C. Ludwig MD, Mannheim – GermanyPractise for Orthopedic Surgery, Hand- and Footsurgery,

Cranio-Mandibular Dysfunction, Posture and Movement Analysis

C. Ludwig MD, Mannheim – GermanyPractise for Orthopedic Surgery, Hand- and Footsurgery,

Cranio-Mandibular Dysfunction, Posture and Movement Analysis

Descending Functional Approach

of the Skeletal System

Descending Functional Approach

of the Skeletal System

The Cranio-Mandibular Dysfunction and Their Orthopaedic Problems –

•Do orthopaedic problems lead to CMD or vice versa?

•What should the dentist know about the total spine especially the cervical spine and

•What should the orthopedic surgeon know about TMJ-, occlusion- and toothpain and -function?

- a summary of diagnostics, treatment and solutions -

•Do orthopaedic problems lead to CMD or vice versa?

•What should the dentist know about the total spine especially the cervical spine and

•What should the orthopedic surgeon know about TMJ-, occlusion- and toothpain and -function?

- a summary of diagnostics, treatment and solutions -

What’s to do in case of this kind of scoliosis?What’s to do in case of this kind of scoliosis?

Christian LudwigChristian Ludwigsettled in own institute since April,1st 1989 as:

Memberships:

Orthopaedic Surgeon (VSO, BVOU, DGOOC, ADO)• Special Surgeon and Traumatologist for Assiciations of the

Professions• Casualty Surgery / Traumatology / (Paraplegiology) (BAO, BNC)• Handsurgery (DIAH e.V., DGH, DAH)• Footsurgery (DAF, GFFC)• Outpatient Operative Treatment• Sports medicine (DSÄB)• Physical Therapy• Chiropractics (Dr.Karl-Sell-Ärzteseminar (MWE) e.V., DGMM) • Acupuncture - TCM (Diploma of DÄGfA) (DÄGfA) • Special Therapy of the Pain (IGOST)• Posture and Movement Analysis (GHBF)• „CMD-Orthopaedy“ (GZM, ICCMO) • Osteopathy - Kinesiology (in several parts)

settled in own institute since April,1st 1989 as:Memberships:

Orthopaedic Surgeon (VSO, BVOU, DGOOC, ADO)• Special Surgeon and Traumatologist for Assiciations of the

Professions• Casualty Surgery / Traumatology / (Paraplegiology) (BAO, BNC)• Handsurgery (DIAH e.V., DGH, DAH)• Footsurgery (DAF, GFFC)• Outpatient Operative Treatment• Sports medicine (DSÄB)• Physical Therapy• Chiropractics (Dr.Karl-Sell-Ärzteseminar (MWE) e.V., DGMM) • Acupuncture - TCM (Diploma of DÄGfA) (DÄGfA) • Special Therapy of the Pain (IGOST)• Posture and Movement Analysis (GHBF)• „CMD-Orthopaedy“ (GZM, ICCMO) • Osteopathy - Kinesiology (in several parts)

CMD-Diagnostics and -therapy are neglected by orthopaedic surgeons to this day at least in Germany!

…or should I better say - ignored?

CMD-Diagnostics and -therapy are neglected by orthopaedic surgeons to this day at least in Germany!

…or should I better say - ignored?

What are You doing today?

Nothin‘!Yeah, but I haven‘t finished yet..

But yesterday You already did the same!

Harold Gelb told me by his paper the other and better way than traditional

medicine to think about head and neck pain...

Harold Gelb told me by his paper the other and better way than traditional

medicine to think about head and neck pain...

„CLINICAL MANAGEMENT OF HEAD-, NECK- AND TMJ-PAIN AND DYSFUNCTION“

„CLINICAL MANAGEMENT OF HEAD-, NECK- AND TMJ-PAIN AND DYSFUNCTION“

Harold GELB - original paper -

1991 Ishiyaku EuroAmerica, Inc.Publishers - St.Louis - TokyoISBN 1-56386-004-X

Harold GELB - original paper -

1991 Ishiyaku EuroAmerica, Inc.Publishers - St.Louis - TokyoISBN 1-56386-004-X

Synonyms for Disorders of the Orofacial System

Synonyms for Disorders of the Orofacial System

according to BARTEL, DGS-head, Halberstadt, GER:

• COSTEN-syndrome • atypic face pain• cranio-mandibular-syndrome• cranio-mandibular dysfunction• KISS-Syndrome (german acronym for:

