Provocation testing to assist craniomandibular pain diagnosis.
Patients with TMD often present with complex pain symptoms, which can make it difficult to reach a diagnosis. Usually palpation of the masticatory muscles and TM joints, range of motion testing and imaging are used in the diagnostic process. Sometimes it is necessary to evaluate the jaw moving muscles from a functional prospective because they cannot be palpated due to inaccessibility or because they have other structures that are more superficial to them. In these instances, provocation testing can be a helpful adjunct in providing some insight into what is occurring in the area being tested and localizing a suspected source of pain. Anesthesia blocking can be used to confirm any positive findings. This article explores several provocation tests that can be used to evaluate conditions of the masticatory musculature, the TM joints and the stylomandibular ligament.
DuPont
John S
JS
Louisiana State University of Dentistry, USA. jdupontdds@eatel.net
Brown
Christopher E
CE
D000779:Anesthetics, Local / Q000008:administration & dosage; D001168:Arthritis / Q000175:diagnosis; D001696:Biomechanical Phenomena; D017271:Craniomandibular Disorders / Q000175:diagnosis* / Q000503:physiopathology; D003952:Diagnostic Imaging; D006801:Humans; D008022:Ligaments / Q000503:physiopathology; D008410:Masticatory Muscles / Q000503:physiopathology; D009119:Muscle Contraction / Q000502:physiology; D009135:Muscular Diseases / Q000175:diagnosis; D009334:Neck Muscles / Q000503:physiopathology; D010173:Palpation; D010808:Physical Examination / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology; D013100:Sphenoid Bone / Q000503:physiopathology; D013704:Temporomandibular Joint / Q000503:physiopathology; D019224:Temporomandibular Joint Disc / Q000503:physiopathology; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis / Q000503:physiopathology
D000779:Anesthetics, Local