Bausch Articulating Papers - Janouch Dental

The Cranio Mandibular Dysfunction (CMD)
The term Cranio Mandibular Dysfunction (CMD) describes typical pain symptoms, such as pain
within the area of the temporomandibular joint, headache, neck and shoulder pain. One of the
causes of CMD can be an incorrect or long-lasting habitual occlusion.
The frequently diagnosed clicking noise of the patient’s temporomandibular joint can normally be
attributed to uncoordinated muscle structure of the masticatory system. In the majority of these
cases, only the temporomandibular joint is considered instead of the intrinsic causes of the
uncoordinated muscle system.
If a patient at this stage is not being treated, The Cranio Mandibular Dysfunction syndrome
manifests itself, after some time, as a genuine TMJ syndrome. Therefore it is very important to
diagnose the difference between arthrological and neuromuscular problems before starting the
treatment. The condition of CMD patients improves rapidly after the neuromuscular and occlusal
equilibration is restored.
“CR” means Centric Relation
“CO” means Centric Occlusion
CR-Position
CO = CR
Fig. 1 Fig. 2
The physiological working position of both
condyles on the posterior slope of the articular
eminentia, in their furthest superior and
anterior position that is not laterally displaced
and in close contact with the thinnest central
loading surface of the articular disc.
All teeth in the mouth should occlude evenly
(CO position) when the condyles are in their CR
position.
These patients have permanently induced occlusal contact in maximum intercuspation
(CO) (Fig 2.) Wear facets and cervical lesions become typical indicators for these parafunctions.
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