Kopfgelenks- induzierte Symmetrie-Störung

In this context there is a painful muscletension in the upper cervical spine with subsequent discom-fort for babies and toddlers

according to BARTEL, DGS-head, Halberstadt, GER:

• COSTEN-syndrome • atypic face pain• cranio-mandibular-syndrome• cranio-mandibular dysfunction• KISS-Syndrome (german acronym for:

Kopfgelenks- induzierte Symmetrie-Störung

In this context there is a painful muscletension in the upper cervical spine with subsequent discom-fort for babies and toddlers

It‘s not the Rock-Group....It‘s not the Rock-Group....

KISS: is an Occipital-Joint-Induced-Disorder-of-Symmetry

KISS: is an Occipital-Joint-Induced-Disorder-of-Symmetry

and leads to symtoms in adults:

„pelvic malalignement, kneepain, low back- and neck pain, acute hearing loss, tinnitus,dizziness, dazed feeling, feeling of brain pressure, head ache, migraine, some metabolismdisorders, sleep disorders and other disorders of autonomic nervous system.

KISS can be differentiated between symptoms, which must be considered as a consequence ofa retarded KISS-disorder in babies and diseases, which depending on later acquired

traumata.Characteristic for the classification under the term “KISS-Syndrome” is only the fact, that thediscomfort is based on a blocking of the upper neck joints C0/1 and the related disorders.“

and leads to symtoms in adults:

„pelvic malalignement, kneepain, low back- and neck pain, acute hearing loss, tinnitus,dizziness, dazed feeling, feeling of brain pressure, head ache, migraine, some metabolismdisorders, sleep disorders and other disorders of autonomic nervous system.

KISS can be differentiated between symptoms, which must be considered as a consequence ofa retarded KISS-disorder in babies and diseases, which depending on later acquired

traumata.Characteristic for the classification under the term “KISS-Syndrome” is only the fact, that thediscomfort is based on a blocking of the upper neck joints C0/1 and the related disorders.“

source: www.kiss-therapie.de

outstanding website - information for physicians, dentists, mothersand ... even orthopaedic surgeons!!!

outstanding website - information for physicians, dentists, mothersand ... even orthopaedic surgeons!!!

KISS I and KISS IIKopfgelenksinduzierte Symmetriestörung

KISS I and KISS IIKopfgelenksinduzierte Symmetriestörung

torticollis (I) and

„stargazer“ (II)

torticollis (I) and

„stargazer“ (II)

Text

What do we use our set of teeth for?What do we use our set of teeth for?• for eating - really? ‘fast food‘ you don‘t need to chew, you

easily can swallow down...“ - 50x masticating per bite?• to grind the food and therefore break it up into its compo-

nents for optimal utilisation... for start of the digestion• as a tool or a weapon - „Mike Tyson“• for fighting - aggression, fury, „distroy him!!!“• to express fear - horror, astonishment, suprise

(first decoupling with „MEERSSEMAN, then bruxism“)

• as a psychological reaction – for processing of psycho-reactive impressions and

„parafunctions“, e.g. nail biting

• to apeal to someone - enticing, teasing, suggesting perfection (Verneers, Brackets)

• for eating - really? ‘fast food‘ you don‘t need to chew, you easily can swallow down...“ - 50x masticating per bite?

• to grind the food and therefore break it up into its compo-nents for optimal utilisation... for start of the digestion

• as a tool or a weapon - „Mike Tyson“• for fighting - aggression, fury, „distroy him!!!“• to express fear - horror, astonishment, suprise

(first decoupling with „MEERSSEMAN, then bruxism“)

• as a psychological reaction – for processing of psycho-reactive impressions and

„parafunctions“, e.g. nail biting

• to apeal to someone - enticing, teasing, suggesting perfection (Verneers, Brackets)

Is a Cranio-Mandibular-Dysfunction hidden behind these smart fellows?

Is a Cranio-Mandibular-Dysfunction hidden behind these smart fellows?

Jean Claude van DammeJean Claude van Damme Arnie Schwarzenegger Arnie Schwarzenegger

Jean Claude van DammeJean Claude van Damme

10°

Is the excessive training used to

...equalize dysbalance...?

…and to stabilize...?

Is the excessive training used to

...equalize dysbalance...?

…and to stabilize...?

