents, and this percentage is estimated to increase by 2% per year and on average require therapy for treatment.[16],[17],[18],[19] More about therapeutic purposes, it is necessary to make a modification to the infrared therapy device, which is commonly used in hospitals and medical rehabilitation clinics. Therefore, in this study, a design of infrared thermography was carried out in order to make it easily applicable and could be widely used, especially in the case of TMD. Several additional components of the test equipment are designed to modify the available infrared thermography device. This study is a preliminary research before the device used to subject as a clinical trial. The type of this study is an experimental laboratory study (especially instrument accuracy study) with an instrument calibration test design. As for the hypothesis of this study was that the device designed can function properly and accurately, has high stability, and is reliable.
Materials and Methods
In this study, a therapeutic device was designed with the addition of several components. The research method used was quality function deployment, in which the design of the device designed for therapy will be tested for reliability before being applied. This type of research is an experimental laboratory study (especially an instrument accuracy study) with an instrument calibration test design. This research was conducted at the Physics Instrumentation Electronic Laboratory of Universitas Syiah Kuala, Banda Aceh, Aceh Province, Indonesia, for approximately 1 year starting from June 2020 to July 2021. Data were collected after the calibration of the infrared therapy device.
Design of the device
The materials used in the design of this infrared therapy tool were a set of infrared lamps, dimers, ultrasonic sensors, memory cards, connecting cables, sockets, batteries, LM35 temperature sensors, thermocouples, and stabilizers. Several components were added to the device, such as a dimer, ultrasonic sensor (to measure distance), LM35 temperature sensor (multi sensor), memory card (to save measurement data), and keypad buttons for easy operation of the device. Multiple sensors are placed on the instrument and on the subject when it will be used later, aiming to measure the instrument’s temperature and the temperature in the jaw joint area as desired. When later this device is applied to the subject, the subject’s temperature obtained from the multiple sensors will be transferred to the dimer via the bluetooth system and recorded by the memory card. The design plan was made for the circuit to be modified into the tool, as shown in [Figure 1]. The finished circuit will be in the design shown in [Figure 2].{Figure 1} {Figure 2}
Calibration
After the tool’s design was modified, it was then carried out to test the operation and calibration of the modified device. The calibration of temperature increases and decreases was carried out to see what the tool’s initial temperature and maximum temperature were from starting to turn on. At the time of calibration, a stabilizer is also used, which aims to stabilize the electric current. The temperature increase and decrease were tested on the tool, calibrated with three repetitions for each sensor, both the sensor on the tool and the thermocouple as a comparison. The temperature increase time recorded was the duration every 30 min. The results were recorded, and then statistical analysis was carried out. The analysis was carried out in two stages, the statistical test to measure the respective values of the increase and decrease in temperature (LM35 sensor and thermocouple) by interrater reliability statistical tests with interclass correlation coefficient (ICC) and then using the Mann–Whitney test analysis to determine the comparison of the measured results on the two sensors whether it can be assumed to be the same or not different.
Statistical analysis
The data obtained were then processed using the interrater reliability statistical test with ICC, to see whether a measuring instrument (device) has adequate and accurate stability. The Cronbach’s alpha value was used for determining the accuracy of a device and the level of reliability, according to Streiner et al. (2000): 0.0–0.20 (less reliable), >0.20–0.40 (somewhat reliable), >0.40–0.60 (quite reliable), >0.60–0.80 (reliable), and >0.80–1.00 (very reliable). The measuring instrument has adequate stability if the ICC between measurements is >0.50 and high stability if the ICC between measurements is ≥0.80.[20],[21]
Results
Tool testing and calibration of temperature increase
The measurement value of the temperature increase for each of the three measurements was statistically tested for both the LM35 sensor and the thermocouple; the range of temperature increases in this study is 120–123°C, with the results of the Cronbach’s alpha value of 0.962 for the LM35 and 0.959 for the thermocouple, both values >0.80–1.00, which means very reliable. The ICC value for single measures on the LM35 is 0.894, whereas the ICC value for single measures on thermocouples was 0.887 [Table 1] and [Table 2], which means that the results of both the LM35 sensor and the thermocouple are included in the ICC value category between measurements ≥0.80. Therefore, it can be said that the measuring instrument has high stability. In statistical tests, it can be said that this tool was reliable, namely the consistency of a series of measurements where the results were in the form of sizes from the same measuring instrument giving the same results [Figure 3].{Table 1} {Table 2} {Figure 3}
It was known that the Kolmogorov–Smirnov test was not significant; therefore, the Mann–Whitney test was carried out to compare whether there was a difference in temperature increase between the LM35 and thermocouple sensors. Based on the statistical test output in the Mann–Whitney test, it was known that the Asymp Sig. 2 (tailed) of 0.860. Thus, there was no difference between the temperature increase value using the LM35 sensor or the thermocouple. It can be assumed that the results are the same for both the LM35 sensor and the thermocouple [Figure 4].{Figure 4}
Tool testing and calibration of temperature decrease
The measurement value for the decrease in temperature for each of the three measurements was statistically tested for both the LM35 sensor and the thermocouple, with the results of the Cronbach’s alpha value of 1.000 for the LM35 and 0.998 for the thermocouple, both values >0.80–1.00, which means very reliable. The ICC value for single measures on the LM35 was 0.999, whereas the ICC value for single measures on the thermocouples was 0.993, which means that the results of both the LM35 sensor and the thermocouple were included in the ICC value category between measurements ≥0.80; therefore it can be said that the measuring instrument has high stability [Figure 5]. Therefore the basis for the decision was taken to accept the hypothesis.{Figure 5}
