Saturday, January 30, 2010

TMD AND VERIGO AS EXPLAINED BY DR NORMAN THOMAS OF THE LAS VEGAS INSTITUTE

Neuromuscular Dentistry frequently eliminates not just headaches and Migranes but vertigo and dizzinss as well. There are many possible ways in which this occurs based on neurological changes in the trigeminal nervous system and the connections to other cranial nerves. The following is an anatomical explanation of how neuromuscular dentistry treats Vertigo. Other causes can include the Tensor tympani and Tensor palati causing increase in pressure in the inner ear creating endolymph movement in the semi-circular canals, Tensor typani and palati influenced by postural anomolies to contract and relax in an imbalanced way, th Head of the condyle seated posteriorly putting pressure on the inner ear, and the Misalignment of Atlas - Axis - Occiput and resulting compression on the balance centre in the brainstem

Patients with TMJ disorders frequently suffer from dizziness and verigo as well as migraines, tension-type headaches, facial pain and many other symptoms usually associate with the trigeminal nervous system and secondary postural canges in the atlas, axis and other cervical vertebrae. The term "The great Imposter" (See "SUFFER NO MORE: DEALING WITH THE GREAT IMPOSTOR" in Sleep and Health Journal http://www.sleepandhealth.com/story/suffer-no-more-dealing-great-impostor)
is often applied to TMJ disorders because they masquerade as so many disorders. The following is an anatomical description by Dr Norman Thomas, the head of Neuromuscular Dental Research at LVI (Las Vegas Institute) research of how imbalance of the HIP plane can result in Vertigo thru actions on the Tensor Tympani and and Tensor Palatini muscles.

Per Dr Thomas "You asked for the explanation I put forward about HIP tinnitus and vertigo. The tensor tympani and tensor palati muscles intertwine as they associate at the side of the bony canal of the pharyngo tympanic tube. The entwined fibers pass downward from their attachment in the scaphoid fossa over the hamular notch into the soft palate. Thus the attachment of tensor typani and palati crosses the fulcrum at the hamular notch between IP and the occipital condyle. When the HIP is this not balanced with gravitational field there is tension on the the palate and the tensor tympani (attached at its distal end to the malleus) while the tensor palati closes the Eustachian tube opening at its palatal end Thus there is pressure in the middle ear which compresses the fenestra ovalis on the medial wall of the middle ear to change circua;lation in the semicircular canals with resulting vertigo and tinnitus."

THE HIP Plane as described in the Journal of Oral Rehabilitation is "The HIP occlusal plane is a horizontal plane passing through the bilateral hamular notches and the incisive papilla (Dent Surv. 1975;51:60)" Other planes of clinical interest in the cranium and face include the he occlusal plane, Frankfort plane, Camper's plane. The hip plane is parallel to the gravitational field.


PubMed abstract
J Oral Rehabil. 2007 Feb;34(2):136-40.
Three-dimensional analysis of the occlusal plane related to the hamular-incisive-papilla occlusal plane in young adults.
Fu PS, Hung CC, Hong JM, Wang JC.

Department of Prosthodontics, Graduate Institute of Dental Science, Kaohsiung Medical University, Kaohsiung, Taiwan.
The planes which serve as references for cranium and face in dental clinical application included the occlusal plane, Frankfort plane, Camper's plane and hamular-incisive-papilla (HIP) plane. The HIP occlusal plane is a horizontal plane passing through the bilateral hamular notches and the incisive papilla (Dent Surv. 1975;51:60). The aim of this study was to estimate the relationship between the various occlusal planes and the HIP plane in Taiwanese young adults with approximately optimal occlusion. Study casts of 100 young adults (50 men and 50 women) were selected in this study. All market points on the maxillary casts were measured by a three-dimensional precise measuring device. The angular relationship between the four various occlusal planes and the HIP plane were investigated. The vertical distances between the cusp tips and incisal edges of maxillary teeth to the HIP plane were measured. Data were performed by the Statistic analysis software programme (JMP 4.02). The Student's t-test and Pearson's correlation test were used to test the statistical significance (P < 0.05). The results showed that the occlusal plane defined as the incisal edge of maxillary central incisor to mesiobuccal cusp tips of maxillary second molars had the smallest included angle with the HIP plane (2.61 +/- 0.81 degrees). The incisal edge of maxillary right central incisal to mesiopalatal cusp tips of maxillary first molars had the largest included angle with the HIP plane (7.72 +/- 1.60 degrees). The curve is drawn through the buccal cusp tips of maxillary teeth had better parallelism with the HIP plane.

PMID: 17244236 [PubMed - indexed for MEDLINE]