The Manual Structural Analysis (MSA) according to Bumann comprises a series of manual techniques for the examination of the jaw (temporomandibular) joints (TMJs). Manual techniques (examinations performed with the hands) have been mainly developed in the USA and the Netherlands since 1970. That’s why a variety of manual techniques for the examination of the TMJs and masticatory muscles is spread all over the world. Mr. Bumann has summed up a series of manual techniques resulting in a systematic and extensive examination which is called Manual Structural Analysis. Many dentists and several universities have made use of MSA for years.
Unfortunately, some of the manual examination techniques aren’t supported efficiently by scientific evidence. Others show a lack of proof about what is examined exactly (lack of specificity). So it’s doubtful which validity should result from the nine directions of TMJ compression which are described in the MSA. The four different types of TMJ clicking mentioned in the MSA are also viewed critically. Moreover, the theory of “occlusal vectors” which considers faulty dental contacts responsible for TMJ disorders is just a hypothesis. In fact, the findings in recent decades have shown that tooth contacts and jaw position play only a minor role in the symptom development of TMJ or chewing muscles. It cannot be excluded that MSA diagnostics might turn a healthy patient into a sick one.
Even though three quarters of the temporomandibular disorders (TMDs) are based on muscular problems the MSA concentrates on diagnostics of TMJ disorders. In the MSA, the palpation of muscles is only treated superficially. The survey of psychological stress factors which is important in pain diagnostics isn’t part of the MSA. Therefore, the Manual Structural Analysis is to be regarded as a uniaxial, somatic diagnostic method focusing on TMJ diagnostics.
As Mr. Bumann was one of the first in Germany who systematized manual examination techniques and conducted a lot of courses, MSA is widely known in Germany. Unfortunately, many of the practitioners are not aware of the fact that only some of the described techniques are validated. Despite of being an extensive and systematic analysis the MSA should be viewed critically regarding scientific and validated diagnostics of the Craniomandibular Dysfunction (CMD).
In contrast, the RDC/TMD (Research Diagnostic Criteria for TMD) or DC/TMD are scientifically validated methods which make use of less diagnostic steps enabling a diagnostic conclusion. The RDC/TMD is a biaxial diagnostic method which takes somatic and psychological findings into account.