The objective of Craniomandibular Function Center (CMFC) is to expand the activity in scentific studies and development of technologies in craniomandibular area by establishing necessary infrastucture. Project realization has proceeded with founding a specialized digital dental scientific research and technology development (SRTD) laboratory, which allow new workplaces for SRTD researchers and auxiliary staff in creation of popular, relevant, inovative and unique methods of prophylaxis, diagnostics and treatment of craniomandibular disorders and active participation in developing new methods in digital dentistry.
The project was partially financed from EU Structural Funds.
CMFC in collaboration with Lithuanian and foreign universities and scientific laboratories plans applied scientific studies and technological development.
Created SRTD infrastructure, permanent observation of world digital odontology tendencies, participation in international odontology events, scientific research and publishing, visiting odontological technology exhibitions, co-operation with leading odontology research centers and communication with modern equipment producers make assuptions in solving digital odontology problems. Digital odontology is fragmented, still in scientific and applied research stage: there is no sequential technological chain and universe method from diagnostics to final result in investigation of function using digital technologies. Therefore there will be performed different applied research on digital systems in creating methods for diagnostics and treatment of craniomandibular disorders.
Scientific Research Centre is also a basis for training of Lithuanian and foreign dentists, who will be able to improve their knowledge in individual courses, seminars and conferences.
Successful realization of the project has lead to the development and adjustment of new treatment technologies with positive result for target market: primarily – Lithuanian people health minimizing the risk of craniomandibular disorders. Activity of SRTD will contribute with improvement of inovative enviroment in Lithuanian private sector, increase an establishment of new science based technologies and new added value generating activity, based by science, knowledge and high technologies.
Project is a long-term constant collaboration with Lithuanian and foreign scientific researches, high technology companies in developing new science and business relations.
THE DENTAL CARE CLINIC UAB “AUKŠTĖJA” HAS ESTABLISHED THE CRANIOMANDIBULAR FUNCTION APPLIED RESEARCH CENTRE, THE FIRST OF SUCH A KIND IN EASTERN EUROPE
The Dental Care Clinic UAB “Aukštėja” has won the competition under Measure “VP2-1.3-ŪM-03-K Intellect LT+”, Priority 1st “Research and Technological Development for Competitiveness and Growth of the Economy” within the Operational Programme for the Economy Growth 2007-2013, and has implemented the project “Establishment of the Craniomandibular Function Applied Research Centre at ‘Aukštėja’, UAB” partially financed by the EU Structural Funds.
In the course of the project, UAB “Aukštėja” has founded the Craniomandibular Function Applied Research Centre, the first of such a kind in Eastern Europe, that will focus on realisation of the planned Scientific Research and Technology Development (SRTD) activities designed for elaboration of unique treatment methods of a masticatory system. In the process of implementation of digital dentistry research, “Aukštėja” Clinic has been cooperating with Lithuanian, German and Italian dental research centres and major producers of medical devices. The new treatment methods will be commercialised in Eastern Europe and Kazakhstan. Due to spread of the techniques worked out at the Research Centre, UAB “Aukštėja” will be able to gain a stronger competitive advantage in the state-of-the-art field of medicine, i.e. digital dentistry, thereby entering the new services export markets based on advanced technologies.
The project is a long-time programme in terms of continuous cooperation with Lithuanian and foreign research and studies institutions and high-technology companies involved in development of modern medical devices.
The SRTD infrastructure worked out during the project is applied for implementation of the predesigned SRTD projects. Succession of the project will also be supported by the fact that managers of the company has already planned marketing and commercialisation activities with respect to the new treatment methods developed on the base of the SRTD, thereby ensuring long-term viability of the project. The added value of the project will be demonstrated by the following key dimensions:
- Results of the planned activities will increase competitiveness, sales and export of the company;
- Long-term workplaces for SRTD researchers will be available;
- Services export (inbound curative tourism) will be encouraged;
- New business and scientific relations with Lithuanian and foreign scientific institutions will be made.
CMD is a systemic disease of the Craniomandibular Feed-Back-System, a disease of the muscles and nerves of the head-shoulder region. (G. Risse)
CMD – Symptoms
Do you suffer from one or more of the listed symptoms and have specific or organic causes been excluded, then you may suffer from the so-called Craniomandibular Dysfunction – CMD, named “Costen Syndrome” too; Costen was the first to diagnose this complex disease, 1934.
