Why a CMD Curriculum?

Functional disorders of the masticatory system are now part of everyday practice. Patients with pain, temporomandibular joint complaints, muscle tension, bruxism, or progressive tooth wear regularly present dentists with diagnostic and therapeutic challenges. At the same time, functional aspects are becoming increasingly important in restorative dentistry, implantology, prosthetics, and orthodontics.

The CMD Curriculum for Dentists systematically imparts the necessary knowledge, scientifically sound and with an exceptionally high practical relevance. The goal is not only to understand the underlying correlations but, above all, to ensure confident implementation in daily practice.

The Hamburg CMD Curriculum

The Hamburg Curriculum Function, CMD and Bruxism has been one of the most comprehensive and practice-oriented advanced training programs in this field for many years. The organizer is the Hamburg Dental Association. The practical training takes place predominantly at the CMD Center Hamburg-Eppendorf.

The curriculum has been continuously developed and, in addition to classic functional diagnostics, now naturally also includes the diagnosis and therapy of bruxism as well as the structured assessment and treatment of tooth wear. It thus reflects the current scientific developments in dentistry.

Learning as in daily practice

The curriculum is divided into 10 modules and deliberately follows the actual course of a dental treatment.

You will learn step by step

• CMD screening,
• clinical functional analysis,
• manual structural analysis,
• the creation of centric records,
• condylar position analysis,
• instrumental movement recording with various systems,
• the evaluation of condylar movement analysis,
• the evaluation of temporomandibular joint MRIs,
• findings evaluation,
• structured diagnosis,
• treatment planning,
• the selection of suitable treatment concepts,
• functional therapy with occlusal splints,
• the management of accompanying physiotherapy and drug therapy,
• the diagnosis and therapy of bruxism,
• the diagnosis of tooth wear, and
• the conception and implementation of subsequent restorative treatments.

Each module logically builds on the previous one. This allows you to apply the content taught immediately after each course section in your own practice.

Scientifically sound – immediately applicable

A key feature of the curriculum is the close connection between science and clinical practice.

For many years, the speakers have been among the formative personalities in German-speaking functional diagnostics. Numerous scientific publications, textbooks, guidelines, and their own developments have been directly incorporated into the curriculum’s content. Participants thus benefit from a training concept that consistently combines scientific evidence with practical implementation.

Practical exercises in small groups

The focus is not on frontal teaching.

Almost every course section includes extensive practical exercises in small groups. Participants train examination techniques, findings collection, diagnosis, and therapeutic decisions directly on patient models or with the support of special software.

This creates the confidence required to subsequently integrate functional diagnostics independently into daily practice.

Who is the curriculum suitable for?

The CMD Curriculum is aimed at dentists who:

• want to master functional diagnostics confidently,
• want to expand their expertise in CMD and bruxism,
• want to functionally secure restorative, implantological, and orthodontic treatments,
• want to systematically diagnose and treat tooth wear,
• want to further develop their practice on a sound scientific basis.

Your benefits for practice

Upon completion of the curriculum, you will have a structured diagnostic and therapeutic concept that you can immediately apply in your daily treatment.

You gain confidence in complex functional issues, recognize connections more quickly, and develop sound therapy concepts for patients with CMD, bruxism, and tooth wear.

Registration

Organizational implementation and registration are handled by the Hamburg Dental Association. On the Dental Association’s website, you will find current dates, the modular structure of the curriculum, and the option for direct booking.

Scientific Foundations

The botulinum toxin training course for dentists provides the scientific, legal and practical foundations for the guideline-compliant use of botulinum toxin in the treatment of bruxism and craniomandibular dysfunctions (CMD).

Botulinum toxin is now a scientifically recognized component of therapy for bruxism and muscle-related complaints of the masticatory system. The current S3 guideline on bruxism confirms the effectiveness of this treatment, provided that careful diagnostics have been carried out beforehand and conservative treatment options have not achieved sufficient therapeutic success. The use of botulinum toxin does not replace cause-oriented diagnostics or established therapeutic measures, but represents an additional treatment option for selected patients.

