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- Dr. Georg Risse - Raesfeldstraße 15 - 48149 Münster - 
- Tel. 0251-294959 -

CMD Orthodontics / TMD-Orthodontics

CMD-Orthodontics - The Orthodontics With Medical Indication
CMD-Orthodontics - The Interdisciplinary Medicine
CMD-Orthodontics - The Next Step In - Evolution of Orthodontics

Definition of Craniomandibular Dysfunction

CMD is a systemic disease of the Craniomandibular Feed-Back-System, a disease of the muscles and nerves of the head-shoulder region. It is mainly caused by malpositioned and malinclined teeth with resulting dysfunction during masticatory activities and swallowing. (G. Risse)

Definition of CMD-Orthodontics, TMD-Orthodontics

  • CMD-Orthodontics / TMJ-Orthodontics is a new and extended definition of orthodontics under special consideration of Craniomandibular Dysfunction, CMD / TMD, consequently fallowing the guidelines of Bio-Functional Orthodontics, BFO, described in short in the article:
    “Functional Anatomy vs. Straight-Wire-Anatomy”, G. Risse, Torino 2007
  • All forms of orthodontic techniques not following the guidelines of Biofunctional Orthodontics, BFO, 2007 do not fulfil the required standard for quality based treatments and prevention of CMD / TMD.
  • CMD / TMD- Orthodontic is the basis for future dental care

Guidelines of New Orthodontics and CMD / TMD Orthodontics
"Functional Anatomy vs. Straight-Wire-Anatomy”, G. Risse, Torino 2007

Percentage of CMD / TMJ-diseases of U.S.-population

  • "Originally it was estimated that over 20% of the average population have symptoms relating to the temporomandibular apparatus at one time or another. This percentage now has increased to over 50%, since more and more symptoms are being connected with this craniomandibular, or temporomandibular,area."
    [Douglas.H. Morgan, Leland R. House, William P. Hall, S.James Vamvas:
    Diseases of the temporomandibular apparatus, Mosby,1982]

  • CMD is present already at childhood by 5% - 8%, extending progressively in complexity and severity.

  • The President of the German Board of Dentistry, Prof. Dr. Meyer,
    2004 informed the public:
    “Between 25 – 40 % of 6 – 18 years old children with wrong positioned teeth or malocclusion suffer by latent inflammatory signs in the region of the temporomandibular joints, TMJ. The patient is realizing these hidden processes in their full spreading too late, mostly as pain in the different regions of the masticatory system.
    It is an imperative duty of dentistry and orthodontics to translate these findings into dental / orthodontic / medical action. An offence against these scientifically accepted standards of quality may be judged as malpractice by court.”

  • CMD may result into a severe disease up to disability for work, and by this CMD becomes a severe problem for social income and health insurances.


  • "CMD" means: Craniomandibular Dysfunction / Disease

  • "Cranium" means: The whole skull

  • "Mandibula" means: The lower jaw

  • "Dysfunction" means: Disease

  • "TMJ's means: Temporomandibular Joint Diseases and Disorders
    [Americand Dental Association, Vol 127, July 1996, Dr. Harold Slavkin]

  • " TMJ's" is an umbrella term for: TMD, TMJ, TMJ-Syndrom and for CMD. [Wikipedia]

  • "CMD" is the international and scientifically more precise definition for the complex diseases / syndrome caused by occlusal dysfunction.

Action field of CMD

The muscles of mastication and swallowing are in close connection with the muscles of the neck and shoulders. Dysfunction and spasm of masticatory muscles affect directly the function of the muscles of the neck and shoulders up to their severe dysfunction and to slipped discs.

Causal connections

Dysfunction of the dental cogwheels by wrong angulated / inclined / positioned teeth cause their unphysiologic gliding and slipping during action, causing dysfunction and spasm of acting muscles and lever arms for the temporomandibular joints, TMJ, often with slipped discs of the TMJs itself with symptoms of clicking, pain, destruction,tinnitus, nausea. The affected spastic muscles cause severe pain up to different forms of headache and migraines.


CMD /TMJ-Orthodontics, the answer to the "Public Awareness Campain of the American Board of Orthodontics, ABO"

"A brief history of orthodontics", Milton B. Asbell recommended by the ABO :

  • "Changes in the areas of practice include a resurgence of treatment of the adult patient and its concomitant expertise as the public becomes aware of personal dental health and esthetics.