2,8°

2,5°

11,4°

Monsieur le GouverneurMonsieur le Gouverneur

model of a grape press

4,3°

3,2°

voilà, le brouxiste!

probably an old KISS-syndrome?

• ...here probably nothing • will be hidden.

• The sytems either have • arranged themselves by • influence of alcohol...

• or by spontaneous • adaptation…

Not every „optical terrible set of teeth“ necessarily has a dysfunction…

Not every „optical terrible set of teeth“ necessarily has a dysfunction…

...but can be an interference field!!!

17

typical „focus“ – set of teethtypical „focus“ – set of teeth

18

typical „focus“- set of teeth ortypical „focus“- set of teeth or

interference field

Iatrogenic malocclusionafter treatment with a headgear!!!

Iatrogenic malocclusionafter treatment with a headgear!!!

many „beautiful bites“ have iatrogenic CMD`s in origin and an abocclusion...

many „beautiful bites“ have iatrogenic CMD`s in origin and an abocclusion...

Lyra

3,9°

3,9°

Aetiology of CMD / CVDAetiology of CMD / CVDAscending CMD:Static disorders (malposition of body axis)• Arthrosis of joints (hip, knee, ankle)• Arthritis of joints Dynamic disorders (malformation of the foot, dysbalances)Muscular diseases (systemical MD - Enceph.Diss.,

atrophies)Nerval diseases (‚Duchênne‘, ,Trendelenburg‘)• Paresis, paralysis, para-/tetraplegia• Acute gen. disease (stroke, apoplexia) Traumata (malunions, shortenings, lengthenings)• Operative treatment (prosthesis depending failures)• Accelerating injuries of the cervical spine “whiplash”Malformations of skel. (scoliois dep. on hemimetamere

segmental pathology)

Ascending CMD:Static disorders (malposition of body axis)• Arthrosis of joints (hip, knee, ankle)• Arthritis of joints Dynamic disorders (malformation of the foot, dysbalances)Muscular diseases (systemical MD - Enceph.Diss.,

atrophies)Nerval diseases (‚Duchênne‘, ,Trendelenburg‘)• Paresis, paralysis, para-/tetraplegia• Acute gen. disease (stroke, apoplexia) Traumata (malunions, shortenings, lengthenings)• Operative treatment (prosthesis depending failures)• Accelerating injuries of the cervical spine “whiplash”Malformations of skel. (scoliois dep. on hemimetamere

segmental pathology)

but: HEADGEAR-treatment

hurts a WHOLE LIFE!!!

but: HEADGEAR-treatment

hurts a WHOLE LIFE!!!

...YOU SHOULD NOT DO THAT

!!!

...YOU SHOULD NOT DO THAT

!!!

„whiplash-injury“ hurts, sometimes more than 6 month!!!...

„whiplash-injury“ hurts, sometimes more than 6 month!!!...

Statical Disorder and Ascending CMDStatical Disorder and Ascending CMD

23

Examples to Adjust and Also to Fix Static DisordersExamples to Adjust and Also to Fix Static Disorders

Aetiology of CMD / CVDAetiology of CMD / CVDDescending CMD:• Psychogenic causes (para-/sympathic/vegetative)• Structural changes (teeth, TMJ, muscles)• „Jaw-treatment“- induced = iatrogenic malocclusion

e.g. by multiband-treatment, brackets etc.

• Unfortunately still „headgear-treatments“• Idol of „beautiful“ teeth and „optimized set of teeth“ and

the related corrections • Trauma -“Lefort“, jaw surgery• Accelerating cervical spine ”whiplash-injury” – occipital

base• Eye-Disorders (partial amaurosis, ametropia)• ENT-Disorders (one-ear-deafness)

Descending CMD:• Psychogenic causes (para-/sympathic/vegetative)• Structural changes (teeth, TMJ, muscles)• „Jaw-treatment“- induced = iatrogenic malocclusion

e.g. by multiband-treatment, brackets etc.

• Unfortunately still „headgear-treatments“• Idol of „beautiful“ teeth and „optimized set of teeth“ and

the related corrections • Trauma -“Lefort“, jaw surgery• Accelerating cervical spine ”whiplash-injury” – occipital

base• Eye-Disorders (partial amaurosis, ametropia)• ENT-Disorders (one-ear-deafness)

Static Disorder and Descending CMDStatic Disorder and Descending CMD

midline-deviation infront locking teeth

in decoupling with wad-rollsa correct midline is resulting

deep- and cross-bite with abraded teeth

abraded teeth

Descending CMD: After Jaw Orthopaedic Treatment: „new tires“…

Descending CMD: After Jaw Orthopaedic Treatment: „new tires“…

...but in locking the frontteeth „there‘s something the matter with the track“!

