TMD diagnostics: manual structural analysis (MSA) and axiography versus MRI

In this study, a total of 21 patients who had presented for treatment on account of temporomandibular symptoms were examined over a period lasting from 2003 until 2008 at the University Clinic of the RWTH Aachen University, Germany. Manual structural analysis (MSA) and axiography were conducted by a treatment provider experienced in functional diagnostics to record the temporomandibular situation of all patients. In addition to this, magnetic resonance imaging (MRI) of the temporomandibular joints (TMJs) was performed on each study participant. The objective of the study was to evaluate the diagnostic value of MSA and axiography in comparison to MRI. For pathological MSA and axiographical findings, defined point values were assigned to each TMJ; these were combined to form an overall point value, the temporomandibular dysfunction (TMD) index. This TMD index comprises a clinical, symptomatic evaluation with the aid of manual structural analysis (MSA), as well as a joint function-related evaluation by means of axiography. In this study, a complete concurrence was observed between TMJs with pathological clinical findings and a high TMD index, whereby only patients with dysfunctional clinical symptoms were included in the evaluation. The question as to whether this index also enables a definition of different treatment areas must be investigated in controlled clinical studies. Parole chiave: temporomandibular dysfunction (TMD), temporomandibular joint, TMD index, axiography, manual structural analysis