asymmetry from different studies in Spain, the Netherlands and Australia it has been even more important for my clinical activity that occlusion plays the important role in the treatment of CMD when the condylar asymmetry is the morphologic reason for an asymmetrical abuse of the stomatognathic system. In our patients with a condylar asymmetry it is of upmost importance to normalize the function of supporting masticatory muscles and asymmetrical temporomandibular joints. Therefore the correct registration of the retruded position of the mandible is the crucial point in all dental therapy. The only way to stabilize such a mandibular position is through occlusal therapy. However, irreversible approaches in form of occlusal adjustments, orthodontics and prosthodontics should not be applied until successful outcome of the reversible application of splint has proven its beneficial effect. Thus, in my opinion occlusion plays an important role in the THERAPY of CMD.
Wo liegen wann die Schwerpunkte der Diagnostik und Therapie? The most important part in diagnostics and the most important part for the therapeutical success is to initially differentiate between origin of pain. Any attempt in therapy must be directed towards the origin of pain. Myogenous origin of pain deserves quite another attention than arthrogenous origin of pain. Alfhoug the ingredients of treatment may be similar the timing of their appiications is different for the two origins of functional pain.
Wie wichtig ist die Physiotherapie bei CMD? CMD with the differential diagnoses of either HYPERMOBILITY, HYPOMOBILITY, BRUXISM or ABUSED PROTRUSION cannot be treated without physicai therapy. Muscie strengthening, muscie relaxation, posture training, increase of awareness of parafunctional activities are all modalities which need time and practice. Dental treatment initially, or even worse, alone is doomed to fail. Without the knowledge from a trained physicai therapist it is my opinion that the above-mentioned conditions should not be touched.
Ist Schienentherapie nicht eine physiotherapeutische Massnahme? The splint influences muscie- and joint function and so does physicai therapy. However, 채s the splint is positioned inside the mouth and applied to the teeth it seems correct to ascribe the splint therapy to a modality of dental treatment. Besides, the difference in education and in level of education between the two professions makes the splint therapy belonging to dentistry. This does not exclude that a physicai therapist may be famili채r with the purpose of the different splints. However, the indications for their appiications, fabrication, insertion and adjustment are the responsibility of the dentist.
'.5^5 GRUPPE .