...but in locking the frontteeth „there‘s something the matter with the track“!

Possible CMD-Symptoms In Head-Neck-Region

Possible CMD-Symptoms In Head-Neck-Region

• vegetativ disturbances (discomfort)• eyedisorders (visus, flickering, diplopy)• head pain, migraine (occipital-, temporal-, head pain)• tooth pain (in spite of healthy teeth, tooth roots • and gingivia)• dizzieness (vertigo)• tinnitus (muscle tonus)• cervical disphonia (modification of the timbre)• psyche (bad temper, stress, depression, disturbed sleep.)

• asymmetrics (face, face-scoliosis)

• vegetativ disturbances (discomfort)• eyedisorders (visus, flickering, diplopy)• head pain, migraine (occipital-, temporal-, head pain)• tooth pain (in spite of healthy teeth, tooth roots • and gingivia)• dizzieness (vertigo)• tinnitus (muscle tonus)• cervical disphonia (modification of the timbre)• psyche (bad temper, stress, depression, disturbed sleep.)

• asymmetrics (face, face-scoliosis)

Possible CMD-Symptoms in Trunk and Lower Extremities

Possible CMD-Symptoms in Trunk and Lower Extremities

• cervical-brachial pain• thoracal disorder (angina pectoris)• „heart attack pain“• muscle hardening / tension• ambiguous disorder in hip and knee joint –

without radiologic signs (not arthrogenic)• low back pain (Ischias)• ambiguous inguinal discomfort (hip-joint)• ambiguous genital and groin discomfort (testicle pain)• ambiguous lower belly discomfort („dysmenorrhoe“)• repetitive blockings in SIJ with pseudo radicular syndrome

• cervical-brachial pain• thoracal disorder (angina pectoris)• „heart attack pain“• muscle hardening / tension• ambiguous disorder in hip and knee joint –

without radiologic signs (not arthrogenic)• low back pain (Ischias)• ambiguous inguinal discomfort (hip-joint)• ambiguous genital and groin discomfort (testicle pain)• ambiguous lower belly discomfort („dysmenorrhoe“)• repetitive blockings in SIJ with pseudo radicular syndrome

Diagnostic Algorithm in the Oral and Cranio Fascial Orthopaedy

Diagnostic Algorithm in the Oral and Cranio Fascial Orthopaedy

Take your time! The patient will tell us

the diagnosis!

Take your time! The patient will tell us

the diagnosis!

Alarm Bells!Alarm Bells!Inspection• Symmetry?• pupils plane parallel to…• biting plane?• acoustic sounds of malocclu-

sion?• aligned occlusion or uncontrolled

positioning of the jaw? • alignement in 13, 23, 33, 43?• snapping: audible – palpabel?• midline deviation?• occipital joints – painful?• loss of height of the bite?• muscletonus of the neck - m.

splenius capitis?• pressure-sensitive jaw muscles:

m. masseter, m. temporalis, m.pterygoideus - medial and lateral?

• throat muscles e.g. omo-hyoid, mylohyoid etc.?

Inspection• Symmetry?• pupils plane parallel to…• biting plane?• acoustic sounds of malocclu-

sion?• aligned occlusion or uncontrolled

positioning of the jaw? • alignement in 13, 23, 33, 43?• snapping: audible – palpabel?• midline deviation?• occipital joints – painful?• loss of height of the bite?• muscletonus of the neck - m.

splenius capitis?• pressure-sensitive jaw muscles:

m. masseter, m. temporalis, m.pterygoideus - medial and lateral?

• throat muscles e.g. omo-hyoid, mylohyoid etc.?

Diagnostic Algorithm in Oral and Craniofacial Orthopaedy

Diagnostic Algorithm in Oral and Craniofacial Orthopaedy

Inspection • teethmarks in the tongue• bruxism – disordered swallowing• deviation of plica• deviation of the tongue when opening the

mouth

Inspection • teethmarks in the tongue• bruxism – disordered swallowing• deviation of plica• deviation of the tongue when opening the

mouth

Functional Diagnostics and TestsFunctional Diagnostics and Tests

...a short excursion to functionality......a short excursion to functionality...

