[Impaired chewing dysfunction. Reconstructive procedures in impaired chewing dysfunction].
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Craniomandibular Disorders↗
Biomedical subjects
M O Ahlers
Publications and source records attributed to M O Ahlers.
Evidence-based development of a diagnosis-dependent therapy planning system and its implementation in modern diagnostic software.
The prerequisite for structured individual therapy of craniomandibular dysfunctions is differential diagnostics. Suggestions for the structured recording of findings and their structured evaluation beyond the global diagnosis of "craniomandibular disorders" have been published. Only this structured approach enables computerization of the diagnostic process. The respective software is available for use in practice (CMDcheck for CMD screening, CMDfact for the differential diagnostics). Based on this structured diagnostics, knowledge-based therapy planning is also conceivable. The prerequisite for this would be a model of achieving consensus on the indicated forms of therapy related to the diagnosis. Therefore, a procedure for evidence-based achievement of consensus on suitable forms of therapy in CMD was developed first in multicentric cooperation, and then implemented in corresponding software. The clinical knowledge of experienced specialists was included consciously for the consensus achievement process. At the same time, anonymized mathematical statistical evaluations were used for control and objectification. Different examiners form different departments of several universities working independently of one another assigned the theoretically conceiveable therapeutic alternatives to the already published diagnostic scheme. After anonymization, the correlation of these assignments was then calculated mathematically. For achieving consensus in those cases for which no agreement initally existed, agreement was subsequently arrived at in the course of a consensus conference on the basis of literature evaluations and the discussion of clinical case examples. This consensus in turn finally served as the basis of a therapy planner implemented in the above-mentioned diagnostic software CMDfact. Contributing to quality assurance, the principles of programming this assistant as well as the interface for linking into the diagnostic software are documented and also published here.
Clinical Protocols↗
Computer assistance in clinical functional analysis.
The use of computers in the dental practice has been primarily restricted to the acquisition of billing data. Additional possibilities for use of PCs exist in diagnostic data acquisition and evaluation; clinical functional analysis seems a particularly suitable application. Such software is now available: CMDfact. Dentally, it is based on a previously developed and published examination and documentation system, the graphic user interface of which is used in the newly developed software. After the examination data have been acquired by mouse click or numerical entry, these are available for evaluation. A special function, the "Diagnosis pilot" is integrated to support the user. This helps in the assignment of the appropriate "Initial diagnoses", since it brings together the individually existing principal symptoms and suitable diagnoses for the initial diagnosis in question and also states which diagnoses "would be appropriate" for this, but are not available. With 3D animation, the software also helps the dentist to explain aspects of CMD to patients. The software also assists the dentist with a detailed multimedia help system, which provides context-sensitive help for every examination step. These help functions explain the sense of the relevant examinations, their performance and evaluation in the form of short texts and explanatory photographs and videos.
Computer Graphics↗