Burns Tmj Pdf

706 views

Published on

A lecture on Template therapy and its effectiveness

Published in: Health & Medicine, Education
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
706
On SlideShare
0
From Embeds
0
Number of Embeds
7
Actions
Shares
0
Downloads
12
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Burns Tmj Pdf

  1. 1. AMERICAN ASSOCIATION of ORTHOPEDIC M EDICINE December 7 & 8, 2007 WORKSHOP Pain M anagem and Healing in the 21st Century ent Jointly Sponsored by Am erican Association of Orthopedic M edicine AAO and the University M of California, San Diego School of Medicine
  2. 2. Contribution from dental to medical Template Therapy and Irregular Output of the Trigeminal Nervous System David L. Burns D.D.S. December 7&8 2007 Fort Wayne, Indiana
  3. 3. Dental Occlusion and Health Dr. David L. Burns Academy of Physiological Dentistry American Dental Association Indiana Dental Association American Academy of Functional Orthodontics American Academy of Pain Management International College of Craniomandibular Orthopedics American Academy of Craniofacial Pain
  4. 4. drdlburns@comcast.net www.davidlburnsdds.com 260-432-8596
  5. 5. CONTENTS HOW DO WE KNOW IF OCCLUSION IS GOOD OR BAD? HOW DO WE TREAT TMD? ANIMAL RESEARCH CLINICAL CASES SPORTS DENTISTRY
  6. 6. HOW DO WE KNOW IF OCCLUSION IS GOOD OR BAD?
  7. 7. OCCLUSION GOOD ----------------- EUSTRESS BAD -------------------DISTRESS FOR WHOLE BODY POSTURE PHYSIOLOGY DYNAMIC FUNCTIONS
  8. 8. WHY DOES OCCLUSION CAUSE EUSTRESS OR DISTRESS? A. MECHANICAL FACTORS B. PHYSIOLOGICAL FACTORS
  9. 9. MECHANICAL FACTORS PHYSIOLOGICAL FACTORS MUSCLES 1. BITE 1. 2. GUZAY’S QUADRANT THEOREM 2. SENSORY- AFFERENT FORCES MUSCLE SPINDLES AXIS-- X&Y GOLGI TENDONS LEVERS EXTEROCEPTORS DISC 3. 3. CENTRAL NERVOUS SYSTEM DISPLACED CORTEX RUPTURED BRAINSTEM 4. COMPRESSION PYRAMUS BONE 4. MOTOR- EFFERENT CERVICAL VERTEBRAE ALPHA- GAMMA AUTONOMIC N.S. PSYCHOSOMATICS 5.
  10. 10. OCCLUSION GOOD ----------------- EUSTRESS BAD -------------------DISTRESS FOR WHOLE BODY POSTURE PHYSIOLOGY DYNAMIC FUNCTIONS
  11. 11. Quadrant Theorem Established by Casey M.Guzay 1973:Chicago, USA Kiyoshi Maehara 1985: Osaka, Japan Center of jaw movement is in the Sub-Atlas .
  12. 12. In order to masticate or speak properly, the cranium has to keep a stable position. In case of deep bite or mal occlusion, neuro motor system is activated more than before. This action causes the posterior muscles to constrict more. Cervical vertebrae then receive the force to cause the compression. The posterior cervical muscles and the masticatory muscles always co-work with each other. It is suggested that the length of the posterior cervical muscles goes along with the length of the masticatory muscles.
  13. 13. Ia and II are proprioception fibers and go into the mesencephalic nucleus, locus cereleus and gray matter of aqueduct of mid-brain. These places act as first ganglia of the trigeminal nerve. Ia II
  14. 14. HOW DO WE TREAT TMD?
  15. 15. What is a Template & Therapy? Kind of mouth piece 1. Stretch of the Masticatory M. 2. Stabilization of the Head Position 3. Improve the diseases and non-specific 4. complaints Connect the medicine and dentistry 5.
  16. 16. How to use the stick in medical care? Template or stick is not a drug This work stabilizes the brain by cutting off the output signals to the masticatory muscles . 1. During the hospitalization patients should bite stick 2. Never take the dentures out during the sleeping time 3. Ease to pain control when bite the Stick or TP. 4. While under anesthesia bite block is necessary in order for the stabilization of blood pressure 5. In case of incurable diseases, stick or Tp help for patients
  17. 17. ANIMAL RESEARCH AND THINKING
  18. 18. Conclusion of Animal Experiments Vertical height loss led to Whole body muscle tension changes 1. Imbalance of Autonomic nervous 2. system. No changes of blood and urine tests 3.