  • Included also are the invasion of areas that had not received much attention in the past, namely, orthognathic surgery and the problems associated with the temporomandibular joint.

  • Orthodontics, and indeed all of dentistry if it is to survive as a profession, must continually reexamine its history and find relevant and significant ideals to meet the crises of today."
    [Am. J. Orthod.Dentofac. Orthop. September 1990,Vol 98, Number3,]


CMD Orthodontics

CMD-Orthodontics is a new complex treatment method to treat Craniomandibular Dysfunction,CMD, or synonyms like "Craniomandibular Disorders" and TMD, "Temporomandibular Disorders" by means of treating occlusal dysfuncton of malinclined teeth and straightened occlusal curve as a centrepiece of CMD or TMD:
The treatment objectives of CMD-Orthodontics are additive to straight teeth and a beautiful smile of common orthodontics the treatment and prevention of medical diseases of the head and shoulders as the prime focus.

By this, CMD-Orthodontics exclusively provides the real medical indication of orthodontics and seriously supports the patient with headaches and pain to avoid or to reduce medication by means of pills.

CMD-Orthodontics provides an individual support for a healthy development and growth of your child in addition.

To treat or avoid all the symptoms of CMD by means of standardized, uniform straight wires and straight wire anatomy of common orthodontics, being in opposition to official Text Book Anatomy, is hard to believe.

The new extended potentialities of CMD-Orthodontics are the result of a new orthodontics, called Bio-Functional Orthodontics, BFO. BFO integrates modern interdisciplinary sciences like System Theory, Biocybernetics, Science of Fuzzy Logic, a new definition of the orthodontic appliance itself as a biomachine consisting of mechanics, teeth and biological reactions on the level of quality-based impulses, individual system loading - beside wire loading - and tooth navigation.

Bio-Functional Orthodontics, BFO, is first class engineering for finest equilibration of the bracket slot size to wire dimensions and their optimal impulse quality to stimulate precisely tooth movement and anchorage control as well.

BFO defines reduced bracket slot sizes down to .016 x .020 inch and wire sizes
down to .010 x .020 inch for individual wire bending.

CMD-Orthodontics and BFO rejects definitvely the application of common orthodontic straight wire anatomy as a basic medical mistake.

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"

  • Tinnitus

  • Pressure on the eyes, sensitivity to light

  • Pain in the neck, shoulder and back/ tensions

  • Trigeminus pain

  • Dizzy spells, vertigo, nausea

  • Loss of concentration

  • "Migraine"

New extended medical definitions of the Disciplines of Dentistry
and Orthodontics

International scientists and official boards of dentistry defined extended medical action fields and responsibility of dentistry and orthodontics . 
More and more it proves, that dentistry and especially orthodontics are the address to treat and prevent all the CMD-symptoms mentioned above causally and successfully.

Craniomandibular System (CMS)

All organs in the head-shoulder region are strongly networked via muscles and nerves by a complex Bio Cybernetic Feed-Back-System. It is called the Craniomandibular System, CMS. (G. Risse)

Organs in the head-shoulder region:

  • Masticatory organ ( teeth, mandibular joints, chewing muscles)
  • Organs of swallowing ( swallowing muscles)
  • Alveolar organ, Parodontium ( sensors)
  • Organ of speech ( speech muscles)
  • Mimic- and contact organs ( mimic muscles)
  • Hearing organ ( ears)
  • Organ of sight (eyes)
  • Olfactory organ ( nose)
  • Central nervous organ ( brain, impulse network via sensors and nerves)
  • The Bio-Cybernetic Feedback-system of the organ of mastication

Craniomandibular Dysfunction (CMD) - Definition

CMD is a systemic disease of the Craniomandibular Feed-Back-System, a disease of the muscles and nerves of the head-shoulder region. It is mainly caused by malpositioned and malinclined teeth with resulting dysfunction during masticatory activities and swallowing. (G. Risse)

CMD - Medicine

CMD – Medicine is the science of the function and dysfunction of the network of the organs in the head-shoulder region. Disorders of these functional connections, the so-called dysfunction, can give way to various forms of chronic pain and diseases.

