Limited enro LLment • register now AACP InstituteOrthodontics for Phase-II Finishing, Sleep Disorders, Alternative Therapies and the Craniofacial Pain Patient, & Integration of Current

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AACP Institute

AACP Institute

Learn From the Experts at AACP!Gain the knowledge and clinical skills required to assess, differentially diagnose, and effectively treat the majority of craniofacial pain patients seen in dental practice today. Simultaneously make progress toward fulfilling AACP Fellowship and AGD Mastership requirements

Limited enroLLment • register now

September 12–14, 2013 Session 1: Craniofacial Pain Disorders, History, Examination, Diagnosis, & Treatment Planning

October 31 – November 1 – 2, 2013 Session 2: Treatment & Management of the Patient with a Craniofacial Pain Disorder

February 13–15, 2014 Session 3: Physical Medicine Modalities, Occlusion, Pharmacology, & Electro-Diagnostic Modalities in the Management of the Craniofacial Pain Patient

April 24–26, 2014 Session 4: Orthodontics for Phase-II Finishing, Sleep Disorders, Alternative Therapies and the Craniofacial Pain Patient, & Integration of Current Concepts in Craniofacial Pain into Dental Practice American Airlines Training & Conference Center, Fort Worth, TX Approximately 96 CE Credits (56 lecture, 40 participation) are Available in this 4-Session Craniofacial Pain Mini-Residency Program

Craniofacial PainMini-Residency

Program Class 9, 2013–2014

Lectures

Hands-On WorkshopsCase Reviews

Case Presentations

Gerald J. Murphy, BS, DDS — Director

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If you are striving for exceptionalism as a practitioner, then this exceptional program is for you. Whether you simply wish to integrate these concepts into an already successful general dental practice or whether your desire is to ultimately focus your practice entirely to this discipline, this program will fulfill your needs.

I urge you to carefully evaluate this brochure, which outlines the programs and the curriculum. In addition, read the testimonials of past participants and visit the members section of the Academy website, www.aacfp.org, and click on “Institute” to see firsthand in both photographic and video format the content and tenor of this excellent program. If you are not a member of the academy, I urge you to become one. You will realize significant savings on your registration fee as well as receive exceptional benefits that membership provides. Contact our Executive Office at 800.322.8651 for details.

I am confident that you will find your continuing education investment dollar well spent and know that the education that you will receive far exceeds the expenditure of time and money involved.

Gerald J. Murphy, BS, DDS Director AACP Institute

“Wow! This program is by far the most complete and detailed approach toward a very complex (and often confusing) part of dentistry. Allowing time to pass between sessions gives the attendees a chance to study, learn, absorb, and apply much of what they are learning. The level of expertise the presenters have is at once impressive and inspirational. The attitude of these presenters is one of the helpful mentoring, and no attendee could feel anything other than a truly open and encouraging attitude from them.

In 40 years of dentistry, and participating in every CE program of national repute, without a doubt this mini-residency provided the most ‘bang for the buck.’

I would strongly encourage anyone practicing dentistry in the year 2010 to take up the challenge of becoming better informed, and more able to treat and help the myriad of patients suffering with TMD and the associated ills.

I know everyone will be pleased (as I have been) to have made the decision to at-tend the program.”

Dr. Michael Folck Virginia Beach, VA

“The AACP Mini-Residency is structured to offer a great deal of didactic and practical learning material. It was instrumental in elevating both my understanding and diagnostic skill, which my TMD patients are benefiting from now. In terms of both value and experience, it is truly one of the best courses available!” Dr. Roger Cheung—BC, Canada

Dear Colleagues,I would like to invite you to join us as a participant in the American Academy of Craniofacial Pain Institute Mini-Residency Program. This unique educational experience affords you the opportunity to participate in the finest program available dealing with craniofacial pain,

temporomandibular disorders, and sleep dentistry.