Prerequisites for the treatment of bruxism and CMD with botulinum toxin

The basis of any treatment is comprehensive dental diagnostics. For patients with CMD, this includes, in particular, Clinical Functional Analysis, and for bruxism, structured screening, for example with the Bruxism Screening Index (BSI). Only on this basis can the indication for treatment with botulinum toxin be made responsibly.

Before an injection, the recommended conservative therapeutic measures should have been exhausted. These include, in particular, individually fitted occlusal splints, physiotherapeutic measures, and patient-specific recommendations to reduce parafunctional activities and for stress management. In addition, comprehensive and specific patient education about the mode of action, limitations, possible side effects and treatment alternatives is an indispensable part of the therapy.

Legal requirements for dentists

According to the assessment of the German Dental Association, the use of botulinum toxin requires appropriate qualification. Since this treatment is neither part of dental studies nor the dental licensing regulations, dentists must provide evidence of their knowledge through qualified continuing education.

In addition, many professional liability insurers require proof of appropriate continuing education before this treatment is introduced. Structured continuing education therefore not only serves patient safety, but also creates the professional and legal prerequisites for use in one’s own practice.

Practical content of the botulinum toxin training course for dentists

This botulinum toxin training course for dentists combines scientific fundamentals with a strong practical component.

In the theoretical part, we cover the following topics, among others:

• scientific evidence for the treatment of bruxism and CMD
• indication and patient selection
• anatomy of the masticatory muscles
• preparations and dosage
• side effects and how to avoid them
• legal framework and documentation

The practical course component teaches ultrasound imaging of the masticatory muscles as well as ultrasound-guided planning and performance of the injections. Under the guidance of the instructor, participants practice anatomical orientation and injection technique on anatomical specimens. Using ultrasound control, relevant anatomical structures can be reliably identified and the injections can be performed in a targeted manner.

Small course groups for maximum learning success

To ensure a high proportion of practical training and intensive personal support, the number of participants is limited to ten dentists. This provides ample opportunity to carry out all practical exercises yourself and discuss individual questions with the instructors.

The continuing education course is aimed at dentists who want to expand their knowledge in the field of bruxism and CMD therapy and safely integrate the scientifically sound use of botulinum toxin into their range of treatments.

Bruxism can lead to CMD and tooth wear. The level of suffering for those affected is sometimes very high. Treatment should be individualized as far as possible and depends on the initial situation. However, this initially requires sufficient diagnostics to assess the contribution of the various problem areas of bruxism, CMD, and the extent of dental wear that has occurred.

During the pandemic, face-to-face training was only possible to a limited extent, but people had time and bought laptops and tablets—and loved it. That’s how this course series for the organizer IFG came about at the time. The structured course series on the diagnosis of bruxism, CMD and restorative treatments presents each topic in a condensed format. The topics of the 8 modules are:

The modules run between 1:09 h and 1:43 h, making them significantly shorter than a curriculum. There are also no practical exercises. In return, the course series offers a low-threshold introduction to the topic without having to travel – and can be watched through over two rainy summer days. PD Dr. Ahlers provides you with more detailed information in a video on the organizer’s website, recorded at the end of filming.

The concept is well received; the course series has already been watched by several hundred dentists and rated very highly. Numerous participants then decided, on the basis of this online course series, to book the complete Curriculum of the Hamburg Dental Association.

Tooth wear is an increasing problem. The incidence is rising rapidly, especially among young patients, and in some cases reaches 25% in Dutch studies. This means that a quarter of the young people affected have damage to the dental hard tissues that requires treatment. It is therefore important for dental practices to recognize these patients at an early stage and to identify the individual causes in those affected. To this end, a Dutch-German working group has developed a multi-stage diagnostic procedure, the Tooth Wear Ealuation System, TWES. This was initially published at the University of Amsterdam ACTA and further developed in cooperation with colleagues from the CMD Center Hamburg-Eppendorf.