Variable Difference of Leglengthin Sitting up from Lieing

Variable Difference of Leglengthin Sitting up from Lieing

without teethcontact, lieing without teethcontact, sitting

with occlusion, lieingwith occlusion, lieing with occlusion, sittingwith occlusion, sitting

Meersseman-Test

Patrick-Kubis-TestPatrick-Kubis-Test

Limitation of abduction of the hip joint on the side of the neck joint blocking C0/C1

Limitation of abduction of the hip joint on the side of the neck joint blocking C0/C1

Radiological DiagnosticsRadiological DiagnosticsX-Ray:• total spine in two planes in load bearing• Pelvis• Joints• Jaw (GUTHMANN) - OPG• right – left single load bearing

CT, MRT:• nicht zwingend erforderlich

X-Ray:• total spine in two planes in load bearing• Pelvis• Joints• Jaw (GUTHMANN) - OPG• right – left single load bearing

CT, MRT:• nicht zwingend erforderlich

Radiological DiagnosticsRadiological Diagnostics

Complementary DiagnosticsComplementary DiagnosticsPhoto-optical

4D-survey, statically and functionally...

Photo-optical 4D-survey,

statically and functionally...

Contact USA:DIERS Medical Systems, Inc.225 W. Washington Street, Suite 2200Chicago, IL 60606USAPhone: +1 (312) 419 0205Fax: +1 (312) 277 3416

39

Standing position without occlusionStanding position without occlusion Standing position with occlusionStanding position with occlusion

Photo-Optical 4D-SurveyPhoto-Optical 4D-Survey

40

Standing with fixed footmusclesStanding with fixed footmuscles

Decoupling „MEERSSEMAN“ with wad rolls and fixed footmusclesDecoupling „MEERSSEMAN“ with wad rolls and fixed footmuscles

Photo-Optical 4D-SurveyPhoto-Optical 4D-Survey

Photo-Optical 4D-SurveyPhoto-Optical 4D-Survey

standing with occlusion on aequilibrium(jig) splint without tensed footmusclesstanding with occlusion on aequilibrium(jig) splint without tensed footmuscles

standing with occlusion on aequilibrium(jig) splint with tensed footmusclesstanding with occlusion on aequilibrium(jig) splint with tensed footmuscles

medreflexx® sensorimotorically insoles

medreflexx® sensorimotorically insoles

Evaluation of Clinical Findings of the Postural Sensori-motorical Examination for Posture and Movement Analysis

Evaluation of Clinical Findings of the Postural Sensori-motorical Examination for Posture and Movement Analysis

1.) technical analyses: X-ray, photo optical 4D survey, gaitanalysis, pedobarography (functionally)

2.) orienting global impression: orthopaedic findings:(standsphase / gait /asymmetry of face and jaw / head positioning / total spine / leg axis / feet / ROM

3.) vestibular test: UNTERBERGER, ROMBERG4.) examination of the sensorimotorical coordination of the footmuscles by

ring-test according to Prof. OMURA (applied kinesiology);examination of the proprioreception of the footmuscles

5.) examination of the craniomandibular system 6.) functional muscular kinetic chain (ascending disturbance) with AK7.) examination of the binocular vision system8.) test of footmuscles (right / left) - size of the insoles

1.) technical analyses: X-ray, photo optical 4D survey, gaitanalysis, pedobarography (functionally)

2.) orienting global impression: orthopaedic findings:(standsphase / gait /asymmetry of face and jaw / head positioning / total spine / leg axis / feet / ROM

3.) vestibular test: UNTERBERGER, ROMBERG4.) examination of the sensorimotorical coordination of the footmuscles by

ring-test according to Prof. OMURA (applied kinesiology);examination of the proprioreception of the footmuscles

5.) examination of the craniomandibular system 6.) functional muscular kinetic chain (ascending disturbance) with AK7.) examination of the binocular vision system8.) test of footmuscles (right / left) - size of the insoles

Τῆς δ᾽ ἀρετῆς ἱδρῶτα θεοὶ προπάροιθεν ἔθηκαν ἀθάνατοι.(Hesiod)Τῆς δ᾽ ἀρετῆς ἱδρῶτα θεοὶ προπάροιθεν ἔθηκαν ἀθάνατοι.(Hesiod)

