Interdisciplinary CMD curriculum – Holistic functional diagnostics and therapy (2024)

Participation in individual modules on request.

In recent years, functional diagnostics and therapy have become more sophisticated. There is a growing understanding that the position of the temporomandibular joint and the associated occlusion are subject to influences from the body. The basis of this curriculum is anatomy and craniomandibular function in order to understand craniomandibular dysfunction. The influencing factors should already be evaluated when considering the therapy in order to be included in the therapy planning. In the course series, the structural, mental and visceral influences are explained and diagnostic techniques are demonstrated and practiced. The adjustment of the temporomandibular joints to the centric condylar position is practiced, taking into account the identified influencing factors.

Collegial final discussion (Dr. Diehl)/handover of certificates

Basic course CMD – Theory and diagnostics of craniomandibular dysfunction (Dr. A. Diehl)
Systematic functional diagnostics of craniomandibular dysfunction is presented in detail in theory and practice after a review of the anatomy of the temporomandibular joint and the surrounding structures. The term centric is explained.
In this context, an introduction to MRI diagnostics of the temporomandibular joint is given.
The workshop will focus on the “Short Screening according to Ahlers and Jakstat”, CMD Screening of the DGFDT, Clinical Functional Analysis and Manual Structural Analysis.
Based on the data collection forms of the German Society for Functional Diagnostics and Therapy “Examination Form Functional Status 2012” and “Examination Form Manual Structural Analysis 2012”, all examinations are explained and their background explained.
All participants practise all diagnostic procedures on their course partner under experienced guidance.
The course is aimed at beginners and colleagues who would like to expand their basic knowledge of the temporomandibular joint and its function. The initial focus is on craniomandibular function in order to understand craniomandibular dysfunction.

Therapy of CMD – splint therapy and adjuvant therapies (Dr. A. Diehl, Dr. A. Wiemann)
The German Society for Functional Diagnostics and Therapy recommends not only splint therapy for the treatment of CMD, but also other accompanying measures as part of multidisciplinary therapy.
The decisive factor for treatment is whether the CMD is acute or chronic. The aim of the therapy is to eliminate pain and optimize the movement of the lower jaw.
Splint therapy is the initial standard dental measure. Occlusal splints have proven themselves clinically and are recognized by scientific studies. Not every cracking noise can be treated with a splint. Therefore, the cracking noises are repeated and the resulting suspected diagnoses and therapies are discussed. Jaw exercises are demonstrated and explained in relation to the diagnoses. Orthodontic treatment options are explained. In this context, an introduction to MRI diagnostics of the temporomandibular joint is given.
The treatment of chronic CMD follows other principles. The treatment principles for chronic diseases apply here. This course provides an overview of the differences between acute and chronic CMD and the corresponding treatment principles.
Multidisciplinary therapy is fast and highly effective because the structural-functional disorders can be resolved at their root causes.
This is based on the current DGFDT scientific communication on the treatment of CMD. The documentation, information and due diligence obligations in the context of functional diagnostics and therapy are discussed in detail.

Supplementary functional diagnostics: Instrumental functional analysis (Zebris JMA) and model analysis (Dr. A. Diehl, F. Birkholz)
Instrumental functional analysis complements temporomandibular joint diagnostics. All degrees of freedom of movement of the lower jaw can be recorded with the examination. Together with the model analysis, this provides further information for treatment planning.
The dynamic recording visualizes the dysfunction and serves to document the initial findings. The measurement should accompany the clinical functional analysis as a follow-up and as a final examination after insertion of the denture for documentation purposes.
The model analysis provides information on the horizontal occlusal plane and the spee curve; both parameters should be optimized as part of functional rehabilitation. The extent to which patient-specific influencing factors must be taken into account in the design of the denture must be examined.
A therapy plan is drawn up after the evaluation. Treatment options include snap-on splints, occlusal splints, long-term temporaries and the planning of definitive dentures.

Holistic CMD and structural influences (Dr. A. Diehl, Dr. U. Janenz, M. Germer, K. Dams, S. Wedekind)
In this course, the focus is on structural influences. The human organism functions according to movement and posture patterns in which the entire organism is involved. The medical history reveals restrictions based on surgical procedures, accidents and pregnancies, among other things.
The focus is on topographical anatomy and fascia. Fascia is an omnipresent connective tissue network that spatially organizes, supports, shapes and holds the body together to achieve the desirable biological principles of balance, comfort and economy.
The nuchal receptor field – also known as the suboccipital sensory field – conveys the relative position between the head and trunk to the brain stem. It is characterized by a high density of receptors. Proprioception involves the depth sensitivity and the vestibular organ. The “cervico-trigeminal convergence” is the neuronal connection between the temporomandibular joint and the cervical spine and the anatomical connection.
Scars and restrictions can have an ascending influence on the position of the jaw. It must then be determined to what extent it is possible to neutralize these influences or whether the resulting habitual jaw position should be accepted. There are also descending influences. It is widely known that CMD can occur, for example, after the removal of wisdom teeth or in the case of a dysfunctional occlusion, which can cause descending symptoms.
Katja Dams will give a lecture on fascial chains, Dr. Uta Janenz on the neck receptor field and orthopaedic diagnostics and therapy, Sara Wedekind on the basic principles of osteopathy, Marco Germer on chiropractic and Dr. Andrea Diehl on the influencing factor of occlusion and posture.

