Competencies
CMD in Cologne - symptoms, treatment, diagnostics & splints
The function of the temporomandibular joint and the masticatory apparatus
In addition to aesthetics, we focus on the treatment of functional disorders, especially craniomandibular dysfunction (CMD), i.e. the masticatory apparatus and temporomandibular joint. Masticatory and temporomandibular joint function is directly linked to the function of the musculoskeletal system.
CMD - craniomandibular dysfunction
The cranium (= skull) and mandible (= lower jaw bone) have a functional relationship with each other. The masticatory organ is a unit consisting of teeth, the periodontium, the temporomandibular joints and the masticatory muscles and nerves.
If the interaction of these individual components is disturbed, we speak of dysfunction.
CMD symptoms
CMD is an extremely complex clinical picture and can therefore manifest itself in many different ways. Frequently occurring CMD symptoms are
- Acute and / or chronic headaches
- Jaw joint pain / jaw joint noises
- Tense jaw muscles
- Teeth grinding / clenching
- Neck pain / back pain
- Tinnitus / ringing in the ears
- Dizziness and much more.
CMD treatment in Cologne Rodenkirchen - occlusal splint and fixed bites
We use occlusal splints and/or fixed bites for therapy. Depending on the clinical picture, as a CMD specialist in Cologne, we supplement the therapy with manual medicine and osteopathic medicine, acupuncture, drug and orthomolecular therapy and work closely with manual physicians and physiotherapists for your CMD treatment.
Mobilization of the temporomandibular joints by the patient
CMD diagnostics - we make your joint visible
As a CMD specialist in Cologne, we carry out detailed examinations of the craniomandibular and musculoskeletal system in our practice. Our aim is to bring together as many diagnostic pieces of the puzzle as possible in order to subsequently carry out a well-founded causal therapy.
- Clinical functional analysis
- Magnetic field-based measurement with the DMD system
- Imaging procedures (e.g. DVT, MRT)
- Close cooperation with manual physicians and
- Physiotherapists
Frequently asked questions / FAQ about fixed braces
Table of contents
- CMD symptoms
- CMD treatment - occlusal splint and fixed bites
- Mobilization of the temporomandibular joints by the patient
- What exactly is CMD?
- How does CMD manifest itself?
- What are the symptoms of CMD?
- What is done for CMD?
- Can you cure CMD yourself?
- How long does it take until CMD is cured?
- Is CMD painful?
- How does a dentist diagnose CMD?
- CMD treatment
- Which medications help with CMD?
- Is CMD psychological?
- What happens if CMD is not treated?
- CMD therapy
- CMD therapy: freedom from pain and improved quality of life
- How bad can CMD get?
- What does health insurance pay for CMD?
- How expensive is CMD treatment?
- Which sport for CMD?
- What does the neurologist do for CMD?
- Can any dentist treat CMD?
- Can the family doctor prescribe CMD?
- How often can a dentist prescribe CMD?
- How is CMD diagnosed?
- Which CMD exercises for craniomandibular dysfunction?
- Why do you get CMD?
- How can you relax the jaw muscles?
- CMD - compact and to the point
What exactly is CMD?
CMD stands for "craniomandibular dysfunction". It is a disorder of the temporomandibular joints and jaw muscles that is often accompanied by pain and restrictions when chewing, speaking and opening the mouth. Causes can include misaligned teeth, stress, muscle tension or injuries. CMD treatment includes a range of measures such as physiotherapy, relaxation exercises, pain therapy and, if necessary, adjustment of the tooth position using a dental splint or orthodontic treatment.
How does CMD manifest itself?
CMD can manifest itself in different ways, but the most common CMD symptoms are:
- Pain in the area of the jaw, face, neck or ears
- Restrictions when opening the mouth
- Cracking noises when chewing or speaking
- Muscle tension in the head and neck area
- Headaches, earaches or toothaches that have no identifiable cause
- Jaw joint noises such as grinding, cracking or rubbing.
Some people with craniomandibular dysfunction also report the following symptoms Dizziness, tinnitus, sleep disorders or problems with posture and the spine. CMD symptoms can vary depending on the severity and cause of the condition. If you suspect that you are suffering from CMD, you should consult an orthodontist to obtain an accurate diagnosis using digital diagnostics and appropriate treatment.
What are the symptoms of CMD?