In clinical practice, the approach is based on a two-stage diagnostic concept.

• The first step is a tooth wear screening to identify conspicuous patients.
• In the second stage, these are examined in more detail (per tooth) with a correspondingly more intensive tooth wear status, supplemented by an assessment of the pathology and the recording of findings that allow conclusions to be drawn about the aetiology. Individual treatment planning is then carried out on this basis.

Both examination steps are now recognized by the German Dental Association as independent services. To implement the procedure in the dental practice, corresponding software is now available to expand the practice software, CMDbrux, the use and application of which is also taught in the course, so that the implementation of the knowledge in the practice is immediately guaranteed.

Studies show that around 10% of patients in dental practices suffer from craniomandibular dysfunctions (CMD) that require treatment. These patients therefore occur in every practice. The incidence of patients with bruxism is even higher. Not recognizing those affected can be just as unpleasant for patients as it is for dental practices.

Dentists are therefore faced with the challenge of recognizing functionally conspicuous patients in order to decide to what extent these patients should be treated in their own practice and when it makes sense to refer them for co-treatment. In view of the limited university training in this area and the complexity of the procedures to be used as well as the patients and clinical pictures, this decision will be different for each practice.

Therefore, every dental practice needs a structured concept for identifying those affected, as the basis for an individual decision on the appropriate treatment pathway. The seminar teaches exactly this concept. It starts with identifying those affected using appropriate screening tests (CMD screening, bruxism screening index, if necessary tooth wear screening). If the result is “positive”, the lecture describes the subsequent steps: a bruxism splint for bruxism or, alternatively, multi-stage functional diagnostic examinations if CMD is suspected (clinical functional analysis, manual structural analysis, model fabrication, registrations, condylar position analysis, movement recording and analysis, and the treatment concept based on this). Depending on the physician’s competencies, the team’s level of training, and the practice equipment, each practice can then decide which steps it offers and in which cases a referral is made. The seminar describes the process chain and outlines the respective technical requirements and the specifications of the relevant guidelines.

Today, treatment with ceramic veneers is a scientifically recognized definitive type of restoration (scientific communication of the DGZMK and DGZ). In addition to esthetic indications, ceramic veneers are now also suitable for the restorative treatment of anterior tooth defects and for permanent functional correction with restoration of canine-protected occlusion (“canine guidance”).

This requires special preparation designs that match the indication and the characteristics of the materials used and enable safe clinical follow-up treatment with predictable results.

In practice, three different types of preparation have emerged. These include classic (labial) veneers, which primarily bring about aesthetic changes and in which the surface on the lip side is only minimally ground. In the case of severe discoloration and, in particular, extensive substance deficits, newer forms of treatment are used (“medium wrap” and “full wrap” veneers). Controlled long-term studies are now available for the various modifications, confirming their durability.

Prerequisites for a planned treatment success are, firstly, careful, structured aesthetic and functional treatment planning and, secondly, a preparation technique that predictably limits the depth of preparation to the enamel—this contributes to a 10x longer service life of the veneers.

The training course systematically describes the various indications, explains the findings to be collected and the material requirements. On this basis, the preparation forms for the various ceramic veneers are explained step by step. This is followed by a brief overview of the dental fabrication options and adhesive cementation.

Event format: Lecture or practical intensive course

In practical intensive courses, the various treatment steps are then trained on a simulator. After demonstration by the course instructor, Priv.-Doz. Dr. M. Oliver Ahlers, participants first perform preparation exercises using preparation instruments developed by the course instructor. Following this, training in the fabrication of provisionals after the preparation of extended veneers can be conducted.

Review by previous organizers: “The feedback from participants on the evaluation forms was consistently positive. Overall, your lecture was perceived as very informative and beneficial.” KZV Lower Saxony, Expert training/Legal department 2026