Level Requirements

• Completion of Levels 1 and 2 are recommended prerequisites.
• 2-3 days of lecture, observation, and participation in Rogers, AR at CNO headquarters.
• A serious introduction to reading TMJ CBCT and MRI scans, and how they relate to TMD treatment.
• 200 question written multiple choice online examination/$400 exam fee/80% to pass/must be taken within 12 months of CNO level 3 attendance.
• 2 hour oral examination regarding 3D imaging and its relevance to TMD diagnosis and therapy by CNO instructors at CNO headquarters in Rogers, Arkansas. This oral examination must be taken within 12 months of CNO level 3 attendance. Topics covered will be similar to those studied in the bibliography disseminated for the level 3 examination/oral exam cost is $800/pass-fail
• Verified attendance at the Piper Education and Research Centers coursework entitled “Utilizing Imaging Skills in Foundational Occlusion” with Dr. Mark Piper in St. Petersburg, Florida. See the following for information regarding the imaging course: http://www.pipererc.com/courses-facility.asp
• Level 3/MCNO listing within the CNO database requires that the doctor be current with CNO annual membership

• How to determine if your patient is a CNO patient Type A, B, or C, hence vetting efficacy of treatment.
• Deciding if a patient possesses “stable and adapted” joints based upon objective metrics.
• How the TMJs affect the bite, and vice versa.
• The basics of how to order, read, and interpret CBCT and MRI scans of the TMJs.
• What to do with the knowledge that the 3D imaging provides.
• How to combine 3D imaging data with occlusal treatment decisions in a reproducible and objective manner.
• How 3D imaging of the TMJs relates to the occlusion.
• When occlusal adjustment corrections are not indicated based upon 3D scans.
• When TMJ surgery is likely the best option for the patient.
• How to decide if MIP is a good restorative treatment position or not, based upon 3D scans.
• How to decide if downwards and forwards may be a good restorative treatment position or not, based upon 3D scans.
• Understanding the relevance of lateral and medial pole cartilagenous tears.
• Basics behind TMJ surgery.
• An introduction to cervical sympathetic inputs for a TMD patient with intractable pain.
• Understanding TMJ anatomy and dynamic function.
• How to “read a bite” to elucidate when TMJ foundational joint issues are present and require 3D imaging for diagnosis.
• When occlusal splints or orthotics are biomechanically indicated, and why they are not much of the time.
• How to objectively and reliably ascertain if a patient possesses stable and adapted TMJ’s based upon clinical exam and 3D imaging.
• How to use Anomalous Medical software to create a virtual representation of your patient's condition.
• An introduction to Dr. Mark Piper's foundational occlusion concepts.
• How to objectively decide when NOT to perform DTR occlusal adjustment therapy on a patient based upon not only the occlusal measurement tools, but on 3D scans of the “backside” TMJs as well.
• The efficacy of using in office CADCAM digital imaging to perpetuate the exact shape of restorative additive alterations the same day, to help ensure the proper perpetuation of additive occlusal changes.

Course Instructors

Dr. Nick Yiannios is a private practitioner, author, researcher and founder of the Center for Neural Occlusion. He is a contributing author in the Handbook of Research on Computerized Occlusal Analysis Applications in Dental Medicine and is credited with identifying the phenomenon known as Frictional Dental Hypersensitivity for dental medicine. He has published multiple times regarding the usage of T-Scan® digital occlusal analysis, EMG interpretation, MRI & CBCT TMJ imaging, dental hypersensitivity, and computer-guided occlusal adjustment procedures in several other textbooks and journals.

Dr. Ed Zebovitz is a world-renowned TMJ surgeon who has spent decades helping patients with occlusal and TMJ/D problems. He actively engages in objectively diagnosing TMJ pathology using both MRI & CBCT imaging prior to surgical or non-surgical intervention. He is visiting faculty at both the Pankey Institute and Spear Education as well as the CNO, and has been a CNO Board Member since 2015.

Mr John Radke has over 50 years of expertise in the TMJ/D & occlusion realm. John is the creator of the BioPak® software, Bio-EMG, JVA, digital Mastication Analysis and Jaw Tracking technologies. His engineering expertise provides a unique perspective for CNO1 attendees, and he is an invaluable resource for those learning the myriad intricacies of using these various technologies in practice. John is also the managing editor of "Advanced Dental Technologies & Techniques", an online scholarly open journal.