It was known that the Kolmogorov–Smirnov test was not significant or sig <0.05; therefore, the Mann–Whitney test was carried out to compare whether there was a difference in temperature decrease between the thermocouple and LM35 devices. Based on the statistical test output in the Mann–Whitney test above, it was known that the Asymp value was Sig. 2 (tailed) of 0.778. Thus, it can be said that there was no difference between the temperature decrease values using a thermocouple or LM35 device [Figure 6].{Figure 6}
Discussion
Therapy with infrared light equipment in TMD disease can also be an option because it is noninvasive, easy to apply, takes a relatively short time, and has minimal contraindications. Although infrared therapy is starting to be of interest in the health world, infrared is also very limited, especially in detecting and treating diseases related to temporomandibular joint conditions. It is known that therapy with this infrared device can generate superficial heat around the treated skin area. It is expected to provide physiological effects needed for healing in the joints of the human body and the temporomandibular joint.[4],[5],[7]
The modification of the tool design in this study aims to obtain a tool that is efficient and easy in its application and is designed in more detail to record patient therapy data. The modified device, with the addition of a dimer, will be able to record the initial temperature, the temperature measurement time; can set how much heat is desired, the minimum and maximum heat; and the increase and decrease in temperature can also be recorded. The tool is also equipped with the addition of a distance sensor, where the distance sensor here functions to regulate how much distance you want when doing therapy. The adjustable distance is the distance the light is exposed to from the instrument to the subject. Similar research was found by Hamza et al. (2014) regarding the design of infrared therapy devices. Still, the study modification was seen on the monitor and aimed to make the system set its own time. Therapy time makes the tool more practical and efficient in its use. In contrast, this study was more about operating the device according to the operator’s wishes for how long the duration was. Then the advantages of this design are that it can also determine the increase and decrease in temperature.[22],[23],[24],[25]
Calibration is carried out, and the results can be seen in the table, namely, when the temperature increase is seen with the Mann–Whitney test, both the LM35 sensor and the thermocouple sensor have no significant difference, which means they can be considered the same; as well as the ICC measurements at the temperature increase for three times, each size statistically tested both the LM35 sensor and the thermocouple, the results of the Cronbach’s alpha value are both >0.80–1.00, which means very reliable. For single measures, ICC values on LM35 and thermocouples are included in the ICC value category between measurements ≥0.80, so it can be said that the measuring instrument has high stability. In statistical tests, it can be said that this tool is reliable, namely the consistency of a series of measurements where the results are in the form of sizes from the same measuring instrument giving the same results.[20],[21]
Likewise, for the calibration of the temperature drop measurement, according to Singgih and Santoso, in 2010, the measurement value of the temperature reduction was obtained by both the LM35 and thermocouple sensors. Based on [Tables 1] and [2], the results of the Cronbach’s alpha value are both >0.80–1.00, which means very reliable. In contrast, the ICC value of single measures results from both the LM35 sensor and the thermocouple is included in the ICC value category between measurements ≥0.80, so it can be said that the measuring instrument has high stability. Based on the statistical test output in the Mann–Whitney test, it is known that the Asymp Sig. 2 (tailed) is of 0.778, so it can be said that there is no difference between the values of temperature reduction using a thermocouple or LM35 device. Therefore, this device can be recommended for therapeutic purposes, especially in the therapy of TMD. In other words, this device can be used as an alternative to other TMD therapy, such as occlusal splints and physical therapy that aims to reduce complaints of disturbances or pain.[23],[26],[27]
Technology has a significant role in achieving efforts to solve problems in therapeutic tools in the health sector; any solution must be designed, implemented, and validated using the knowledge that is appropriate to the case at hand, according to the study of Aragane et al. (2019), which developed the technology of a tool to accurately detect certain disorders or diseases and to process and analyze sensory data to track physiological data. This matter is beneficial in determining a diagnosis of disease or disorder. Likewise, with the tools designed in this study, several additional components such as sensors are useful further to facilitate the transfer of data from treated patients. Temperature data generated from this study can be well-calibrated, and the results are accurate. In statistical tests, it can be said that this tool is reliable, namely, the consistency of a series of measurements where the results are in the form of sizes from the same measuring instrument giving the same results. The device can be recommended for therapeutic use, especially for TMD therapy.[28],[29],[30],[31]
This study’s focus is limited to only instrument calibration testing as a preliminary study to determine whether the device is feasible and reliable to be used as a therapeutic tool. Therefore, it is necessary to continue clinical trials of instrument application to subjects. Further research may be needed to see the effectiveness of the tools that have been designed. Apart from being applied directly to the issue, it may also be suggested to develop an instrument system with a prototype design and digital printing and add more complete components so that the tool is more practical and efficient for widespread use and expected to be used in hospitals, clinics, or dentist practices.
