Table 1 Physical examination directed toward mandibular dysfunction
From: Orthognathic surgery and temporomandibular joint symptoms
Examination | Observations |
|---|---|
Inspection | Facial asymmetry, swelling, and masseter and temporal muscle hypertrophy Opening pattern (corrected and uncorrected deviations, uncoordinated movements, limitations) |
Assessment of range of mandibular movement | Maximum opening with comfort, with pain, and with clinician assistance Maximum lateral and protrusive movements |
Palpation examination | Masticatory muscles Temporomandibular joints Neck muscles and accessory muscles of the jaw Parotid and submandibular areas Lymph nodes |
Provocation tests | Static pain test (mandibular resistance against pressure) Pain in the joints or muscles with tooth clenching Reproduction of symptoms with chewing (wax, sugarless gum) |
Intraoral examination | Signs of parafunction (cheek or lip biting, accentuated linea alba, scalloped tongue borders, occlusal wear, tooth mobility, generalized sensitivity to percussion, thermal testing, multiple fractures of enamel, restorations) |