Matthias Fink

The Functional Relationship Between the Craniomandibular System, Cervical Spine, and the Sacroiliac Joint: A Preliminary Investigation

ABSTRACT The hypothesis of a functional coupling between the muscles of the craniomandibular system and the muscles of other body areas is still controversial. The purpose of this pilot study was to examine whether there is a relationship between the craniomandibular system, the craniocervical system and the sacropelvic region. To test this hypothesis, the prevalence and localization of dysfunction of the cervical spine and the sacroiliac joint were examined in a prospective, experimental trial. Twenty healthy students underwent an artificial occlusal interference, which caused an occlusal interference. The upper cervical spine (C0-C3) and the sacroiliac joint were examined before, during and after this experimental test. The primary outcome with these experimental conditions was the occurrence of hypomobile functional abnormalities. In the presence of occlusal interference, functional abnormalities were detected in both regions examined and these changes were statistically significant. The clinical implications of these findings may be that a complementary examination of these areas in CMD patients could be useful.

Asymptomatic Cervical Spine Dysfunction (CSD) in Patients with Internal Derangement of the Temporomandibular Joint

ABSTRACT Patients with temporomandibular disorders (TMDs) frequently show symptoms related to the cervical spine. It is however unknown whether patients with TMD who have no symptoms in the neck region often have signs of cervical spine dysfunction (CSD) and whether there is a predominant localization of these asymptomatic CSDs. In a prospective and controlled examiner-blinded clinical trial, the prevalence and localization of asymptomatic CSD in patients with TMD was examined. Thirty patients with internal derangement of the temporomandibular joint but without any neck problems were compared with 30 age and gender matched healthy controls. Significantly more asymptomatic dysfunctions of the vertebral joints and increased muscle tenderness were found in the patient group. The difference between patients and nonpatients for vertebral joint dysfunction and muscle tenderness was greatest in the upper cervical spine. These findings support the thesis that a complementary examination of this area should be performed, even when TMD patients do not report any neck problems.

Medical and Physical Therapy of Temporomandibular Joint Disk Displacement without Reduction

ABSTRACT The objective of this study was to determine the influence of medical and physical therapy on long-term treatment outcome in 72 patients with anterior disk displacement without reduction. Patients were treated solely with occlusal splints (group I), with splints and supplementary medical therapy (group II), with splints and physical therapy (group III) or with splints, medical, and physical therapy (group IV). After therapy, the maintenance of improvement was objectively and subjectively assessed with an extensive clinical examination and a postal questionnaire. The percentage of pain free patients after therapy was 76% in group I, 88% in group II, 43% in group III, and 65% in group IV. There was a statistically significant higher increase of maximum jaw opening after therapy in group II than in the control groups (p<0.05). The improvement in mouth opening came to 9.7 mm in group I, 14.5 mm in group II, 7.3 mm in group III, and 11.2 mm in group IV. Medical therapy seems to have a positive influence on the treatment outcome of patients with anterior disk displacement without reduction.

Angewandte Kinesiologie in Medizin und Zahnmedizin: eine kritische übersicht

SummaryThe “Applied Kinesiology” evolved in the USA is increasingly being used in Central Europe. In this review the development of the method and its practical application in medicine and in dentistry are elucidated. Furthermore, the propagation of the method by the International College of Applied Kinesiology (ICAK) and the “Touch for Health” (TFH) is described. School medicine’s criticism of applied kinesiology as well as the methodological replies from “Applied Kinesiologists” are outlined. It is important to realise that there is to date a lack of evidence for the effectiveness, validity and reliability of applied kinesiology. The following requirements are thus vital: applied kinesiologists must develop clear criteria for single subgroups of applied kinesiology, prove the effectiveness of their methods, and explain their findings in agreement with current medical knowledge.ZusammenfassungDie in den USA entwickelte „angewandte Kinesiologie“ findet zunehmend auch in Mitteleuropa Anwendung. In dem Übersichtsartikel wird die Entwicklung der Methode, die Vorgehensweise in Medizin und Zahnmedizin sowie die Verbreitung durch das International College of Applied Kinesiology (ICAK) und die „Touch for Health“-(TFH-)Bewegung dargestellt. Auf die Kritik der Schulmedizin an der angewandten Kinesiologie wird ebenso eingegangen wie auf die Kritik der „Kinesiologen“ an schulmedizinischen Studien zur Überprüfung der Kinesiologie. Es muss festgestellt werden, dass es bisher keinen befriedigenden wissenschaftlichen Nachweis für die Wirksamkeit der angewandten Kinesiologie gibt. Daraus leiten sich folgende Forderungen an die Kinesiologen ab: klare Definitionen zu erarbeiten, die es ermöglichen, die vielen Gruppen und Subgruppen der Kinesiologie eindeutig zu identifizieren und von einander abzugrenzen, wissenschaftliche Nachweise für die Wirksamkeit der einzelnen Vorgehensweisen zu erbringen und die von der angewandten Kinesiologie beschriebenen Phänomene mit anerkanntem medizinischem Wissen in Einklang zu bringen.