- Headaches in the temples region
- Headaches in the area of forehead and eyes
- Headaches in the back of the head, possibly extending to the shoulders
- Pain in the mandibular jaws
- Clicking of the mandibular jaws
- “Full ears”
- Pressure on the eyes, sensitivity to light
- Pain in the neck, shoulder and back/ tensions
- Trigeminus pain
- Dizzy spells, vertigo, nausea
- Loss of concentration
Craniomandibular disorders (CMD), their relevance to different disciplines of odontology (general dentistry, surgery, orthodontics, prosthodontics, dental technicians) and overlap with neurology, otolaryngology, osteopathy and other branches of medicine have been a highly debated topic. Numerous articles in scientific literature regarding the importance and necessity of interdisciplinary teamwork in dentistry were announced.
CMD is difficult to define. For example, Luther used the term CMD to refer to the variety of symptoms, signs, and combinations that have been assigned to the TMJ and its related structures. Dibbets and van der Weele commented that many different definitions of CDM dysfunction have come into existence and consequently, even in a single individual the diagnosis of TMJ dysfunction depends on the definition used. The term “craniomandibular disorders” (or CMD) refers to a group of neuromuscular conditions occurring in the temporomandibular region. These conditions are characterized by pain in the mastication muscles and in the TMJ, or both (Okeson and de Leeuw). These perturbations contribute to the deterioration of the quality of life of patients as well as their social functioning.
The disorder is multifactorial with a degree of psychogenic influence varying throughout an individual’s life with phases of symptoms affecting the quality of life. In an attempt to treat this complex group of disorders, several psychophysiological and psychological accounts have been proposed, but none of them was able to clearly elucidate a direct correlation with CMD (Michelotti and Iodice).
An examination of the review of the literature on craniomandibular disorders reveals that approximately 75% of the population has at least one sign of CMD (abnormal jaw movement, joint noises, tenderness on palpation, etc.) and approximately 33% have at least one symptom (facial pain, joint pain, etc.). According to Saghafi and Curl, an estimated 85 to 95% of the population will exhibit one or more symptoms of CMD in their lifetime with 5 to 6% of the population reporting clinically significant CMD related jaw pain. CMD affect children, adolescents, and adults. Egermark-Eriksson et al. found that CMD are present in 16–25% of children, 30% of adolescents, and 60% of adults.
The etiology and pathophysiology of CMD are poorly understood; If the multifactorial aspect of the disorder is no longer a subject of inquiry, the role of different factors in CMD is still unclear and is yet to be elucidated.
For several decades, the claim that occlusion plays a significant causal role in CMD has been debated and a substantial body of literature that investigates this issue has seen the light. The belief in this causal relationship was originally based on direct clinical observation. Recently, a number of researches have challenged this view, claiming that existing scientific literature “does not support” this hypothesis. Researchers such as Luther, John et al., and Badel et al. did not find any strong support for an occlusal etiology of CMD, at least not as a unique or dominant factor. Pullinger and Seligman estimated that the contribution of occlusion to CMD is minimal and in most cases does not exceed 10–20%. They further suggested that the role of occlusion in TMD, quite apart from the issue of causation, might be more related to its potential as a perpetuating factor. The causative association between dental occlusion and TMJ remains an open question to be discussed in the scientific world of dentistry.
Traditionally it was believed that these disorders could be treated through gnathological occlusal principles mainly using bite splints. However, there are fundamental differences between gnathological and neuromuscular approaches in therapy when addressing the needs of patients who present with the numerous signs and symptoms that compromise the craniomandibular dysfunctional patient. Therefore, a new approach, referred to as the biopsychosocial model, came into existence; it is more scientific and widely accepted by the dental scientific community since its explanations rest on a medico-cognitive approach.
Which reference to choose during treatment especially in the presence of CMD? This issue has attracted considerable controversy during last decade.
Centric relation concepts have largely been replaced by neuromuscular dentistry concepts that are considered far more physiologic. Every individual has a position appropriate to him, and there is no single position of “normal” centric relation [Rinchuse DJ, Kandasamy S]. In her/his treatment, the dentist must adopt a mandibular reference adapted to his patient and which best respects the balance existing in the stomatognathic system.
It is obvious that symptoms of craniomandibular dysfunction spread further from odontology and overlap with neurology, otolaryngology, osteopathy and other branches of medicine, therefore work in team is especially important for precise craniomandibular disorders diagnostics, treatment and rehabilitation.