CMD-Orthodontics – Causal treatment  and prevention of CMD

The aim of every therapy is to treat more the origin of a disease rather its symptoms.
By this, the individual reconstruction of malinclined and malpositioned teeth and their dysfunction is the centrepiece of CMD-Orthodontics. The focus of the discipline of CMD-Orthodontics is to treat Craniomandibular dysfunction on the background of Bio-Functional Orthodontics, BFO. BFO is a new orthodontics by modern sciences of System Theory, Functional Anatomy and Bio-Function, Bio-Functional Mechanics and Bio-Functional Engineering.
As CMD-Orthodontics is treating the origin of the CMD-Syndrome with its complex variety of its single symptoms, CMD-Orthodontics is highly effective and is in the position to provide individual guarantees of success.
CMD-Orthodontics provides the discipline of orthodontics its medical and curative indication – beside optimal aesthetics, as beauty follows optimal function.
CMD Orthodontics saves millions of Dollars to patients and Health Insurance Companies, prevention from loss of working hours.

Background of CMD-Orthodontics:

CMD Orthodontics relies on comprehensive knowledge of:

  • Functional anatomy
  • Age adapted anatomy and function
  • Science of cmd and its origin 
  • Science of bio-function 
  • Science of bio-functional network
  • Science of Bio Cybernetic Feed back
  • Science of System Theory in biology, medicine and physics
  • Science of Bio-Functional Orthodontics, BFO, and its guide lines 
    • Functional Anatomy,
    • Age adapted angulation of teeth and bones
  • Science of Bio-Functional Orthodontic Mechanics
    • Bracket slot size .016 x .020 inch and reduced wire sizes down to .010 x .020 inch
    • Individual wire bending 
    • Light force - / moment-impulses 
    • Individual mechanical orthodontic system construction and system energy and system loading, system navigation
  • Science of Fuzzy logic, Fuzzy Set Theory
  • Science of mechanical System Theory


CMD Orthodontics, a Support for Dentists

CMD-Orthodontics is the ideal pre-treatment for any (expensive) dental operation and restoration, as wrong positioned and wrong angulated teeth mostly are the origin for parodontal diseases, occlusal dysfunction, Temporomandibular Dysfunctions (TMJ) and all the various CMD symptoms. To treat CMD-solely by means of dental restoration is a risky and expensive enterprise. 
A functionally prepared occlusion by Bio-Functional Orthodontics and Functional Anatomy reduces complex liabilities for dental restorations.

Ideal Conditions for CMD

Common Straight Wire Orthodontics means: positioning of teeth in a straight occlusion and inclinations of teeth being in opposition to prescriptions of Official Functional Anatomy, general Dentistry and even against findings of Evolution. A straight occlusion is a characteristic feature of prehistoric hominids. The homo sapiens of today is characterized by an occlusal curve, the so called Curve of Spee / Curve of Compensation.

  • By straightening the occlusal curve, the inclinations of the upper molars are getting wrong, their crowns are drifting forward and downwards. Mesial positioned upper molar crowns force later erupting anterior teeth in young patients to erupt more mesially, causing unnecessary extractions or a prominent facial feature of a prehistoric hominid (Domino-effect).
  • Additionally the axis of the mesial inclined upper molars are loaded diagonal by function instead by an axial loading.
  • A straightening of the Occlusal Curve, Curve of Spee / Compensation Curve cause a lever arm in the molar region with heavy resulting wrong and destructive lever forces for the TMJ, Temporomandibular Joints.
  • Straight Wire Anatomy and their techniques are the ideal precondition for CMD-Dysfunction.
  • Straight wire orthodontics is the worst credible accident in dental education by complex disinformation.
  • Definitions of “Occlusion”

Straight-Wire-Anatomy and Techniques: “A pure nonsense”.

On the Foundation meeting of the IAAID, International Academy of Advanced Interdisciplinary Dentistry, on October 20-21, 2006, Prof. Slavicek defined “Contemporary Orthodontic Straight-Wire-Anatomy and Straight-Wire-Techniques are a pure nonsense, a danger in dentistry.” Many severe, by straight-wire orthodontics mal practiced cases were presented on this meeting. They were successfully treated by a second orthodontic treatment creating a Curve of Spee by means of the Sato-Technique.