Craniomandibular dysfunction CMD stands for and refers to a group of disorders that affect the masticatory muscles, temporomandibular joints and the temporomandibular joint. CMD symptoms can be diverse and vary from person to person. Here are some common possible symptoms:
Possible symptoms of craniomandibular dysfunction:
- Pain in the temporomandibular joints, chewing muscles or face
- Headaches or migraines
- Teeth grinding or clenching (bruxism)
- Restrictions in jaw mobility, e.g. difficulty opening or closing the mouth
- Cracking or grinding in the jaw joints during movement
- Tension in the shoulders and neck area
- Earache or tinnitus (ringing in the ears)
- Dizziness
- Dental problems, e.g. wear of the tooth surfaces, tooth loosening or sensitivity can also be CMD symptoms. It is important to consult a specialized orthodontist / CMD specialist Cologne if you suspect a problem in order to receive an accurate diagnosis and appropriate treatment.
What is done for CMD?
CMD treatment depends on the individual diagnosis and symptoms. Here are some possible treatment options:
- Orthodontic CMD treatment: If CMD is caused by misaligned teeth, orthodontic treatment can help to correct the position of the teeth and jaw.
- Relaxation exercises and physiotherapy: Various CMD exercises can help to relax the jaw muscles and improve the mobility of the temporomandibular joints. A physiotherapist can recommend special CMD exercises that are tailored to the individual needs of the patient.
- Pain therapy: Pain medication or muscle relaxants can temporarily help to relieve pain and muscle tension.
- Behavioral changes: Stress reduction and changes in diet or sleeping position can help to reduce symptoms.
- Dental splints: A dental splint (also known as a bite splint) can help to reduce pressure on the jaw joints and correct the position of the teeth.
- Surgical interventions: In rare cases, surgery may be necessary to treat the cause, e.g. severe jaw injuries or tumors.
It is important to consult a qualified and specialized CMD specialist in Cologne, who can perform an accurate digital diagnostics diagnosis and make an individual recommendation for treatment.
Can you cure CMD yourself?
There is no simple answer as to whether you can cure CMD yourself, as treatment depends on various factors, including the cause and severity of the condition, as well as the patient's individual symptoms and needs.
However, it is unlikely that craniomandibular dysfunction can be completely cured without professional medical help. However, there are various measures that can help to reduce the symptoms and slow down the progression of the condition. These include, for example, avoiding excessive use of the jaw, stress reduction, relaxation exercises, a healthy diet and sufficient sleep.
It is important to see a qualified orthodontist in Cologne Rodenkirchen at an early stage to get an accurate diagnosis and start appropriate CMD treatment. Early diagnosis and treatment can help to slow down the progression of the condition and prevent long-term damage.
How long does it take until CMD is cured?
The duration of CMD treatment depends on various factors, including the cause and severity of the condition as well as the patient's individual symptoms and needs.
There is no single cure time, as treatment is usually aimed at reducing symptoms and slowing the progression of the disease. In some cases, symptoms can be significantly improved after a few weeks or months of treatment. In other cases, however, treatment by the CMD specialist Cologne may take longer, especially if the condition is chronic or has caused serious complications.
It is important to have regular monitoring and adjustment of treatment by a qualified orthodontist / CMD specialist Cologne to ensure that treatment for craniomandibular dysfunction remains effective and is adjusted as necessary to achieve the best possible results.
Is CMD painful?
Yes, CMD can be very painful. The most common symptoms include pain in the jaw area, headaches, facial pain and earaches. This pain can worsen when the jaw is moved or when pressure is applied to the jaw, for example when chewing or grinding teeth.
Some patients also experience muscle tension or muscle spasms in the jaw and neck area, which can lead to further pain. In some cases, craniomandibular dysfunction can also lead to dental discomfort or toothache.
It is important to see a qualified orthodontist if you have persistent jaw, head or facial pain in order to receive an accurate diagnosis and appropriate CMD treatment. Early treatment with your orthodontist in Cologne Rodenkirchen can help to reduce pain and prevent long-term damage.
How does a dentist diagnose CMD?