  19. 19. Reference of Animal Experiments Rats : Dr. Tatsuya Ueda Dr. Kiyoshi Maehara 1. 2. Guinea Pigs: Dr. Yukio Azuma, Dr. Hitoshi Taga, Dr. Masaharu Hashimoto Dr. Kiyoshi Maehara 3. Beagle Dogs: Dr. Masaharu Hashimoto, Dr. Kiyoshi Maehara, Dr. Teruaki Sumioka 4. Rhesus Monkeys: Dr. David Burns, Dr. Masaharu Hashimoto, Dr. Keiichi Tamaki, Dr. Kiyoshi Maehara 1-2 Asahi University School of Dentistry Department of Pharmacology 3-4 Fujisawa Pharmaceutical Company Limited
  20. 20. CLINICAL CASES
  21. 21. Clinical Findings 1 Posture: Malposture,Humpback and 1.. 1.. Scoliosis etc. 2. Stabilization of cervical vertebra: Cervical spondylosis deformans, Headache, Shoulder/Neck stiffness, Glaucoma and Numbness of finger/arms 3. Analgesic action : All kind of pain caused from inflammation or neuralgia below the pons which is a trigeminal pathway.
  22. 22. Clinical findings 2 of blood flow to brain 4..Improvement from vertebral arteries : Consequence of the cerebral infarction, Parkinson’ Epilepsy, Parkinson’s disease and Dementia 5..Stabilization of autonomic nervous system: Hyper・ Hyper・Hypotension, Diarrhea, Fatigue, Diabetes and Anxiety neurosis 6..Stabilization of immune system: Asthma、 Asthma、Atopic dermatitis, Collagen disease and Myasthenia gravis
  23. 23. Clinical findings 3 Improvement of motor function and 7. skills: protect from sports injury, acceleration of motor reflexes: Strength of the muscles and light and motor reflex 8. Improvement of TMJ disorder: Clicking, can’t open mouth due to lock jaw, arthritis of TMJ and so on Leads to proper occlusion 9.
  24. 24. An actress suffered from whiplash by traffic accident and could not remember her script. She was cured within a week by the template wearing.
  25. 25. Effect of the template therapy with sleep apnea syndrome patients. Hitoshi TAGA1) , Teruaki TOMARU1) Satoshi NAITOH2) , Kiyoshi MAEHARA3) 1)Showa Univ. Med. Fujigaoka Hosp. Dept. of Anesthesiology 2)Showa Univ. Med. Fujigaoka Hosp. Dept. of Otolaryngology 3)Hamamatsu Med. Univ. Dept. of Oral Surgery
  26. 26. 30 20 % 10 0 UPPP Template Nose Septo Reduce Tonsillect drops plasty weight omy Choice of treatment for the SAS patients.
  27. 27. 97 ** 96.5 96 Effect of template * 95.5 on mean SpO2. 95 % 94.5 AI<20:n=17, before after 94 ≦ 20≦AI<40:n=5, 93.5 ≦ 40≦AI:n=4. *p<0.05, 93 AI<20 20≦AI<40 40≦AI **p<0.01. 90 * 85 80 Effect of template 75 on lowest SpO2. % 70 65 AI<20:n=17, ≦ ≦ 60 20≦AI<40:n=5, 40≦AI: 55 n=4. 50 *p<0.05. AI<20 20≦AI<40 40≦AI
  28. 28. 13% stationary 13% effective marked improvement 27% 74% 39% Effect of template 34% Effect of UPPP
  29. 29. SPORTS DENTISTRY
  30. 30. Clinical findings 3 Improvement of motor function and 7. skills: protect from sports injury, acceleration of motor reflexes: Strength of the muscles and light and motor reflex 8. Improvement of TMJ disorder: Clicking, can’t open mouth due to lock jaw, arthritis of TMJ and so on Leads to proper occlusion 9.
  31. 31. Reasons for the Effectiveness of Template Therapy From the viewpoint of the physics: 1. Guzay’s Quadrant Theorem 2. From the viewpoint of the physiology: Masticatory muscles are stretched and controlled by the trigeminal nervous system (Controlled by brainstem directly)
  32. 32. We Are Looking For The Neuro-Dentistry Dental treatment is same as brainstem treatment: 1. Reduce pain from oral area: stabilization of spinal tract of trigeminal 2. Improve the malocclusion: stabilization of the basal ganglia 3. Increase vertical of bite: stimulate to the mesencephalic nucleus, locus cereleus and gray matter of cerebral aqueduct of mid-brain (Reduce the pain which is closely related to neuro system)
  33. 33. Conclusion WHEN WE BITE SOMETHING Mechanism of action is stabilization of the brain: The muscles are no longer overactive from bite 1. overclosure only stimulation to the trigeminal mesencephalon and gray matter of the mid aqueduct where pain is reduced 2. The teeth are important for chewing but also support ones head position and posture. 3..When teeth are missing and/or not replaced, the brain is going to overwork resulting in brain fatigue/ tiredness

×