Conclusions
It can be concluded that there was no difference between the value of increase and decrease temperature using the LM35 sensor or thermocouple. It can be assumed that the results are the same, and the ICC value category for both the LM35 sensor and the thermocouple is very reliable and has high stability.
Acknowledgement
The authors wish to thank Universitas Syiah Kuala, Aceh Province.
Financial support and sponsorship
This study was supported by Universitas Syiah Kuala PNBP research grant funds.
Conflict of interest
There are no conflicts of interest.
Authors’ contributions
LR: primary author, concept designs, data extraction, writing original draft, methodology, and resources; MY: concept designs, data extraction, writing original draft, methodology, resources, conceptualization, validation, data curation, article review, and guarantor; CS: concept designs, data extraction, writing original draft, methodology, resources, article review, and guarantor; SS: corresponding author, concept designs, data extraction, writing original draft, methodology, resources, conceptualization, validation, data curation, article review, and guarantor.
Ethical policy and institutional review board statement
Not applicable.
Patient declaration of consent
Not applicable because it is not in vivo or case report study.
Data availability statement
The data that support the findings of this study are available from the authors on reasonable request.
References
| 1 | Machoy M, Szyszka-Sommerfeld L, Rahnama M, Koprowski R, Wilczyński S, Woźniak K Diagnosis of temporomandibular disorders using thermovision imaging. Pain Res Manag 2020; 2020:5481365. |
| 2 | Barbosa JS, Amorim A, Arruda M, Medeiros G, Freitas A, Vieira L, et al. Infrared thermography assessment of patients with temporomandibular disorders. Dentomaxillofac Radiol 2020;49:20190392. |
| 3 | Perpetuini D, Trippetti N, Cardone D, Breda L, D’Attilio M, Merla A Detection of temporomandibular joint disfunction in juvenile idiopathic arthritis through infrared thermal imaging and a machine learning procedure. Proceedings of the European Medical and Biological Engineering Conference; Portorož, Slovenia. 29 November–3 December 2020. Berlin/Heidelberg, Germany: Springer; 2020. p. 372-81. |
| 4 | Vatansever F, Hamblin MR Far infrared radiation (FIR): Its biological effects and medical applications. Photonics Lasers Med 2012;4:255-66. |
| 5 | Antonaci F, Rossi E, Voiticovschi-Iosob C, Dalla Volta G, Marceglia S Frontal infrared thermography in healthy individuals and chronic migraine patients: Reliability of the method. Cephalalgia 2019;39:489-96. |
| 6 | Rahmayani L, Yahya M, Soraya C, Syahreza S Thermal condition of muscle area around the temporomandibular joint in patient with systemic lupus erythematosus using infrared thermography application: A case report. J Int Soc Prev Community Dent 2020;10:674-9. |
| 7 | Khairnar S, Bhate K, S N SK, Kshirsagar K, Jagtap B, Kakodkar P Comparative evaluation of low-level laser therapy and ultrasound heat therapy in reducing temporomandibular joint disorder pain. J Dent Anesth Pain Med 2019;19:289-94. |
| 8 | Mohamed MAH, Abdallah KF, Hussein FA Three-dimensional assessment of mandibular condylar volume and position subsequent to twin block functional therapy of skeletal class II malocclusion accompanied by low-level laser therapy. Dent J 2020;8:115. |
| 9 | de Melo DP, Bento PM, Peixoto LR, Martins SKLD, Martins CC Is infrared thermography effective in the diagnosis of temporomandibular disorders? A systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2019;127:185-92. |
| 10 | Mouli C, Kumar M, Senthil B, Parthiban S, Malarvizhi A, Karthik R Application of thermography in dentistry: A review. IOSR J Dent Med Sci 2012;1:39-43. |
| 11 | Liu X, Wang Y, Luan J. Facial paralysis detection in infrared thermal images using asymmetry analysis of temperature and texture features. Diagnostics (Basel) 2021;11:2309. |
| 12 | Altindiş T, Güngörmüş M Thermographic evaluation of occlusal splint and low level laser therapy in myofascial pain syndrome. Complement Ther Med 2019;44:277-81. |