Craniomandibular dysfunction is a collective term for a range of disorders and complaints associated with the temporomandibular joints, the muscles of mastication and the surrounding structures. Orthodontists / CMD specialists in Cologne are experts in the field of jaw and tooth misalignment and play an important role in the diagnosis and treatment of craniomandibular dysfunction. Diagnosis by an orthodontist generally involves the following steps:
- Medical history: The orthodontist first takes a thorough medical history to gather information about the patient's medical history, complaints, symptoms and possible triggering factors. This includes questions about the occurrence of pain, jaw joint noises, restricted mouth opening, night-time teeth grinding (bruxism) and other associated complaints.
- Clinical examination: The orthodontist then performs a clinical examination in which the patient is carefully examined for signs. This includes inspection and palpation of the temporomandibular joints and masticatory muscles, assessment of mouth opening and closing movements as well as checking for tooth wear and occlusal disorders (malocclusion).
- Imaging procedures: In some cases, the orthodontist may order additional diagnostic tests to better understand the extent. These include imaging procedures such as X-rays, magnetic resonance imaging (MRI) or computed tomography (CT) to take a closer look at the temporomandibular joints and surrounding structures.
- Treatment planning: After diagnosing craniomandibular dysfunction, the orthodontist will create an individualized treatment plan based on the patient's specific needs. CMD therapy may include conservative measures such as physiotherapy, CMD splint or occlusal splint therapy, medication and relaxation techniques. In more complex cases, orthodontic or oral surgery treatment may be required to correct misalignments of the teeth or jaw that contribute to craniomandibular dysfunction.
Orthodontists play a very important role in the diagnosis and treatment of CMD. They use their expertise in jaw and tooth misalignment to perform a thorough medical history, clinical examination and, if necessary, imaging procedures to identify CMD and create an appropriate treatment plan.
CMD treatment
CMD treatment (cranio-mandibular dysfunction) aims to alleviate pain and discomfort in the temporomandibular joint, chewing pain and headaches as well as other symptoms caused by a malfunction of the temporomandibular joint. Individually adapted measures such as physiotherapy, splinting, medication or, if necessary, dental corrections are used to achieve an optimal bite and harmonious function of the masticatory apparatus. A comprehensive diagnosis is crucial for the success of the treatment, which is why cooperation between orthodontists, orthopaedists, physiotherapists and other specialists is important. CMD treatment can significantly improve the quality of life of affected patients and contribute to long-term pain relief and stabilization of the temporomandibular joint.
Which medications help with CMD?
Different therapeutic approaches are used in CMD treatment, which vary depending on the cause, severity of the condition and the patient's individual symptoms. One option is pain therapy, which helps to temporarily relieve pain and muscle tension.
Another approach involves the use of medicines that help to relax the muscles and thus reduce muscle tension in the jaw area. In some cases, preparations can also be used to reduce pain and muscle tension in the jaw area and relieve stress at the same time.
If the patient suffers from anxiety or sleep disorders, certain remedies can be used to alleviate the symptoms. However, such preparations should only be used in the short term and under medical supervision.
It is important to point out that pharmacological therapy approaches are only part of a comprehensive CMD treatment and are not necessary in every case. Long-term use of pain therapies or muscle relaxants can have undesirable side effects and should therefore only be carried out under medical supervision.
Is CMD psychological?
In many cases, craniomandibular dysfunction has a multifactorial cause, whereby both physical and psychological factors can play a role. Stress, anxiety, depression and other emotional stresses can contribute to aggravating or causing CMD.
Increased tension in the jaw and neck area, which can occur during stress or anxiety, can lead to overstraining of the jaw muscles and thus cause or worsen craniomandibular dysfunction.
However, it is important to emphasize that it is not a purely psychological disorder and can have an organic cause, e.g. due to misaligned teeth, trauma or other physical factors. Holistic treatment should therefore take both physical and psychological aspects into account.
It can be helpful to incorporate stress management techniques such as relaxation exercises, meditation, yoga or psychotherapy into CMD therapy to address the emotional factors that can contribute to the condition.
What happens if CMD is not treated?
If craniomandibular dysfunction is not treated, the symptoms can worsen over time and lead to serious complications. The pain in the jaw and head area can become chronic and spread to other areas of the body, such as the neck, back and shoulders.
Untreated craniomandibular dysfunction can worsen jaw mobility, which can lead to difficulty chewing, speaking and opening the mouth. Craniomandibular dysfunction can also cause teeth to wear down faster and increase the risk of tooth loss. In some cases, CMD can lead to ringing in the ears such as tinnitus. Sleep disorders and psychological stress can affect the patient's quality of life. It is therefore important to ensure timely diagnosis and CMD treatment to avoid long-term damage and complications.
