Manual Structural Analysis according to A.Bumann
The manual structure analysis (abbreviated by MSA) according to A. Bumann is a series of manual techniques for the study of the temporomandibular joints and masticatory muscles. Manual investigation techniques (performed with the hands) was mainly developed in the USA and Netherlands, but is also used in many parts of the world. Therefore, there are numerous manual techniques for investigating the temporomandibular joint and masticatory muscles, but each using slightly various form from the worldwide spread. Bumann summarized a large number of manual examination techniques to develop a systematic and comprehensive examination guideline, which stays under the name of manual structural analysis. Many dentists and universities have used the manual structure analysis for years.
Criticism
Some of the manual examination techniques are not scientifically documented, and in other cases, the structures to study are unclear (lack specificity). For example the significance of the nine different compression directions of the TMJ is not certain. The four different types of jaw joint clicking cannot be properly analyzed, nonetheless they are part of the structural analysis. And finally, the theory of “occlusal vectors” which wants to realize disorders directly caused in the TMJ by interfering tooth contacts, remains only a hypothesis. It is therefore possible that healthy patients could possibly be misdiagnosed as sick with the manual structure analysis. Furthermore, the manual structure analysis focuses primarily on the diagnosis of the TMJ, although, three quarters of craniomandibular dysfunctions are of muscular origin. The palpation of the muscles is relatively shortly dealt with during the manual structure analysis. Unfortunately, a significant collection of psychological stress factors has been completely left out in the manual structure analysis. The manual structure analysis is therefore classified as a, single-axis, somatic diagnostic procedure focusing on joint diagnostics. Since the author Bumann was one of the first in Germany who systemized the manual examination techniques and taught them in countless courses, the manual structure analysis in Germany is very widespread. Users are usually not aware that it is a mixture of some validated, but also numerous little or non-validated investigation techniques.
In contrast to the MSA, the RDC/TMD (Research Diagnostic Criteria for TMD) are comprehensive and scientifically validated. Furthermore the RDC/TMD require much less investigative steps to come to a diagnostic assessment. The RDC/TMD is a two-axis diagnostic procedure and are based on the somatic and psychological findings alike.