The American “Straight Wire Orthodontics” needs a 15 Mill. "Public awareness campaign”, “More Than A Smile”

Officials of the American Association of Orthodontics, AAO, invest millions to convince the public that a trained orthodontist applies a prefabricated, standardized and automated straight wire better than a general dentist: 
“The campaign emphasizes that ‘orthodontists receive an additional two to three years of specialized education beyond dental school to learn the proper way to align and straighten teeth’.” Up to now CMD–Orthodontics is not mentioned by this campaign.
The main guideline of Common Orthodontics is aesthetics and to align teeth on a (straight) wire for a prehistoric straight occlusion. It will be hard to explain the public the curative, medical effect of an orthodontics with prehistoric anatomy and insufficiently controllable standardized straight wire techniques.

Informed consent

In not informing the patient of Official Functional Anatomy and the danger for CMD by occlusal disharmony, increased extractions and insufficiently controllable Ni Ti-wires means a worthless “informed consent” and means bodily harm. 

New additional education

The Institute of Craniomandibular Dysfunction, ICMD, provides seminars and lectures for orthodontists, dentists and general medical doctors.
Orthodontists need a profound new education in interdisciplinary sciences with a final examination, as common orthodontics on the level of Straight Wire Anatomy and Straight Wire Techniques are highly against guidelines of Functional Anatomy, biological legislations and any kind of modern sciences. By this, Common Orthodontics is misleading in various forms, being the possible source of CMD in many cases. Many young and adult patients with CMD after Common Orthodontic treatment can be treated by CMD Orthodontics on the level of Bio-Functional Orthodontics, BFO, successfully.

Design your future

Design the future of your office and meet the needs of patients.
The new medical orientation of Orthodontics towards therapy of Craniomandibular Dysfunction, CMD, by CMD Orthodontics - beside "straightening teeth" - provides an entirely new market of medicine, combined with interdisciplinary advisors and cooperators and new patients.
By CMD-Orthodontics you are treating different forms of pain and diseases of the head and shoulders by correcting dental and occlusal dysfunction individually and precisely by fixed biofunctional mechanics, BFO, Bio-Functional Orthodontics.
CMD-Orthodontics is focussing the market of headache, migraines and all the symptoms of CMD, listed above.
CMD –Orthodontics and Bio-Functional Orthodontics, BFO, as well, are the next steps into interdisciplinary medicine and the next steps of orthodontic Evolution.


The angulation of upper 1st permanent molars, 
the key to functional occlusion
(G. Risse)

Centrepiece in Orthodontics / Dentistry

Are the upper first molars, the first erupting permanent teeth, angulated (inclinated) with their crowns too much mesially, all other later erupting teeth are forced to erupt too much mesially too, with wrong angulations, wrong function, too much protruded centrals, or missing space for canines and unnecessary extractions – Domino Effect. (G. Risse)
By this, the angulation of the upper first molars are the centrepiece of orthodontic diagnosis and treatment.

As an orientation:
The age adapted angulations of the upper first molars are:

At the age of   6 years about:    -17°
At the age of 10 years about:    -10°
At the age of 18 years (adult):   -  5° (Text Book Anatomy)


To treat especially young patients for straight wire angulations by + 5° degrees of the upper first molars (Common Orthodontics) means a difference of 15° degrees to – 10° degrees of a 10 – 11 years old patient.
By this the crowns of the 1st upper molars will get a rotational moment forward up to 5° degrees around the apex of the molars, as the apex of the upper first molars will be stationed by missing space distally and by the germs of the second upper molars of a young patient behind the apex of the 1st upper molars. (“row boat effect”).
Mesial rotated crowns of the upper first molars by 10°- 15° degrees mean a mesial postinoning of the first upper molars of about 5-7 mm each side.
This again means a severe crowding or missing space anteriorly of 5-7 mm,labial positioned canines, protruded upper front teeth, beside a mesial malpositioning of the upper teeth in relation to the lower teeth, (Domino effect). This mesial rotation of the first upper molars mostly will be achieved by the first straight levelling archwire.
No information or disinformation may mean bodily harm, mismanagement and reliability for possible dental and Craniomandibular Dysfunction, CMD, or unnecessary extractions.


Institute of Craniomandibular Dysfunction, ICMD
- Dr. Georg Risse - Raesfeldstraße 15 - 48149 Münster - 
- Tel. 0251-294959 -

Zuständige Kammer: Zahnärztekammer Westfalen-Lippe Münster
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