This exceptional four-part program combines pre-study-classroom lecture as well as hands and on participation to cover the area of craniofacial pain, temporomandibular disorders, and sleep dentistry in their entirety. The program is ideal for those doctors wishing to achieve fellowship in the American Academy of Craniofacial Pain. Fellowship in the Academy sets the doctor apart from the general dental population who treat craniofacial pain as part of a general dental practice or who limit their practice to this discipline.

Achieving fellowship in the Academy demonstrates that the doctor has completed exhaustive training, demonstrated extensive experience, and has been thoroughly tested and evaluated by a testing body. This provides professionals in the health-care community, as well as patients, a means of selecting you as the professional they wish to refer to or seek care from. In addition, for those doctors who are on the Academy of General Dentistry mastership track, this program offers a combination of both lecture and participation that are required for the fulfillment of those requirements.

The program is designed for both the neophyte in this area who wishes to pursue exceptional educational experience to provide himself or herself with a broad base of knowledge and for the experienced practitioner helping himself or herself to categorize and systematize his or her approach to the treatment of patients.

The greatest benefit that you will receive is the training to help a suffering patient population, many of whom have been experiencing pain for years and have thought their quest for relief to be hopeless. Many of these suffering people have seen a multitude of health-care providers, with no relief forthcoming.

In addition, the areas of craniofacial pain/temporomandibular disorders and sleep dentistry afford an excellent and lucrative income center to an existing practice, affording you access to a multitude of patients seeking relief for their problems.

AACP InstituteC r a n i o FaC i a l Pa i n M i n i - r e s i d e n C y P r o g r a M

C r a n i o faC i a l Pa i n M i n i - r e s i d e n C y P r o g r a M

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AACP Institute

PROgRam BenefitsEnrollment is limited to ensure quality instruction, with priority registration given to dentists who register to attend the entire 4-session program.

Passing grades on all 4 exams offered with this program satisfy AACP Fellowship written exam requirements; case presentation and review prepares qualified candidates for the oral portion of the AACP Fellowship exam.

Curriculum and session content is evidence-based and 100% approved and endorsed by the American Academy of Craniofacial Pain, resulting in a superior learning experience.

teaCHing/LeaRning metHOdOLOgiesLecture and participation is included in every session, with emphasis on clinically relevant knowledge and skills.

Case review and case presentation experiences encourage development of a logical framework you can use to approach patients (and complete oral case defenses required for tier advancement in AACP and other organizations).

Stand-alone sessions enable you to enroll in the entire mini-residency program or attend individual sessions based on your schedule and personal interests.

end-Of-sessiOn examsFellowship in the AACP is available to AACP members only. Dentists wishing to test for Fellowship in the AACP will take four individual written examinations. The examination covering Session 1 will be given the evening prior to the start of Session 2, the Session 2 examination will be given the evening prior to the start of Session 3, the Session 3 exam will be given the evening prior to the start of Session 4, and Session 4 testing may be completed by mail utilizing a desig-nated proctor prior to the AACP Summer Symposium or completed the day prior to the start of this summer meeting. Participation in the examination portion of the Craniofacial Pain Mini-Residency program is optional and at the discretion of each participant.

COntinuing eduCatiOn CReditsApproximately 96 CE credits (56 lecture, 40 participation) are available to participants in this 4-session Craniofacial Pain Mini-Residency program.

“My experience with the mini-residency program offered by the AACP Institute went well beyond my expectations. Instead of receiving cookbook treatment modalities, I was presented with a philosophy of total patient care that will positively affect my practice and my patients for the remainder of my dental career. The instruction was top-notch and the hands-on aspect of the course was not matched by any other program I’ve seen.” Dr. Rob Herron —Columbus, KS

distinguisHed faCuLtyRonald C. Auvenshine, DDS, PhDDiplomate: American Board of Orofacial Pain

