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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...

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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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Picture of Dr. Leonard Hess

Leonard A. Hess, DDS is the Clinical Director at The Dawson Academy and joined the faculty in 2009. He owns Union County Center for Comprehensive Dentistry in Charlotte, North Carolina, and practices full time in addition to teaching continuing education courses. He is a member of the editorial board for Inside Dentistry and has had over 17 articles published in peer-reviewed journals. He is also a member of the American Academy of Restorative Dentistry, AACD, ADA, AES, and NCDS. Dr. Hess began teaching continuing education courses in 2005 on topics including occlusion, smile design, treatment planning, preparation design, and practice integration of Complete Care Dentistry. He’s taught full-day continuing education courses at the American Academy of Cosmetic Dentistry’s national meeting, The Greater New York Dental Meeting, AACD National Meeting, Pacific Dental Conference, Ontario Dental Association meeting, and The Yankee Dental Conference. Dr. Hess has taught courses in Japan, Germany, Poland, China, and Canada.