THE JAW IS ESSENTIAL IN THE REGULATION OF NORMAL BODY POSTURE. THE SWALLOW SERVES AS A NEUROMUSCULAR RESETTING MECHANISM THAT CAN CORRECT OR CAUSE POSTURAL PROBLEMS THROUGHOUT THE ENTIRE BODY.
THERE ARE ONLY THREE MAJOR SET POINTS IN THE BODY FOR NEUROMUSCULARLY RESETTING POSTURE. ONE IS THE BITE WHEN WE SWALLOW APPROXIMATELY 2000 TIMES A DAY. THE SECOND IS OUR FEET /LEGS /HIPS WHEN WE STAND AND THE THIRD IS THE HIPS WHEN WE SIT.
THE QUADRANT THEOREM OF GUZAY EXPLAINS THE IMPORTANCE OF THE JAW TO FULL BODY POSTURE IN MATHEMATICAL AND ENGINEERING TERMS.
IT IS EASIER FOR THE LAY PERSON TO UNDERSTAND THE IMPORTANCE OF THE JAW BY IMAGINING STANDING ON THE DOCTORS SCALE. THE 100 POUND MARKER IS SET, THEN THE TEN POUND MARKER IS SET, AND FINALLY THE ONE POUND MARKER IS SET TILL THE SCALE PERFECTLY BALANCES.
THE PROBLEM IS THAT IF YOU MOVE THAT ONE POUND WEIGHT JUST A LITTLE TO THE RIGHT OR LEFT THE SCALE DOES NOT GO A LITTLE OUT OF BALANCE IT GOES "KLUNK" EITHER UP OR DOWN DEPENDING ON WHICH WAY YOU MOVED THE WEIGHT.
ION A SIMILAR MANNER THE JAW DOES THE SAME THING FOR HEAD POSITION AND WHOLE BODY POSTURE. PATIENTS WITH CHRONIC NECK, JAW OR HEADACHE PAIN COULD BE DESCRIBED AS HAVING BEEN "KLUNKED"
UNLIKE THE SCALE WHICH ONLY MOVES IN TWO DIRECTIONS THE JAW CAN BE DISPLACED ANTERIOR-POSTERIORLY, VERTICALLY TOO CLOSE OR TOO FAR APART (VERTICAL DIMENSION). SIDE TO SIDE OR OBLIQUELY. IT CAN ALSO BE TIPPED SIDE TO SIDE. FRONT TO BACK OR OBLIQUELY AND IT CAN BE ROTATED IN EITHER DIRECTION ON THE HORIZONTAL PLANE.
NEUROMUSCULAR DENTISTRY HAS THE TOOLS TO UNDERSTAND AND UNWIND THE POSTURAL ABBERATIONS AND ALLOW A RETURN TO A NORMAL PHYSIOLOGIC STATE. THIS IS WHERE HEALING CAN OCCUR ALLOWING LONG TERM RESOLUTION OF THE PATIENTS PROBLEMS.
THIS IS AN OVERSIMPLIFICATION BECAUSE ALL OF THE PROBLEMS IN JAW POSTURE ARE ALSO RELATED TO HEAD POSITION. AN EVALUATION OF THE ATLAS/AXIS RELATIONSHIP CAN BE INVALUABLE IN TREATING POSTURAL DISCREPANCIES,
THE FIRST STEP, FROM A NEUROMUSCULAR DENTISTRY APPOACH IS TO USE TECHNOLOGY TO MEASURE JAW POSITION AND FUNCTION AND TO DESIGN A DIAGNOSTIC NEUROMUSCULAR ORTHOTIC THAT ALLOWS THE HEALING PROCESS TO BEGIN. AS HEALING OCCURS HEAD AND NECK POSTURE WILL CONTINUALLY CHANGE UNTIL A NEW HOMEOSTASIS IS REACHED.
FREQUENTLY, TOTAL POSTURA; CORRECTION MAY INVOLVE ORTHOTICS FOR SHOES OR EVEN FOR "BUTT LIFTS" FOR SITTING. THE PODIATRIST CAN SERVE AN IMPORTANT ROLE IN POSTUROLOGY AS CAN GAIT ANALYSIS. EVEN THE OPTICIAN CAN PROVIDE A VITAL LINK IN HEALING FOR PATIENTS WHOSE POSTURE IS ADVERSELY EFFECTED BY EYEGLASSES AND HOW WELL THEY FIT PATIENTS WORK AND LIFESTYLE FUNCTIONS. MASSAGE THERAPISTS AND EXERCISE THERAPISTS FREQUENTLY ALLOW COMPLETE HEALING AND HELP ESTABLISH A HEALTHY PHYSIOLOGY.