Dennis R. Brenkert, DDS, MSDiplomate: American Board of Craniofacial

Pain, American Academy of Pain Management, American Board of Orthodontics

Fellow: AACP

Jeffrey S. McCarty, DDSDiplomate: American Board of Craniofacial

Pain, American Academy of Pain Management

Fellow: AACP

Paul Mitsch, DMDFellow: AACP

Gerald J. Murphy, BS, DDSDirector, AACP Institute AACP Past PresidentDiplomate: American Board of Craniofacial

Pain, American Academy of Pain Management

Fellow: AACP

Wesley E. Shankland, II, DDS, MSAACP Past President Diplomate: American Board of

CraniofacialPainFellow: AACP

H. Clifton Simmons III, DDSAACP Past PresidentDiplomate: American Board of Craniofacial

Pain, American Board of Orofacial Pain, American Academy of Pain Management

Fellow: AACP

Jamison R. Spencer, DMD, MSAACP Past President Diplomate: American Board of Craniofacial

Pain, American Board of Dental Sleep Medicine

Fellow: AACP

Robert L. Talley, DDSAACP Past PresidentDiplomate: American Board of Craniofacial


Fellow: AACP

Larry L. Tilley, DDSAACP Past PresidentDiplomate: American Board of Craniofacial


Fellow: AACP

AACP is an ADA CERP-Recognized Provider.ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education.ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.AACP designates this program for approximately 96 credit hours of continuing education credits.November 1993 to December 2015

Approved PACE Program Provider FAGD/MAGD Credit.Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement.June 1, 2011 to May 31, 2015.


“I am constantly going to courses and trying to do a better job. There were many cases that I just could not understand why my treatment was not working. This course brought it all together and gave me other tools to use—that work.” Dr. Greg Sanchez—Albuquerque, NM

Craniofacial Pain Disorders, History, Examination, Diagnosis, & Treatment Planning

OBjeCtivesUpon completion of Session 1, participants should be able to:

1. Recognize the most commonly occurring craniofacial pain disorders.

2. Complete a comprehensive history and examination of the craniofacial pain patient.

3. Understand the more commonly used diagnostic tests and when to implement them.

4. Make a provisional diagnosis based on patient complaints.By the end of Session 1, participants should also have acquired, improved, and/or updated their knowledge of and ability to understand the clinical relevance of head-and-neck anatomy, recognize and diagnose dental-alveolar pains, and develop a treatment plan for the craniofacial pain patient.

22 aPProxiMate Ce Credit Hours16 Lecture credits plus 6 participation credits

day 1: • Session and Course Overview

• Basic Head, Neck, & TMJ Anatomy as it Relates to Physical Examination

• Comprehensive History

• Examination — Physical Evaluation

• Muscle Identification & Palpation Workshop

• Question & Answer Session

day 2: • Plain Film & CT Imaging

• Joint Vibration Analysis (JVA)

• Magnetic Resonance Imaging (MRI)

• Temporomandibular Disorders

• Craniofacial & Neuropathic Pain Syndromes


day 3: • Range-of-Motion Evaluation, Cranial Nerve Evaluation, & Otologic Evaluation Workshop

• Actual Patient History, Examination, & Consultation

• Treatment Planning

• Patient Consultation, Insurance Coding (CPT & ICD codes), Informed Consent, & Narrative Reports

• Case Planning for Session 2


session 1C r a n i o FaC i a l Pa i n M i n i - r e s i d e n C y P r o g r a M



“As an orthodontist, this mini-residency gave me a thorough understanding of the anatomy, physiology, and function of the masticatory complex and the many modalities available in treatment. It was one of the most intense and informative courses that I have ever completed.”

Treatment & Management of the Patient With a Craniofacial Pain Disorder


1. Treat and manage the myofacial pain-disorder patient.

2. Treat and manage patients with intra-articular pathology of the TMJ.

3. Treat and manage craniofacial pain syndromes.By the end of Session 2, participants should also have acquired, improved, and/or updated their knowledge of intraoral orthotics (e.g., types, designs, fabrications, and management) and their ability to deliver-trigger point injections, deliver intra-articular injections, and manipulate the TMJ to reduce a non-reducing disc displacement.

