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Dawson Quick Tip: The Importance of Load Testing

Hi, my name's Dr. Leonard Hess and I'd like to spend a moment with you discussing the importance of load testing as we evaluate the health and make a diagnosis of a condition of the temporomandibular joint.

Transcript continued below...


One of the things we always must remember is that the temporomandibular joint is a load-bearing joint. Just like any other joint in the body, if it's incapable of accepting a load, that is going to help us to determine whether or not the joint is healthy and to make a diagnosis of the joint.

Proper Bimanual Manipulation TechniqueWhen we're load testing the joint, it's importance that we're always using bimanual manipulation with our proper technique. We always start off by loading the joint first under light pressure, then we proceed to medium and firm pressure, always asking the patient if they feel tension or tenderness.

Remember that tension is typically going to always be an indicator that the lateral pterygoid muscle is not releasing and allowing those condyle to seat up into centriculation.

If the patient is describing a sensation of tenderness, then invariably what we're talking about is an intracapsular problem and we're having the joint being loaded onto the innervated fibers in the posterior joint space.

Load testing is such an important component of the complete examination because the information that we gain from that is extremely valuable.

We have to understand that centric relation cannot be felt, it can only be verified through load testing.

So don't forget to load test when you're doing your complete examination, and I think that you'll find yourself a lot more confident when you're making your diagnosis of the condition of the temporomandibular joint.

Thanks a lot.

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Dr. Leonard A. Hess maintains a comprehensive-focused private practice in Monroe, North Carolina. Growing up in the mid-west, Dr. Hess attended Indiana University for his undergraduate education. His doctor of Dental Surgery degree was obtained from Northwestern University Dental School in Chicago, IL. Dr. Hess is a member of the American Academy of Cosmetic Dentistry, American Equilibration Society, ADA, AGD, NCDS, and CDS. Locally, Dr. Hess has served on the peer-review board for his ADA district. He has also served on the Board of Directors of SPCC College in Union Co. As a senior faculty member of the Dawson Academy, Dr. Hess has demonstrated a passion for learning and teaching from the very start of his career. In the past six years Dr. Hess has taught hundreds of hours of hands-on continuing education throughout the country. From study clubs to the AACD national meeting, Dr. Hess has helped thousands of his peers incorporate functional esthetic care into their practices. Dr. Hess currently evaluates and tests new products for manufacturers such as Whip-Mix, Septodont, Heraeus, Kerr, and Dentsply. In addition, Dr. Hess is a frequently featured author in Advanced Esthetics and Interdisciplinary Dentistry, Inside Dentistry, Contemporary Esthetics and Restorative Dentistry, and Vistas. Dr. Hess resides with his wife and son in Weddington, NC. Outside of dentistry he enjoys spending time with his family, golf, aviation, traveling, skiing, and auto racing.