The centric condylar position – manual adjustment of the temporomandibular joints in centric position
The German Society for Functional Diagnostics and Therapy (DGFDT) defines the centric condylar position as the cranio-ventral, not laterally displaced position of both condyles with physiological loading of the tissue structures involved.
The function of a joint is primarily the movement and execution of complex movement sequences. This requires interaction between the muscular, ligamentous and osseous parts of the joint. The movement patterns, also known as movement stereotypes, are movement sequences that are based on algorithmic muscle activation. Pathological movement sequences deviate from this. The movements of the mandible are jaw opening, jaw closure, protrusion, laterotrusion, the maximum movement capacity was described by Posselt based on the border movement of the lower incisal point.
The positioning of the temporomandibular joints in the centric condylar position is shown in this course. Acupuncture and manual and osteopathic techniques are used to move the temporomandibular joints into a centric position. If a discrepancy between centric and habitual occlusion is diagnosed, we show how centric occlusion can be stabilized, e.g. with snap-on splints, tabletops or grinding. The therapy is supported by jaw exercises.

Holistic CMD and mental influences (Dr. A. Diehl, Dr. W. Nickel, S. Kleinschmidt)
Taking a medical history and explaining the clinical picture and treatment options for CMD are very important when talking to the patient. In particular, more attention is being paid to raising awareness of the clinical picture of CMD.
The German Society for Functional Diagnostics and Therapy (DGFDT) recommends psychosocial screening, which includes tests for psychological co-factors. They offer an opportunity to raise awareness of patient-specific problems in the context of primary diagnostics. A distinction is made between screenings for the diagnosis of complaints and for psychosocial influencing factors. The questionnaires recommended by the DGFDT are presented and explained for both areas. The medical history form according to “Türp and Marinello” is also presented.
The differences between stress and trauma and their symptoms are shown. Stress-related CMD is treated differently to trauma-associated CMD. Post-traumatic stress disorder (PTSD) often causes chronic muscle tension and neck pain. The clinical picture is discussed and treatment options are presented.
There will be a practical exercise day with Susanne Kleinschmidt, who will introduce techniques from yoga and body therapy. Dr. Nickel will talk about the connection between emotions and body tension as well as possibilities of emotion regulation and Dr. Andrea Diehl about diagnostics, screenings and documentation in the context of CMD treatment.

Holistic CMD and visceral influences (Dr. A. Diehl, B. Conte, P. Lehman)
The treatment of chronic CMD is subject to the treatment principles for chronic diseases. Patients with chronic CMD have at least one other complaint.
Diet and digestion also have an influence on posture. Obesity, food allergies or intestinal dysbiosis change posture and can therefore influence the position of the temporomandibular joint. Therefore, intestinal cleansing or the detection of a food intolerance, as adjuvant therapy, can be a support for pain therapy. Applied kinesiology offers the possibility of obtaining an indication of intestinal dysbiosis or a food allergy or intolerance.
In this course, conventional medicine and complementary medicine are repeated and combined to form a successful diagnostic and therapeutic concept. The focus is on the development of a successful individual treatment concept to restore craniomandibular function.
Birgit Conte will explain and demonstrate bioresonance therapy; Petra Lehmann will present singing bowl massage.

Collegial final discussion (Dr. Diehl)

Handing over of the certificates

Topic: Basic course CMD – Theory and diagnosis of craniomandibular dysfunction

Speaker: Dr. Diehl

Course date: Fri 19.01.2024 from 12:00 – 18:00 o’clock

Reachability on the day of the course: 0176 46545215

Venue: Practice Dr. Andrea Diehl zahnMedic, Marburger Str. 2, 10789 Berlin

Route planner Google Maps (external link)

Topic: Basic course CMD – Theory and diagnosis of craniomandibular dysfunction

Speaker: Dr. Diehl

Course date: Fri 26.01.2024 from 12:00 – 18:00 o’clock

Reachability on the day of the course: 0176 46545215

Venue: Practice Dr. Andrea Diehl zahnMedic, Marburger Str. 2, 10789 Berlin

Route planner Google Maps (external link)