23.5 aPProxiMate Ce Credit Hours10 Lecture credits plus 13.5 participation credits

day 1: • Welcome & Session Overview

• Case Reports & Discussion

• Head-and-Neck Anatomy as it Relates to TMD, Muscle Disorders, & Craniofacial Pain Disorders

• Anatomy Lab with Dissected Specimens

• Overview of Muscle Disorders

• Appliances (Splints) for Muscle Disorders

• Occlusal Registration Workshop

• Myofascial Pain Disorders: Introduction to Spray & Stretch

day 2: • Spray & Stretch Technique Workshop

• Introduction to Trigger-Point Injections

• Trigger-Point Injection Workshop

• The NTI Appliance

• Pathology/Disease Process of TM Joints

• TM Joint Injection Techniques

• TM Joint Injection Workshop

• Non-Reducing Disc-Displacement Reduction Technique & Temporary Appliance Fabrication

• Appliances for Disc-Interference Disorders: Types, Occlusal Registration, Fabrication, & Management

day 3: • Temporary Splint Fabrication Workshop for Non- Reducing Disc Displacements, NTI Fabrication Workshop

• Common Craniofacial Pain Disorders

• Craniofacial Pain Disorder Diagnostic & Therapeutic Injections Workshop

• Practice-Management Discussion

• Discussion of Case Presentation & Overview of Session 3

• Testing & Review

session 2

Ken Dillehay — Wichita, KS


6

Physical Medicine Modalities, Occlusion, Pharmacology, & Electro-Diagnostic Modalities in the Management of the Craniofacial Pain Patient


1. Prescribe the physical medicine modalities that best complement and enhance the treatment objectives.

2. Understand principles of occlusion to develop ideal occlusal patterns for treatment orthotics and phase-II prosthetic finishing.

3. Evaluate the necessity for pharmacologic management of the craniofacial pain patient.

4. Apply electro-diagnostic instrumentation in the evaluation of the craniofacial pain patient.

By the end of Session 3, participants should also have acquired, improved, and/or updated their knowledge of and ability to administer physical medicine modalities in a clinical setting; understand when prosthetic finishing is required and the best approach to satisfy patient needs; understand what medications patients may present with and how these medications may adversely affect pain patterns; appreciate when, why, and what medications to prescribe; understand the reasons for local anethetic failures; appreciate the role of osteocavitation lesions in craniofacial pain disorders; understand the role of percutaneous radio frequency thermoneurolysis in craniofacial pain treatment; secure a neuromuscular occlusal registration to fabricate a neuromuscular orthotic; and organize and prepare a proper case presentation.

24 aPProxiMate Ce Credit Hours14.5 Lecture credits plus 9.5 participation credits

day 1: • Welcome & Session Overview

• Case Reports & Discussion

• Electrotherapy & Electrophysics Concepts

• Application of High-Voltage & Transcutaneous Electrical Nerve Stimulation (TENS)

• Overview of Microcurrent, Inferential Stimulation, & Laser Therapy

• High-Voltage Stimulation & TENS Demonstration & Workshop

• Ultrasound & Iontophoresis Demonstration & Workshop

• Neuromuscular Techniques for the Upper Quarter: Workshop

day 2: • Principles of Occlusion

• Prosthetic Case Finishing

• Pharmacologic Management of the Craniofacial Pain Patient

• Mechanism of Local Anesthetic & Reasons for Local Anesthetic Failures

• Differential Diagnosis of Osteocavitation Lesions

• Causes of Myofascial Treatment Failures

• Perpetuating Factors of Myofascial Disorders Workshop

• Percutaneous Radiofrequency Thermoneurolysis

day 3: • Introduction to Neuromuscular Recording Devices, Computerized Mandibular Scanning, Electromyography, & Ultra-Low Frequency TENS