CMD therapy
Craniomandibular dysfunction is a condition that affects the temporomandibular joints, muscles and nerves in the facial area. Typical symptoms include pain in the jaw area, difficulty chewing, facial pain and headaches. The causes are varied and can include stress, dental problems or injury. Treatment often involves a combination of physiotherapy, pain therapy and dental treatment.
If you require further information on CMD therapy, we recommend that you consult a specialist orthodontist.
CMD therapy: freedom from pain and improved quality of life
Cranio-mandibular dysfunction is a condition that can cause pain in the temporomandibular joint and surrounding muscles. CMD therapy aims to alleviate the symptoms and correct the causes of the condition by combining various treatment approaches such as physiotherapy, splint therapy, drug therapy, stress management, orthodontic treatment and, in rare cases, surgery. It is important to see a specialist if CMD symptoms persist or worsen in order to receive an accurate diagnosis and an individualized treatment plan.
In addition to professional treatment, sufferers can also take self-help measures to alleviate symptoms, such as heat or cold applications, a soft diet, avoiding bad habits and taking regular breaks with stretching exercises. Through a combination of professional treatment and self-help measures, sufferers can reduce their pain and discomfort and improve their quality of life in the long term.
How bad can CMD get?
Craniomandibular dysfunction CMD can occur in various degrees of severity and can range from mild symptoms to severe effects on the patient's quality of life. In some cases, craniomandibular dysfunction can lead to chronic pain, limited jaw mobility, tooth wear, tinnitus and sleep disorders. If craniomandibular dysfunction is left untreated, the symptoms can also become chronic over time and lead to further complications.
In rare cases, craniomandibular dysfunction can lead to severe functional disorders of the temporomandibular joint, such as disc displacement or joint wear. These can lead to permanent restrictions in jaw mobility and pain.
It is important to note that the severity of the condition depends on various factors, including the cause and duration of the condition, the individual's symptoms and the patient's response to treatment. Early diagnosis and CMD treatment can help prevent long-term damage and complications and improve the patient's quality of life.
What does health insurance pay for CMD?
The coverage of CMD treatment by health insurance can depend on various factors, including the type and severity of the condition, the chosen treatment method and the individual insurance conditions. In principle, statutory health insurance companies in Germany will cover part of the costs of treatment if certain conditions are met.
Special CMD treatment can usually only be carried out if there is a medical necessity and successful therapy cannot be achieved by other means. A therapeutic goal can consist of various elements, e.g. conservative treatment methods such as physiotherapy, pain therapy or occlusal splints. In severe cases, surgical therapy may also be necessary.
Statutory health insurance companies only cover the costs of CMD treatment in certain cases and to a limited extent. Private health insurance companies may offer different conditions and benefits. It is therefore advisable to find out in advance about the conditions and benefits of your own health insurance company and, if necessary, to obtain a declaration of assumption of costs.
It is important to note that the assumption of costs for CMD treatment depends on various factors and can vary from case to case. Exact information can only be provided by the health insurance company or the treating doctor.
How expensive is CMD treatment?
The cost of CMD treatment can vary depending on the type and severity of the condition, the chosen treatment method and the duration of the therapy. Conservative treatment such as physiotherapy or a bite splint is generally less cost-intensive than surgical treatment.
The cost of a bite splint, which is usually the first choice as a conservative treatment option for craniomandibular dysfunction. If the CMD splint is fitted by an orthodontist, he or she can also arrange for a custom-made splint, which may incur higher costs.
Surgical treatment, such as arthroscopy or temporomandibular joint surgery, can usually cost several thousand euros. The costs can vary depending on the extent and severity of the operation.
It is important to note that the cost of CMD therapy depends on various factors and can vary from case to case. It is advisable to enquire with your health insurance provider about the assumption of costs before starting therapy and, if necessary, to obtain a declaration of assumption of costs.
Which sport for CMD?
In the case of CMD, it is advisable to focus on sports that do not put excessive strain on the temporomandibular joints and do not overstress the jaw muscles. Gentle sports that can improve posture and relieve tension are particularly recommended. Here are some sports that may be suitable for people with craniomandibular dysfunction:
- Swimming: Swimming is an excellent sport for people with CMD as it is easy on the joints and relaxing for the body.