Topic: Treatment of CMD – splint therapy and adjuvant therapies

Speaker: Dr. Diehl

Course date: Fri 16.02.2024 from 12:00 – 18:00 o’clock

Reachability on the day of the course: 0176 46545215

Venue: Practice Dr. Andrea Diehl zahnMedic, Marburger Str. 2, 10789 Berlin

Route planner Google Maps (external link)

Topic: Treatment of CMD – splint therapy and adjuvant therapies

Speaker: Dr. Diehl

Course date: Fri 23.02.2024 from 12:00 – 18:00 o’clock

Reachability on the day of the course: 0176 46545215

Venue: Practice Dr. Andrea Diehl zahnMedic, Marburger Str. 2, 10789 Berlin

Route planner Google Maps (external link)

Topic: Supplementary functional diagnostics: Instrumental functional analysis (Zebris JMA) and model analysis

Speakers: Dr. Diehl, ZMT Birkholz

Course date: Fri 15.03.24, 12:00 – 18:00

Reachability on the day of the course: 0176 46545215

Venue: Practice Dr. Andrea Diehl zahnMedic, Marburger Str. 2, 10789 Berlin

Route planner Google Maps (external link)

Topic: Holistic CMD and structural influences

Speakers: Dr. Diehl, Dr. Dams, Mr. Germer, Dr. Janenz, Ms. Wedekind

Course dates: Fri 12.04.24, 12:00 – 18:00 and Fri 19.04.24, 12:00 – 18:00

Reachability on the day of the course: 0176 46545215

Venue: Practice Dr. Andrea Diehl zahnMedic, Marburger Str. 2, 10789 Berlin

Route planner Google Maps (external link)

Topic: The centric condylar position – manual adjustment of the temporomandibular joints in centric position

Speaker: Dr. Diehl

Course dates: Fri 26.04.24, 12:00 – 18:00

Reachability on the day of the course: 0176 46545215

Venue: Practice Dr. Andrea Diehl zahnMedic, Marburger Str. 2, 10789 Berlin

Route planner Google Maps (external link)

Topic: Holistic CMD and mental influences

Speakers: Dr. Diehl and Fr. Kleinschmidt on 31.05.2024, Dr. Diehl on 07.06.2024

Course dates: Fri 31.05.24, 10:00 – 16:00 and Fri 07.06.24, 12:00 – 18:00

Reachability on the day of the course: 0176 46545215

Venue 31.05.2024: me myself and yoga, Forststraße 10, 12163 Berlin-Steglitz

Route planner Google Maps (external link)

Venue 07.06.2024: Practice Dr. Andrea Diehl zahnMedic, Marburger Str. 2, 10789 Berlin

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Topic: Holistic CMD and visceral influences

Speakers: Dr. Diehl on 21.06.2024, Dr. Diehl and Ms. Conte and Ms. Lehmann on 28.06.2024

Course dates: Fri 21.06.2024, 12:00 – 18:00 and Fri 28.06.2024, 12:00 – 18:00

Reachability on the day of the course: 0176 46545215

Venue: Practice Dr. Andrea Diehl zahnMedic, Marburger Str. 2, 10789 Berlin

Route planner Google Maps (external link)

Course dates

Basic CMD course – theory and diagnosis of craniomandibular dysfunction
Fri 19.01.24, 12:00 – 18:00

Basic CMD course – theory and diagnosis of craniomandibular dysfunction
Fri 26.01.24, 12:00 – 18:00

CMD therapy – splint therapy and adjuvant therapies
Fri 16.02.24, 12:00 – 18:00

CMD therapy – splint therapy and adjuvant therapies
Fri 23.02.24, 12:00 – 18:00

Supplementary functional diagnostics: Instrumental functional analysis (Zebris JMA) and model analysis
Fri 15.03.24, 12:00 – 18:00

Holistic CMD and structural influences
Fri 12.04.24, 12:00 – 18:00

Holistic CMD and structural influences
Fri 19.04.24, 12:00 – 18:00

The centric condylar position – manual adjustment of the temporomandibular joints in centric position
Fri 26.04.24, 12:00 – 18:00

Holistic CMD and mental influences
Fri 31.05.24, 10:00 – 16:00

Holistic CMD and mental influences
Fri 07.06.24, 12:00 – 18:00

Holistic CMD and visceral influences
Fri 21.06.24, 12:00 – 18:00

Holistic CMD and visceral influences
Fri 28.06.24, 12:00 – 18:00

Course details

Seminar: FOBI-CF-CMD
Course: 2401
Target group: Dentists
Points: 84+15
Course fee: 3.650,- €
Moderation:
Dr. Andrea Diehl
Speakers: MDT Florian Birkholz, alternative practitioner Birgit Conte,
Physiotherapist Katja Dams, Dr. Andrea Diehl, Marco Germer, Dr. Uta Janenz, Susanne Kleinschmidt, Petra Lehmann, Dr. Wolf-Richard Nickel, Sara Wedekind, Dr. Annette Wiemann