• Occlusal Registration Workshop, Registration with TENS, Registration with Closest Speaking Space

• TM Joint Vibratography & Sonography

• Neuromuscular Philosophy & Practice

• Putting It Together

• Testing & Review

session 3C r a n i o FaC i a l Pa i n M i n i - r e s i d e n C y P r o g r a M



Orthodontics for Phase-II Finishing, Sleep Disorders, Alternative Therapies and the Craniofacial Pain Patient, & Integration of Current Concepts in Craniofacial Pain into Dental Practice


1. Determine the best orthodontic approach for phase-II finishing.

2. Evaluate the craniofacial pain patient for obstructive sleep apnea (OSA).

3. Determine if oral appliance therapy for OSA is indicated and, if so, the type of appliance to prescribe.

4. Understand the role of alternative therapies in the management of the craniofacial pain patient.

5. Have the management skills to integrate craniofacial pain into the general dental practice.

By the end of Session 4, participants should also have acquired, improved, and/or updated their knowledge of and ability to use cephalometric analysis in orthodontic care of the extracapsular and intracapsular TMD patient plus orthodontic care to improve the airway, understand growth and development of the craniofacial complex, determine the timing for orthodontic treatment to correct craniofacial development problems, use diagnostic instrumentation for OSA, and appreciate what types of alternative therapies might best complement traditional therapeutic techniques.

25.75 aPProxiMate Ce Credit Hours15.5 Lecture credits plus 10.25 participation credits

day 1: • Case Presentations

• Occlusion/Orthodontics/Malocclusion Philosophies

• Growth & Development of the Craniofacial Complex

• Orthodontic Diagnosis & Cephalometric Analysis

• Cephalometric Workshop

• Orthodontic Treatment Timing

• Orthodontics for the Extra-Capsular Patient

• Arc-Length Analysis Workshop

• Orthodontics for the Repositioned Patient

• Protocol if TMD Problems Return During/After

• Orthodontic Treatment

• Orthodontic Treatment to Help the Airway

day 2: • Introduction to the History of Sleep Medicine/Dentistry

• The Nature of Sleep

• Sleep Disorders

• Pediatric Development & OSA

• Obstructive Sleep Apnea

• Parasomnias

• Oral Appliance Fabrication Workshop

• Examination/Diagnosis

• Treatment Options

• Oral Sleep Appliances: Selection & Treatment Procedures

• Ambulatory Sleep-Study Workshop

• Problem Solving & Discussion

day 3: • Concepts of Cranial Therapy and their Relationship to the Craniofacial Pain Patient

• Cranial Therapy Workshop

• Applied Nutrition for the Craniofacial Pain Patient

• Alternative Therapies for Craniofacial Pain

• Integration of Current Concepts in Craniofacial Pain into Dental Practice

• Group Discussion and Problem Solving

session 4


Hurry! Enrollment is limited and offered on a first-come, first-served basis.

HOW tO RegisteRRegister online at www.aacfp.org or complete the registration form and submit via:

email [email protected] fax 703.435.4390 mail AACP 12100 Sunset Hills Rd Suite 130 Reston, VA 20190Enrollment is limited; participants who register for the entire 4-session mini-residency will receive priority. Please do not make hotel and travel arrangements until you receive confirmation from the AACP Institute that your registration has been accepted.

sessiOn datesseptember 12–14, 2013Session 1: Craniofacial Pain Disorders, History, Examination, Diagnosis, & Treatment Planning

October 31, november 1–2, 2013Session 2: Treatment & Management of the Patient with a Craniofacial Pain Disorder

february 13–15, 2014Session 3: Physical Medicine Modalities, Occlusion, Pharmacology, & Electro-Diagnostic Modalities in the Management of the Craniofacial Pain Patient

april 24 –26, 2014Session 4: Orthodontics for Phase-II Finishing, Sleep Disorders, Alternative Therapies and the Craniofacial Pain Patient, & Integration of Current Concepts in Craniofacial Pain into Dental PracticeApproximately 96 CE credits (56 lecture, 40 participation) are available to participants in this 4-session Craniofacial Pain Mini-Residency program.

tuitionentire 4-session Program $10,740 (AACP-Member Doctors) $13,600* (Non-Member doctors)

individual sessions $3,500 (AACP-Member Doctors) $4,215* (Non-Member doctors)

* Join AACP and save. To request a membership application, call the AACP Executive Office at 800.322.8651.