- Yoga: Yoga is a gentle sport that can help to relieve tension in the body and improve posture.
- Pilates: Pilates is another gentle sport that can help improve posture.
- Cycling: Cycling is a sport that is easy on the joints and can help to strengthen muscles and relieve tension.
- Nordic walking: Nordic walking is a gentle form of walking that uses poles to activate additional muscle groups and improve posture.
However, it is important to remember that everyone is different and not all sports are equally suitable for everyone. Before taking up a new sport, a doctor or physiotherapist should therefore be consulted to check suitability and, if necessary, receive individual recommendations.
What does the neurologist do for CMD?
Craniomandibular dysfunction is a disorder of the temporomandibular joint and the surrounding tissue. It is usually diagnosed and treated by an orthodontist. In some cases, however, a neurologist may also be involved in the treatment of CMD.
A neurologist is a specialist for diseases of the nervous system and can be consulted for CMD therapy if the symptoms extend beyond the temporomandibular joint and neurological causes are suspected. A neurological examination can help to rule out other diseases or make an accurate diagnosis.
If neurological causes are suspected, the following examinations can be carried out:
- Electromyography (EMG): An EMG exam can help measure muscle activity and detect abnormal muscle activity associated with CMD.
- Electroneurography (ENG): An ENG examination can help to detect nerve damage.
- Magnetic resonance imaging (MRI): An MRI scan can be helpful in detecting damage to the temporomandibular joint and surrounding structures and making an accurate diagnosis.
It is important to note that the involvement of a neurologist in CMD treatment depends on various factors and can vary from case to case. Precise information can only be provided by the treating physicians.
Can any dentist treat CMD?
While in principle any dentist is able to treat craniomandibular dysfunction, CMD specialists in Cologne often have more in-depth knowledge of diagnosis and treatment due to their specialized training and experience. Orthodontists have additional training in the treatment of temporomandibular joint disorders and therefore have broader expertise in dealing with craniomandibular dysfunction. They have specialized equipment such as TMJ sonography or X-ray procedures to effectively diagnose and treat craniomandibular dysfunction.
For this reason, many experts recommend consulting an experienced orthodontist if you have any suspicions to ensure an accurate diagnosis and effective treatment. Orthodontists can perform a comprehensive examination and develop a customized treatment to alleviate symptoms and prevent long-term damage.
Can the family doctor prescribe CMD?
The general practitioner cannot prescribe CMD directly, as it is a disease of the temporomandibular joint and the surrounding tissue and is usually diagnosed and treated by a treating dentist or orthodontist.
However, if a patient is suffering from symptoms that indicate craniomandibular dysfunction, the GP can refer the patient to an appropriate specialist such as a treating dentist or orthodontist. The treating CMD dentist or CMD specialist in Cologne can then carry out a comprehensive examination, make an accurate diagnosis and initiate suitable CMD therapy.
However, the GP can play an important role in CMD treatment, especially if the symptoms are related to other conditions or factors such as stress or psychological problems. In this case, the GP can plan holistic treatment and, if necessary, consult other specialists such as a psychologist or physiotherapist to ensure comprehensive therapy.
How often can a dentist prescribe CMD?
CMD cannot be prescribed directly, as CMD is not a medication or remedy, but a disorder of the temporomandibular joint and surrounding tissues. However, a dentist or orthodontist can make a diagnosis and initiate appropriate treatment.
The frequency with which a dentist or orthodontist can diagnose and treat craniomandibular dysfunction depends on various factors, such as the number of patients visiting the practice, the severity of the conditions and the experience and qualifications of the treating dentist or orthodontist.
As a rule, there are no restrictions on the number of CMD treatments that a dentist or orthodontist may perform. Treatment is tailored to the individual patient and can vary in length depending on the severity of the condition and other factors. However, the dentist or orthodontist will carry out regular check-ups to monitor the progress of the treatment and make adjustments if necessary.
However, it is important to note that the cost of CMD therapy depends on various factors and can vary from case to case. The costs may also depend on the patient's health insurance company and the individual insurance conditions. It is therefore advisable to obtain detailed information in advance about the conditions and benefits of your own health insurance and, if necessary, to obtain a declaration of assumption of costs.
How is CMD diagnosed?
