MSA is an abbreviation for Manual Structural Analysis and was introduced by A. Bumann. It is a series of manual techniques for the examination of the mandibular joints and the chewing apparatus. Manual examination techniques (i.e. using the hands) were mainly developed in the US and the Netherlands but also in other countries. This explains why different variations of these techniques for examining the mandibular joints and chewing apparatus are now common throughout the world. Bumann compiled a large number of different manual examination techniques into a systematic and comprehensive clinical system and called it Manual Structural Analysis. MSA has been used by many universities and dentists for years.
Review: some of the manual examination techniques are ill-founded scientifically and with others it is just not clear what it is that is actually supposed to be examined (no specifics). It is also unclear what significance the nine different directions of compression of the mandibular joint that are listed in MSA are supposed to have. Moreover, the four different types of jaw clicking which are described in the MSA are somehow dubious. And finally, the theory of ‘occlusal vectors’ which he would like to acknowledge as direct causes of mandibular disorders where there is poor contact between the teeth, is nothing more than a hypothesis. In fact, one of the most important findings of recent decades is that tooth contact and tooth position play a subordinate role in the development of TMJ and disorders of the chewing apparatus. Therefore, it cannot be ruled out that with MSA, healthy patients are wrongly diagnosed as ill.
Furthermore, MSA concentrates mainly on diagnosis of the mandibular joint although three quarters of all cranio-mandibular disorders actually originate from the muscles. But MSA only deals cursorily with palpation of the muscles themselves. And something that is missing entirely from the MSA is the very significant importance that psychological stress factors have. MSA should therefore be classed as a one-sided, somatic diagnostic procedure that focuses on the joints.
As Bumann was one of the first people in Germany who taught manual examination techniques in numerous systematic courses, MSA is very common in Germany. Practitioners who use these techniques are usually not aware that they consist of a mixture of not only validated examination techniques but also techniques that have not been validated at all. Although MSA is structured in a very systematic and comprehensive way, it is by no means a scientifically recognised (i.e. validated) diagnostic procedure for CMD. On the other hand, RDC/TMD (Research Diagnostic Criteria for TMD) has been validated and also requires significantly fewer steps in the examination process in order to reach a diagnostic conclusion. RDC/TMD is a two-way diagnostic procedure whereby both somatic and psychological findings are taken into account.