We are not looking for referrals. We are looking for a place to measure.
This page is the only one in this section that runs in the other direction. For all other specialties it is about when you send someone to us. Here it is about whom we send to you – and with which question.
Why we approach you first
Radiologists are not among the usual referrers to a CMD clinic. Of all the specialties, however, they have the greatest expertise on the jaw joint – and the only view of it that does not depend on palpating, feeling and describing.
We do not need this view to support diagnoses that we make anyway. We need it to check whether our therapy does what we claim it does.
Four imaging situations, one question
Does a neuromuscular repositioning change the position of the condyle and disc – and does the change persist over time?
Baseline
- without splint, in habitual intercuspation
- with splint, in the 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. According to the current state of the art, real-time MRI delivers moving images of the condyle and disc at up to ten frames per second with 0.75 mm resolution. Only this makes it possible to answer the question that matters at all: does the disc move along – or is it overridden?
We know the weakness of the still image. It is the reason for this project.
MRI remains the reference standard – and on its own does not support a treatment decision
Disc displacement also occurs in people without symptoms and correlates only weakly with pain and function; the reliability of reporting is limited. Anyone who derives a treatment from a single still image overstretches the finding. Reviews on MRI diagnosis of disc displacement.
Which is exactly why the before-and-after comparison
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. That is the only design in which imaging is suitable as a measure of efficacy for this condition.
Where the evidence ends
According to current data, instrument-based motion recording (jaw tracking) has no proven diagnostic value for detecting CMD. For computer-assisted axiography there is an opposing position – a sensitivity of around 85 % for disc displacements compared with MRI. We report both figures, because one of them speaks against our own measurement technology.
According to the German S2k guideline, instrumental functional analysis is expressly not a method of assessing pain and builds on clinical functional analysis. That 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.
What we provide and what comes back
From us
- a clear, one-line question for each scan
- clinical findings according to DC/TMD, so that the image has a 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 including: “no change detectable”
We mean the last point seriously. A project that only tolerates confirming findings is not a review. We expect null findings and want to see them.
Three routes – you choose
I want to know more
Examination protocol, the questions word for word and the sources in full text.
I have a technical question
About the sequence, positioning, or the reproducibility of the therapeutic position.
I am interested in collaborating
A conversation in which we go through the protocol together – by phone, by e-mail or at your practice.