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For radiologists

We are not looking for referrals. We are looking for an imaging partner.

This page is the only one in this section that runs the other way. For all other specialties, it is about when you send someone to us. Here it is about whom we send to you – and with what question.

Why we approach you first

Radiologists are not among the usual referrers to a CMD clinic. But of all the specialties, you have the greatest expertise on the temporomandibular joint – and the only view of it that does not depend on palpation, feel and description.

We do not need this view to support diagnoses we make anyway. We need it to check whether our therapy does what we claim it does.

The question

Four imaging situations, one question

Does neuromuscular repositioning change the position of condyle and disc – and does the change persist over time?

Baseline

  • Without splint, in habitual intercuspation
  • With splint, in therapeutic position

Follow-up

  • The same two situations after a defined interval
  • Dynamic, where technically available

Why dynamics make the difference. A still image shows a position, not a function. Real-time MRI currently provides moving images of condyle and disc at up to ten frames per second at 0.75 mm resolution. Only then can the question at stake be answered at all: does the disc move along – or is it overridden?

What the data support

We know the weakness of the still image. It is the reason for this project.

  1. 01Measured

    MRI remains the reference standard – and alone does not justify a treatment decision

    Disc displacement occurs in asymptomatic people too and correlates only weakly with pain and function; the reliability of reporting is limited. Deriving treatment from a single still image overstretches the finding. Reviews on MRI diagnosis of disc displacement.

  2. 02Our approach

    That is exactly why we compare before and after

    What a cross-sectional image cannot do, comparing the same person with themselves can: it does not measure whether a position is “normal”, but whether something changes under a defined intervention. This is the only design in which imaging is suitable as a measure of efficacy for this condition.

  3. 03Where the evidence ends

    Where the evidence ends

    According to current data, instrumental movement recording (jaw tracking) has no proven diagnostic value for detecting CMD. For computer-aided axiography there is a counter-position – a sensitivity of about 85 % for disc displacement compared with MRI. We list both, because one of them argues against our own measurement technology.

    According to the S2k guideline, instrumental functional analysis is explicitly not a method of pain assessment and builds on clinical functional analysis. This is stated here too, because it limits our own diagnostics. And the core question of this project is open – which is why we are asking it.

Collaboration

What we provide and what comes back

From us

  • A clear, one-line question per scan
  • Clinical findings according to DC/TMD, so the image has context
  • The therapeutic position, documented and reproducible
  • Appointment windows for follow-up, planned in advance

From you

  • A report in your usual form – no special format
  • Explicitly also: “no change detectable”

We mean the last point seriously.

A project that only tolerates confirming findings is not a test. We expect null findings and want to see them.

Next steps

Three routes – your choice

  • 01

    I want to know more

    Examination protocol, questions in full and the sources in full text.

    Request documents
  • 02

    I have a technical question

    On the sequence, positioning, reproducibility of the therapeutic position.

    Ask a question
  • 03

    I am interested in collaborating

    A conversation in which we go through the protocol together – by phone, email or at your practice.

    Get in touch

Other specialties

To the overview