Craniomandibular dysfunction is best diagnosed by an experienced orthodontist / CMD specialist Cologne, as they have specialized knowledge and skills to effectively identify and treat the condition.
The diagnosis is usually made through a comprehensive examination of the temporomandibular joint, the jaw muscles and the teeth. The orthodontist can use various diagnostic procedures, such as clinical examination, imaging procedures such as X-rays or MRI, and functional tests such as TMJ sonography or electronic muscle analysis.
An experienced orthodontist can accurately interpret the symptoms and make a precise diagnosis in order to develop an effective therapy. They can also regularly monitor the progress of CMD treatment and make adjustments if necessary to achieve optimal results.
It is important to note that craniomandibular dysfunction is a complex condition that is often difficult to diagnose. However, an experienced orthodontist with specialized knowledge and skills can make an accurate diagnosis and develop a customized treatment to alleviate the symptoms of craniomandibular dysfunction and minimize the long-term effects of the condition.
Which CMD exercises for craniomandibular dysfunction?
There are various CMD exercises that can help with craniomandibular dysfunction to relax the jaw muscles and improve the mobility of the jaw. Here are some examples:
- Stretching exercises for the jaw muscles: One way to stretch the jaw muscles is to gently open and close the mouth while pressing against the lower jaw with your hand. Another option is to open your mouth and tilt your head back slightly to stretch the jaw muscles.
- Jaw loosening exercises: This exercise involves loosening the lower jaw and moving it slowly to the right and left and up and down.
- Tongue exercises: This exercise consists of pressing the tongue against the roof of the mouth and then slowly pulling it back.
- Relaxation exercises: Relaxation exercises such as yoga, progressive muscle relaxation or breathing exercises can help to release tension in the jaw and the entire body region and achieve deeper relaxation.
However, it is important to note that every person is different and not all CMD exercises are equally suitable for every patient. Before starting a new exercise, a doctor or physiotherapist should therefore be consulted to check suitability and, if necessary, receive individual recommendations.
Why do you get CMD?
The exact causes of CMD (craniomandibular dysfunction) have not yet been fully researched. It is assumed that a combination of factors can contribute to its development. Here are some possible causes:
- Stress: Stress can increase muscle tension and lead to tension in the jaw area
- Misaligned teeth: Poor occlusion or misalignment of the teeth or jaw can lead to the jaw being overloaded
- Excessive teeth grinding or clenching: Constant clenching or grinding of the teeth can lead to overloading of the jaw muscles and the temporomandibular joint.
- Injuries or trauma: Injuries or trauma to the temporomandibular joint or jaw muscles.
- Arthritis: Inflammatory diseases such as arthritis can affect the temporomandibular joints
It is important to note that craniomandibular dysfunction is a complex condition and that the causes can vary from person to person. A precise diagnosis by your orthodontist in Cologne Rodenkirchen is therefore important in order to initiate suitable CMD therapy.
How can you relax the jaw muscles?
There are several ways to relax the jaw muscles:
- Heat applications: A heat treatment can help to increase blood circulation in the jaw area and relieve tension in the muscles. For example, you can place a warm towel on your face or use a hot water bottle.
- Massage: A gentle massage in the jaw area can help to loosen the muscles and relieve tension.
- Relaxation exercises: Relaxation exercises such as yoga, breathing exercises or progressive muscle relaxation can help to reduce stress and tension in the body, including in the jaw area.
- Physiotherapy: A physiotherapist can use special techniques to stretch and loosen the jaw muscles.
- Avoid trigger factors: To relax the jaw muscles, it is important to avoid trigger factors such as teeth grinding, jaw clenching or chewing gum.
- Mouthguard: A mouthguard individually fitted by a CMD dentist can help to reduce teeth grinding and jaw clenching and thus relieve the jaw muscles.
However, it is important to note that CM treatment can be complex and that each patient should be considered individually. It is therefore advisable to seek advice from an orthodontist to obtain the best options for relaxing the jaw muscles.
CMD - compact and to the point
Sources:
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- Manfredini, D., Guarda-Nardini, L., Winocur, E., & Piccotti, F. (2012). Research diagnostic criteria for temporomandibular disorders: A systematic review of axis I epidemiologic findings. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 114(6), e50-e81. DOI: https://doi.org/10.1016/j.tripleo.2011.04.021
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