Course loCation

American Airlines Training & Conference Center — Fort Worth, TX

registration deadlineRegister early. Registrations will be accepted on a first-come, first-served basis. Payment of tuition in full is required to guarantee your space.

Hotel aCCoMModations

For reservations, call the American Airlines Training & Conference Center at 800.777.6464 – OR – 817.956.6030

$189 (facility use + overnight guest room)

$ 92 (facility use only; no guest room)

Rate includes continental breakfast and all-day

break service, plus lunch and dinner buffets. FREE

shuttle service between the AAT&CC and Dallas/

Fort Worth International Airport is also provided.

“Multiple sessions, with time in between them, allows for learning in layers. This helped me to gradually incorporate into my practice what was being taught. There is so much more to treating TMD symptoms than just making a splint. This is a new growth center within my practice and is of great value to my patients. Time and money well spent!” Dr. Kristin Morris— Cedar Rapids, IA

r e g i s t r at i o n i n F o r M at i o nAACP Institute

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ratesPackage rate (with guest room): $189 (plus tax) per person/per day, including overnight accommodations; round-trip shuttle transportation from DFW international airport to the AATCC; and continental breakfast; all-day break service; lunch and dinner buffets; and unlimited use of the facilities.

The above room rate is inclusive of guest-service fees and service charges applicable to guest rooms and group functions. Lunch and dinner buffets plus gratuities for bell staff and housekeeping; in-room coffee; and unlimited use of the fitness center, heated swimming pool, tennis, basketball, and volleyball facilities are included.

day rate (without guest room): $92 (plus tax) per person/per day, including round-trip shuttle transportation from DFW International Airport to the AATCC; and continental breakfast; all-day break service; and lunch and dinner buffets, excluding overnight accommodations.

The “day rate” is applicable to participants in the Craniofacial Pain Mini-Residency program who do not require overnight accommodations. Continental breakfast, all-day break service, and lunch and dinner buffets are included; taxes and service charges are not included.

CHeCk-in, CHeCk-out PoliCiesGuest accommodations will be available at 3:00 PM on arrival day and reserved until 11:00 AM on departure day. American Airlines Training & Conference Center would appreciate receiving flight arrival times, if available. Any participant wishing special consideration for late checkout should inquire at the front desk on the day of departure.

guest-rooM CHargesCraniofacial Pain Mini-Residency program participants will pay their own account upon departure. When reservations are made, a deposit equal to the package or room rate and tax for the night will be required. An individual’s deposit is refundable to the individual if the American Airlines Training & Conference Center receives notice of an individual’s cancellation at least 24 hours prior to scheduled arrival.

Upon check-in, each guest will be required to present a valid credit card, on which an amount of sufficient pre-authorization can be obtained to cover the package or room rate, tax charges, and guest fees for the length of the guest’s stay plus the anticipated use of the American Airlines Training & Conference Center’s ancillary services. Each guest’s home/business address and e-mail address will also be required.

transPortationComplimentary shuttle transportation is available to and from the American Airlines Training & Conference Center and Dallas/Fort Worth International Airport. Complete instructions for calling from the airport will be sent to Craniofacial Pain Mini-Residency-registered attendees. If you take a taxi, be sure to tell the driver you wish to go to the American Airlines Training & Conference Center (at Highway 360 and 183) in Fort Worth. If you request “American Airlines Center,” you may find yourself in Dallas at a sporting event or concert.