| 13 | Connelly ST, Tartaglia GM, Silva RG Contemporary Management of Temporomandibular Disorders. Cham, Switzerland: Springer 2019. p. 105-23. |
| 14 | Karthik R, Hafila MIF, Saravanan C, Vivek N, Priyadarsini P, Ashwath B Assessing prevalence of temporomandibular disorders among university students: A questionnaire study. J Int Soc Prev Community Dent 2017;7:24-9. |
| 15 | Medeiros RA, Vieira DL, Silva EVFD, Rezende LVML, Santos RWD, Tabata LF Prevalence of symptoms of temporomandibular disorders, oral behaviors, anxiety, and depression in dentistry students during the period of social isolation due to COVID-19. J Appl Oral Sci 2020;28:e20200445. |
| 16 | Valesan LF, Da-Cas CD, Réus JC, Denardin ACS, Garanhani RR, Bonotto D, et al. Prevalence of temporomandibular joint disorders: A systematic review and meta-analysis. Clin Oral Investig 2021;25:441-53. |
| 17 | Muddebihal F, Alawadh H, Salahuddin M, Alrasheed SS, Alryes MM, Sayeed MU A survey report of temporomandibular joint disorder using Fonseca’s and research diagnostic criteria during routine dental examination: A cross-sectional study. J Int Oral Health 2021;13:245-50. |
| 18 | Al-Gunaid TH, Eshky RT Perspectives, attitudes, and practices of orthodontists, prosthodontists, and maxillofacial surgeons toward temporomandibular joint disorders: A cross-sectional survey. J Int Oral Health 2021;13:251-7. |
| 19 | Umniyati H The prevalence of temporomandibular disorder joint (TMD) and its severity among YARSI University employees. J Dentomaxillofac Sci 2020;5:82-5. |
| 20 | Streiner DL, Norman GR Health Measurement Scales: A Practical Guide to Their Development and Use. Oxford: Oxford University Press; 2000. |
| 21 | Polgar S, Thomas SA Introduction to Research in the Health Sciences. London: Churchill Livingstone/Harcourt Publishers Ltd; 2000. |
| 22 | Hamza A, Farah E, Salman E, Hassan R, Bushara FBG Design of an infrared physiotherapy monitor. J Phys Ther Health Promot 2014;2:24-8. |
| 23 | Cristiano L Use of infrared as a complementary treatment approach in medicine and aesthetic medicine. Asp Biomed Clin Case Rep 2019;2:77-81. |
| 24 | Gu Z The design of infrared thermal imaging device for scoliosis examination. 6th International Conference on Smart Grid and Electrical Automation (ICSGEA) 29-30 May 2021. Kunming, China; 2021. p. 259-62. |
| 25 | de Resende CMBM, de Oliveira Medeiros FGL, de Figueiredo Rêgo CR, Bispo ASL, Barbosa GAS, de Almeida EO Short-term effectiveness of conservative therapies in pain, quality of life, and sleep in patients with temporomandibular disorders: A randomized clinical trial. Cranio 2021;39:335-43. |
| 26 | Alkhutari AS, Alyahya A, Rodrigues Conti PC, Christidis N, Al-Moraissi EA Is the therapeutic effect of occlusal stabilization appliances more than just placebo effect in the management of painful temporomandibular disorders? A network meta-analysis of randomized clinical trials. J Prosthet Dent 2021;126:24-32. |
| 27 | Abdel-Gawwad EA, Abdullah AAB, Farhat MY, Helal MA Effect of using photobiomodulation, stabilization, and anterior repositioning splints on the pain level of subjects with temporomandibular joint disc displacement with reduction. Braz Dent Sci 2021;24:1-8. |
| 28 | van der Meer HA, Calixtre LB, Engelbert RHH, Visscher CM, Nijhuis-van der Sanden MW, Speksnijder CM Effects of physical therapy for temporomandibular disorders on headache pain intensity: A systematic review. Musculoskelet Sci Pract 2020;50:102277. |
| 29 | Al-khafajiy M, Baker T, Chalmers C, Asim M, Kolivand H, Fahim M, et al. Remote health monitoring of elderly through wearable sensors. Multimed Tools Appl 2019;78:24681-706. |
| 30 | Aragane Y, Higashino H The “Enseki” sandbath: A novel, safe and effective far-infrared bathing procedure for health. Photodermatol Photoimmunol Photomed 2019;35:31-9. |
| 31 | Swärdh E, Nordgren T, Opava CH, Demmelmaier I “A necessary investment in future health”: Perceptions of physical activity maintenance among people with rheumatoid arthritis. Phys Ther 2020;100:2144-53. |
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