Screening tests to assess the condition of the Temporomandibular Joint

Introduction: Temporomandibular disorders are a group of disorders of the temporomandibular joint (TMJ), its musculature and associated structures. Patients exhibit two major sites of breakdown, namely the muscles used for chewing, and also the temporomandibular joints. Diagnostic tests which allow rapid assessment of the TMJ and its musculature could allow more patients access to treatment. These diagnostic tests are used in Orthopaedics and could also be used to make a rapid assessment of the TMJ possible. These tests are called: Joint play, End-feel, Static pain and Dynamic pain tests. Joint-play is a measure of the condition of the bone surface. End-feel is a measure of the joint elasticity. Static pain is a measure of muscular pain and Dynamic pain is a measure of bone pain. These tests, when used together, allow the practitioner to make a diagnosis of the condition of TMJ. Objective: To determine whether these tests could allow the dental practitioner to diagnose the condition of the TMJ in order to determine whether the disorder is primarily due to a problem in the jaw muscles, or in the jaw bones or if it is a combination of the two. Methods: Fifty joints were examined using these diagnostic tests. Each joint was tested using the End-feel test, Joint play test, Static pain test and Dynamic pain test and the diagnosis was confirmed by a specialist. Results: There were 37 normal joints and 13 joints with signs of degeneration. The origin of degeneration was determined as follows: 6 were of muscular origin; 4 had a combination of muscular and bony origin and 3 were of bony origin. Conclusion: Emphasis should be placed on diagnosing the condition of the joint that will ultimately lead to a better understanding of the origin of the clinical signs and symptoms associated with temporomandibular disorders.