Questions?Call the American Airlines Center 817.956.1000

American Airlines Training & Conference Center



TUITION OPTIONS

LOCatiOn and imPORtant datesAll sessions in this limited-enrollment program will be held at the American Airlines Training & Conference Center at Dallas/Fort Worth International Airport.

september 12–14, 2013 session 1: Craniofacial Pain Disorders, History, Examination, Diagnosis, & Treatment Planning

october 31, november 1–2, 2013 session 2: Treatment & Management of the Patient with a Craniofacial Pain Disorder

February 13–15, 2014 session 3: Physical Medicine Modalities, Occlusion, Pharmacology, & Electro-Diagnostic Modalities in the Management of the Craniofacial Pain Patient

april 24–26, 2014 session 4: Orthodontics for Phase-II Finishing, Sleep Disorders, Alternative Therapies and the Craniofacial Pain Patient, & Integration of Current Concepts in Craniofacial Pain into Dental Practice

VISION:The American Academy of Craniofacial Pain will continue to be the organization promoting advancement of knowledge in Craniofacial Pain, Temporomandibular Disorders, and Dental Sleep Medicine by providing a common ground for clinical practice and research to professionals for the benefit of the public.

MISSION: The American Academy of Craniofacial Pain is committed to the relief of craniofacial pain, temporomandibular disorders and dental sleep related disorders and supporting the advancement of education, research and dissemination of knowledge and skills in these areas.

“Leading the TMD and Dental Sleep Community” is more than a slogan. It is our guiding rule! To ensure that our members are heard, since 1985 the AACP has been actively involved with:

Research organizations, such as the National Institutes of Health (NIH) and the National Institute of Dental & Craniofacial Research (NIDCR). Professional and political organizations, including the American Dental Association (ADA), state and local dental associations, licensing boards and the Food & Drug Administration (FDA). Ongoing clinical research that elevates professional standards of diagnostic testing, treatment protocols and outcome effectiveness.

RegistRatiOnRegister online at www.aacfp.org or complete the registration form and submit via:

email [email protected] fax 703.435.4390 mail AACP 12100 Sunset Hills Rd Suite 130 Reston, VA 20190

Hurry! Enrollment is limited and offered on a first-come, first-served basis.

fORms Of PaymentVISA, Mastercard and Check (in US funds, drawn on a US bank) Note: Tuition payment must be received by the AACP to reserve your space in this limited-enrollment mini-residency program!

jOin and saveTuition savings is one of many benefits of being an AACP member. To qualify, simply submit a completed AACP membership application (with processing fee) with your Craniofacial Pain Mini-Residency program registration. To request your membership application, call AACP at 800.322.8651.

american academy of Craniofacial Pain

Leading the TMD and Dental

Sleep Community

www.aacfp.org

CanCeLLatiOn POLiCy Refunds will be made only if your space is filled. Refund requests (less 10% of TOTAL cost of the program) must be submitted in writing or email at least 30 days prior to the program start date. Due to non-refundable commitments, we cannot offer refunds after this date.


Program Member Non-Member Amount Due with Registration

entire 4-session Mini-residency

$ 10,740 $ 13,600 Save $1,000 with a 1 time tuition payment of:

– OR –

– or – Make the first of 3 equal installments of:

$9,740 (AACP Members)$12,600 (Non-Members)

$3,580 (AACP Members)$4,533.33 (Non-Members)

individual sessions $ 3,500 $ 4,215 Tuition due in full with registration

NOTE:

s


liMited enrollMent. register noWEnrollment is limited. Participants who register for the entire 4-session mini-residency will receive priority. Please do not make hotel and travel arrangements until you have received confirmation from the AACP Institute that your registration has been accepted.

