The first step in diagnosing temporomandibular joint disorders is to take a detailed medical history.
This is followed by a manual functional and structural analysis of the masticatory muscles, the temporomandibular joints, the teeth and tooth position, and the soft tissues. In addition, an orienting examination of the neck and cervical muscles is performed, as well as the most important facial nerves.
If necessary, further diagnostic procedures are performed:
X-ray or DVT (volume tomography)
If during the clinical examination a suspicion of an arthritic change at the temporomandibular joints arises, X-ray or DVT of the temporomandibular joints may be necessary.
Magnetic resonance imaging (MRI)
If there are clicking or rubbing noises in the temporomandibular joint and mouth opening restriction, it may be necessary to obtain an MRI. This is an imaging procedure without X-rays to visualize the soft tissue portions of the temporomandibular joints, especially to check the position of the interarticular disc (discus).
Examination of body statics (note: we only perform this on children)
The temporomandibular joint, masticatory muscles, head posture, spine and pelvis are always interrelated. If there are disturbances in these areas, the CMD syndrome (Craniomandibular Dysfunction Syndrome) can develop.
One by one, pelvic, shoulder and head posture as well as leg length are evaluated and attention is paid to malpositions, and function and pain points are checked. If findings are detected, an accompanying physio-therapeutic treatment (manual therapy, osteopathy, craniosacral therapy) is scheduled.
Instrumental occlusion analysis and determination of the centric position of the temporomandibular joints
To determine whether there is a connection between malocclusion of the teeth and the jaws, a patient-faithful transfer of the bite situation into a chewing simulator is used.
For this purpose, the spatial position of the maxilla in relation to the facial skull and the joint axis are transferred (using a bite fork and a facebow) into a
semi-individual articulator (chewing simulator).
The movable mandible is assigned to the maxilla with a wax bite, the so-called "centric registration". In this case, the mandible should be in a relaxed position in the socket with the temporomandibular joint heads in the muscles.
The analysis of the examinations shows whether there is a difference between the clenching of the teeth in the ideal centric temporomandibular joint position and the habitual clenching of the teeth. If there is such a difference, the temporomandibular joint is not in the ideal position during habitual occlusion. The reason for this is often malocclusion of the teeth.
If this is the case, it can be the cause of many complaints such as jaw joint clicking, headaches, muscle pains, cervical vertebrae problems and tinnitus.
Afterwards, the results of the respective examinations are evaluated and the possible treatment options are discussed with the patient(s).
