The clinician is positioned behind the patient. The clinician places his thumb right on the lower dental arch of the locking side, left or right. The other hand is placed on the temporale of the same side in order to stabilize the patient s head during the manipulative maneuver. The distal phalange of the thumb is flexed and the joint of the second phalange contacts the upper arch at the molar level, functioning as a fulcrum. The power of the lever is expressed by the third, fourth and fifth finger positioned on the lower border of the mandibular body.
Light pressure is applied on the lower second molar.
The pressure is applied in a back and down direction and is increased inward as the condyle is freed of interference with the disk. The hand stabilizing the head applies a progressive pressure in the opposite direction to the hand on the teeth and inclines the head forward. At the same time, the clinician moves the mandible in an antero-medial direction. The index finger of the stabilizing hand, pushes the condyle out of the fossa and compresses the empty fossa when the mandible is opened. This mandibular manipulation is dependent upon the clinician s technical ability.