can the symptoms of a tmd be positively influenced by an osteopathic treatment.

in literature the term craniomandibulair dysfunction has not been decisively
defined this results in that diagnosis CMD/tmg-dysfunctie is used for patienten
with very divergent symptoms the symptom profile of the patienten varies in
accordance with the conception of the research worker on the basis of the
traditional symptoms such as kaakgewrichtsgeluiden, pain and movement
restriction seem diagnosis most clear problems to put onstaan by overlapping of
the symptoms, causes by other syndromes, as well as by influences from other
regions.

As a result of the vele symptoms which can appear at these patientengroep
several diagnoses to be mostly put because many occupational groups occupy
themselves such as dentists, dental surgeons, chiropraktikers, osteopaten and
fysiotherapeuten, there are also many behandelconcepten without clear
directives until now have been there not yet confessed which behandelmethode is
most effective operative for this reason is I of plan for a study into the
possible value of osteopatische a treatment at this complex problem.

method of research: a randomised controlled clinical study.

the goal of the research is to include 80 patients.
the criteria for inclusion the presence of a tmd which should be diagnosed by a
dentist using the helkimo-index.To be sure that all questions are understood
the group of patients has to have a good understanding of the Dutch language.
Criteria for exclusion:the dentist and possibly the dokter will diside if there
are medical grounds to exclude a patient for this research.For example a high
fever,an infection illness,an accident trauma etc.
The selected group of patients are asked if they are willing to take part in
the research.The selected group of patients are also asked not to take part in
another paramedic treatment or alternative treatment for these symptoms while
this research is ongoing.After the group of people have met the inclusion and
exclusion criteria the treatment for each patients will be randomly
chosen.Randomising takes place by drawing not transparant,closed envelopes
containing the treatments to be applied which are osteopathic treatment,placebo
treatment or controlgroup.To insure the objectivity of the research the
referring dentist do not know the group in which the patients are placed.
the follow-up period is approximately six months.During this period there are
four checkpoints,messuring with the following parameters:general
evaluation,questionnaire of the most predominant symptoms and the V.A.S.score.
general evaluation:the patients are asked to evaluate the change in their
complaints.
questionnaire of the most predominant symptoms of a tmd.
V.A.S.score:the vas score is a messuring instrument that is very trustworthy
and very sensitive to small changes.
Checkpoints:the checkpoints are at the start of the research, after six
weeks,after 12 weeks and after six months.These take place at the referring
dentists practice.
Treatment:The osteopathic treatment,performed by a trained osteopath,takes
place based on the black box method.
This mains that the health professional treats the patient according to his own
insight in aggrement with the norms of the proffesional body to which he
belongs.
the placebo treatment which is carried out by a physiotherapist consists of
active movements.
The control group recieves no treatment.

The behandelinterventies are frequently applied and are not taxable for the
patient.
By means of exclusie so called contra indications for the treatment are already
excluded.

The patient at all times are possible and without statement of reason cancelling

The duration is approximately 4 treatment of 1/2 up to 1 hours and filling in
the questionnaires