Cervicogenic Temporal Mandibular Disorder (CTMD)

Introduction and Perspective

Chiropractic and dental literature suggest an association between Temporal Mandibular Disorders, commonly called TMJ or TMD, and cervical chiropractic. One study in Cranio (April 2005, Vol 23, No. 2 pp119-129) showed the production of scoliosis in rats as a result of experimentally-induced malocclusion. All of the rats with scoliosis exhibited a tilt of the atlas or what the Upper Cervical Research Foundation would call Atlas Laterality.

Dr. Marshall Dickholtz Sr. has conducted preliminary studies with Chicago area neuro-muscular dentists who are members of the International College of Cranio-mandibular Orthopaedics (ICCMO) on approximately 8 patients with TMD/TMJ in preparation for designing the protocol used in this project. This protocol has been submitted for approval to an institutional review board. All of the preliminary subjects with TMJ have responded to upper cervical misalignment correction. Earlier data from the office of Dr. Dickholtz Sr. supports the effects of chiropractic on pain associated with TMJ. There are a number of NUCCA doctors and UCRF board members who have been working with dentists and dental researchers for more than fifteen years.

Research Goals

This project is designed to provide an understanding of the interconnections between TMD and malposition of the atlas. In addition to providing an understanding between TMD and atlas malposition, this project is expected to determine the optimal way in which dentists and upper cervical chiropractors can work together for the benefit of the patient. The question to be answered is, “Does a malposition of the upper cervical spine change the dental occlusion or bite? For example, if the atlas is corrected and not malpositioned, does that decrease the number of adjustments needed on dental occlusion and appliances? Clinical observations to date support the view that increased spinal stability and dental function are seen with patients using an integrated approach to dental care. The cervical spine-jaw-head modeling at the University of Toledo will be used to interpret what is seen dentally and chiropractically and will provide a biomechanical model relating TMD and misaligned cervical vertebrae.

Principal Investigators/ Credentials

Dr. Marshall Dickholtz Sr. will be the lead chiropractor and the other investigators will be announced once an Institutional Review Board has approved the project. The involved University faculty has yet to be finalized.

Estimated Expenses

Dental organizations are providing $200,000 for their share in this joint project. UCRF is responsible for $185,000 of the projected cost. This covers $100,000 for chiropractic services, and $85,000 for data management, writing of research results, writing/organization of IRB (Institutional Review Board) proposal and additional involvement with University.

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