Program Member Non-Member Amount Due with Registration

entire 4-session Mini-residency

$ 10,740 $ 13,600 Save $1,000 with a 1 time tuition payment of:

– OR –

– or – Make the first of 3 equal installments of:

$9,740 (AACP Members)$12,600 (Non-Members)

$3,580 (AACP Members)$4,533.33 (Non-Members)

individual sessions $ 3,500 $ 4,215 Tuition due in full with registration*Join AACP and save! To request a membership application call 800.322.8651 or visit our website at www.aacfp.org

PaRt 1: RegistRant’s infORmatiOn — PLease PRint CLeaRLy

Name

Street Address

City State ZIP Country

Phone Fax

E-mail

PaRt 2: RegistRatiOn detaiLs

Membership Status (please check one)

Tuition Amount(from chart above)

p AACP Memberp Non-Member

p entire 4-session Mini-residencyp session 1: September 12–14, 2013

p session 3: February 13–15, 2014p session 4: April 24–26, 2014 $________________

p session 2: October 31, November 1–2, 2013

CanCeLLatiOn POLiCy Refunds will be made only if your space is filled. Refund requests (less 10% of TOTAL cost of the program) must be submitted in writing or email at least 30 days prior to the program start date. Due to non-refundable commitments, we cannot offer refunds after this date.

Please initial at the left to confirm that you have read, understand, and agree to the AACP cancellation policy. Your regisitration will not be accepted WITHOUT this acknowlegdement.

PaRt 3: Payment OPtiOns• Enclosed is my check (in US dollars, drawn on a US bank) payable to AACP in the amount of $___________• Please charge $___________ to my • VISA • Mastercard

Cardholder Name (exactly as it appears on the card)

Card Number Expiration Date

Billing Address (if different from above)

Cardholder’s Signature

tO RegisteR: Register online at www.aacfp.org, or complete the registration form and email to [email protected], fax to 703.435.4390, or mail to aaCP, 12100 sunset Hills Rd, ste 130, Reston, va 20190. Full payment is required to guarantee your space in this course. Since enrollment is limited, we recommend that you do not make your travel arrangements or hotel reservations until you receive confirmation from the AACP Institute that your registration is confirmed. Instructions for providing occlusal models and bite registrations for each of your appliances will be furnished to you at that time.

Craniofacial Pain Mini-Residency Program


AACP InstituteC r a n i o F a C i a l P a i n M i n i - r e s i d e n C y P r o g r a M

register today!Enrollment is limited; participants who register for the entire 4-session mini-residency will receive priority. Please do not make hotel and travel arrangements until you receive confirmation from the AACP Institute that your registration has been accepted. There will be approximately 96 CE credits (56 lecture, 40 participation) available to participants in this 4-session Craniofacial Pain Mini-Residency program.

Course dates, locations, and registration information are available online at www.aacfp.org or call the AACP Institute at 800.322.8651.

aaCP institute Registration Information 800.322.8651

Program Information 308.384.5100

Fax 703.435.4390

LOCatiOn and imPORtant datesAll sessions in this limited-enrollment program will be held at the American Airlines Training & Conference Center at Dallas/Fort Worth International Airport.

september 12 –14, 2013 session 1: Craniofacial Pain Disorders, History, Examination, Diagnosis, & Treatment Planning

october 31, november 1–2, 2013 session 2: Treatment & Management of the Patient with a Craniofacial Pain Disorder

February 13–15, 2014 session 3: Physical Medicine Modalities, Occlusion, Pharmacology, & Electro-Diagnostic Modalities in the Management of the Craniofacial Pain Patient

april 24–26, 2014 session 4: Orthodontics for Phase-II Finishing, Sleep Disorders, Alternative Therapies and the Craniofacial Pain Patient, & Integration of Current Concepts in Craniofacial Pain into Dental Practice

“What can be said about any activities that affirms our hopes for the future? The value of such fine education is truly a bargain. I am excited that I am experiencing this at my 30th year of practice.”

Dr. Paul F. Mitsch—Augusta, KS

Documents

Limited enro LLment • register now AACP InstituteOrthodontics for Phase-II Finishing, Sleep Disorders, Alternative Therapies and the Craniofacial Pain Patient, & Integration of Current