CNO6
Sympathetics in Dental Medicine & TMJ MRI/CBCT Imaging
THE Missing Links in General & Specialty Practice
14 AGD CREDIT HOURS-online course/recording of the live CNO6 course in the fall of ’25
Likely one of the most important unknowns in the practice of dental medicine, the autonomic sympathetics and their influence upon dental medicine is HUGE! CNO6 outlines the safe and effective use of 3rd order/post-ganglionic sympathetic neck blocks in dental and surgical practice; the why, the how, and the what for. The understanding and usage of 3rd order sympathetic blocks in dental and specialty practice is MASSIVE, as this course will proffer.
Most every system within the human body contains antagonistic autonomic sympathetic and autonomic parasympathetic nerve fibers which are essential for the regulation of a plethora of physiologic functions, including, importantly, the regulation of blood flow. Using the dental pulp as an example, 10% of the pulp consists of 3rd order, unmyelinated autonomic sympathetic fibers (influencing both nociception and blood perfusion), whilst 90% of the dental pulp consists of a delta, a beta, and c fibers of trigeminal sensory origination (influencing both nociception and/or proprioception).The dental pulp has never been shown histologically to possess parasympathetic fibers to counter its sympathetic innervation (unlike most other parts of the human body), which can lead to many undesirable outcomes, such as the need for endodontic therapy following routine restorative procedures, incomplete lower IAN blocks, dry sockets, dystonia of muscles, and much more. Ramping down sympathetic inflow to the maxillofacial region via the initiation of 3rd order sympathetic blocks utilizing local anesthetic, can often PREVENT the aforementioned problems from occurring. 3rd order blocks prevent excessive vasoconstriction, leading to better blood perfusion within the pulp, alveolar bone, masticatory muscles, the TM joint, and the periodontium. Very few general or specialty practitioners are even aware of the aforementioned facts which are extremely relevant to many confounding issues that are routinely faced by them in everyday practice, and are oblivious to the havoc that the influence that these autonomic sympathetic nerve fibers can have upon operative, surgical, muscular, orthopedic, endodontic, orthodontic and periodontal conditions. As CNO6 demonstrates, it turns out that there are MASSIVE influences on not only the health of the dental pulp, but also upon the periodontium, alveolar bone, muscles, & the TMJs; essentially the entire masticatory system. Additionally, the CNO has recently published novel clinical research showing that the usage of local anesthetic targeting 3rd order neurons in the neck leads to consistent anxiolysis; finally-a simple cure for procedural anxiety is here (Piper, Yiannios & Radke, 2026)!
Course Outline
The neurology and anatomy surrounding these sympathetic pathways in CNO6 are intensely scrutinized, and viewers will learn how to safely incorporate 3rd order sympathetic nerve blocks within their practices. The Greater Auricular Nerve, Erb’s point, and the Transverse Cervical Nerve are highlighted specifically in CNO6. Novel research relating to the sympathetics which has been recently published by the CNO is also proffered. Many case studies and demonstrations are also visualized within the course as well.
Day two of CNO6 demonstrates the usefulness of incorporating TMJ CBCT and MRI imaging into everyday general and specialty practice. The practitioner who has at least a basic understanding of TMJ imaging will be able to identify confounding TMJ/D problems that others will totally miss, and more practically, learn to vet the TMJ orthopedics and thus the stability of the occlusion prior to initiating irreversible occlusal therapies including roundhouse full mouth reconstructions, cosmetic veneer smile makeovers, implant prosthetics, orthodontic therapy and orthognathic surgeries. Day 2 of CNO6 is basically a quick but thorough introduction to TMJ 3D imaging, outlining why this skillset can positively affect both diagnostics and treatment outcomes. Those who are interested in a deeper dive relating to TMJ imaging are invited to view CNO3 online, which is a very detailed course relating to imaging of the TMJs using CBCT and MRI. T-Scan digital occlusal analysis and joint vibration analysis (JVA) training and its usage within everyday dental practice is also presented within this continuing education course.
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