„prior virtue the immortal gods have set the sweat“„prior virtue the immortal gods have set the sweat“

TMJ-MedicineTMJ-MedicineOrthopaedy Orthopaedy

NeurologyNeurologyENT ENT

OphthalmologyOphthalmology

Goal: Restoration of Statics, Dynamics and FunctionGoal: Restoration of Statics, Dynamics and Function

Physiotherapy - Manual Medicine - Osteopathy Physiotherapy - Manual Medicine - Osteopathy

Interdisciplinary

Working Group

Interdisciplinary

Working GroupPsychosomaticsPsychosomatics

You never know what to expect!

Surgeons without anatomy are equal to moles: The whole day they are in the dark, and what they are leaving are... mounds! (Virchow)

Thank You for

attention!

Thank You for

attention!

Geddes

LiteratureLiterature• APPLIED KINESIOLOGY (AK)

- Wolfgang Gerz 1996 AKSE Verlag / ISBN 3-00-000616-8

• MANUAL OF THE MUSCLE-TRIGGERPOINTS- Janet G. Travell - David Simons2000 Urban&Fischer / ISBN 3-437-41400-1/3

• DENTAL FUNCTIONAL THERAPY- Wolfgang B. Freesmeyer 1993 Hanser-Verlag / ISBN 3-446-15657-7

• THE LITTLE DIFFERENT HEAD- AND FACEPAIN -- Kares, Schindler, Schöttl 2001 ICCMO Ratgeber / ISBN 3-00-008243-3

• CLINICAL MANAGEMENT OF HEAD-, NECK- AND TMJ-PAIN AND DYSFUNCTION - Harold Gelb - original paper -

1991 Ishiyaku EuroAmerica, Inc. Publishers – St.Louis – Tokyo ISBN 1-56386-004-X

• MANUAL MEDICINE Zeitschrift der Deutschen Gesellschaft für Manuelle Medizin / Springer-Verlag

• APPLIED KINESIOLOGY (AK)- Wolfgang Gerz 1996 AKSE Verlag / ISBN 3-00-000616-8

• MANUAL OF THE MUSCLE-TRIGGERPOINTS- Janet G. Travell - David Simons2000 Urban&Fischer / ISBN 3-437-41400-1/3

• DENTAL FUNCTIONAL THERAPY- Wolfgang B. Freesmeyer 1993 Hanser-Verlag / ISBN 3-446-15657-7

• THE LITTLE DIFFERENT HEAD- AND FACEPAIN -- Kares, Schindler, Schöttl 2001 ICCMO Ratgeber / ISBN 3-00-008243-3

• CLINICAL MANAGEMENT OF HEAD-, NECK- AND TMJ-PAIN AND DYSFUNCTION - Harold Gelb - original paper -

1991 Ishiyaku EuroAmerica, Inc. Publishers – St.Louis – Tokyo ISBN 1-56386-004-X

• MANUAL MEDICINE Zeitschrift der Deutschen Gesellschaft für Manuelle Medizin / Springer-Verlag

49

...at least I would like to introduce my hometown MANNHEIM...at least I would like to introduce my hometown MANNHEIM

Mannheim the City between the rivers Rhein and Neckar

Mannheim the City between the rivers Rhein and Neckar

• only some examples:• Foundation of BASF - Chemical factory• Mercedes Benz- invention of the first three wheel car in the world• Mercedes Benz Bus construction and production• ROCHE pharmaceutics• „petrolub“ machine oil and other lubricants• Invention of Bulldog LANZ, nowadays John Deere• Schiller Town, Schiller Theatre, poet and author of „Räuber“• Classic music emsemble foundation of Stamitz• Invention the first rocketplane by Julius Hatry• the first pop-academy in Europe• a huge baroque palace, bigger than Versailles in France

• only some examples:• Foundation of BASF - Chemical factory• Mercedes Benz- invention of the first three wheel car in the world• Mercedes Benz Bus construction and production• ROCHE pharmaceutics• „petrolub“ machine oil and other lubricants• Invention of Bulldog LANZ, nowadays John Deere• Schiller Town, Schiller Theatre, poet and author of „Räuber“• Classic music emsemble foundation of Stamitz• Invention the first rocketplane by Julius Hatry• the first pop-academy in Europe• a huge baroque palace, bigger than Versailles in France