THE FOLLOWING PUBMED ABSTRACT FROM CRANIO DISCUSSES SOME OF THE POSTURAL ISSUES ON JUST THE FORWARD BACKWARD POSITION OF THE JAW. CLASS 2 IS BACKWARD POSITION, CLASS 3 IS FOWARD POSITION AND CLASS 1 IS NORMAL POSITION. THIS IS ONLY DISCUSSING SKELETAL POSITION HOWEVER AND NOT TRUE PHYSIOLOGIC POSITION THAT WOULD BE MESURED WITH NEUROMUSCULAR DENTAL MEASUREMENTS OF EMG AND MKG OR COMPUTERIZED MANDIBULAR SCAN.
Cranio. 2005 Jul;23(3):219-28.
Evaluation of cervical posture of children in skeletal class I, II, and III.
D'Attilio M, Caputi S, Epifania E, Festa F, Tecco S.
Source
Department of Orthodontics, University of Chieti, Italy.
Abstract
Previous studies on the relationship between morphological structure of the face and cervical posture have predominantly focused on vertical dimensions of the face. The aim of this study was to investigate whether there are significant differences in cervical posture in subjects with a different sagittal morphology of the face, i.e., a different skeletal class. One hundred twenty (120) children (60 males and 60 females, average age 9.5 yrs., SD+/-0.5) were admitted for orthodontic treatment. Selection criteria was: European ethnic origin, date of birth, considerable skeletal growth potential remaining and an absence of temporomandibular joint dysfunction (TMD). Lateral skull radiographs were taken in mirror position. Subjects were divided into three groups based on their skeletal class. The cephalometric tracings included postural variables. The most interesting findings were: 1. children in skeletal class III showed a significantly lower cervical lordosis angle (p<0.001) than the children in skeletal class I and skeletal class II; 2. children in skeletal class II showed a significantly higher extension of the head upon the spinal column compared to children in skeletal class I and skeletal class III (p<0.001 and p<0.01, respectively). This is probably because the lower part of their spinal column was straighter than those of subjects in skeletal class I and II (p<0.01 and p<0.001, respectively). Significant differences among the three groups were also observed in the inclination of maxillary and mandibular bases to the spinal column. The posture of the neck seems to be strongly associated with the sagittal as well as the vertical structure of the face.
PMID: 16128357 [PubMed - indexed for MEDLINE]
Showing posts with label FORWARD HEAD POSTURE. Show all posts
Showing posts with label FORWARD HEAD POSTURE. Show all posts
Sunday, May 29, 2011
TMJ disorders, headaches and facial pain frequently involve cervical musculature. Acute pain relief is accomplished with cervical muscle injection
An article (pubmed abstract below) in the Journal of Orofacial Pain. "Treatment of acute orofacial pain with lower cervical intramuscular bupivacaine injections: a 1-year retrospective review of 114 patients." dicusses the use of cevical intramuscular injections to turn off acute pain in the ER. The study showed that 94% of patients had complete of partial relief with injection of a long acting anaesthetic.
There is a connection between the jaw and the neck that is incredibly important in the treatment of muscular headaches, facial pain, migraines, chronic daily headaches and TMJ disorders (TMD). The jaw acts as a counter-balance to the head and allows maintenance of head posture minimal excessive muscle adaptation. This is well described mathematically in engineering terms in the "Quadrant Theorem of Guzay". The jaw position is vital to body posture and abberations in jaw position can act as a descending disorder that can effect the entire body.
Forward head posture is frequently seen in TMJ and Headache patients. This forward posture cause exponential increases in muscle work just to maintain head posture.
Rcobado estimated that it takes double the muscle work from cervical muscles to low back for every centimeter of forward head posture, Three centimeters forward head posture would increase chronic muscle adaptation 8 fold (2X2X2=8) while a 5 centimeter forward head posture would increase it 32 times (2X2X2X2X2=32). The reason muscular injections work so well in relieving acute and chronic headaches and facial pain is that these muscles are grossly overworked in TMD patients.
Treating the muscles can give relief of acute pain but returning the system to a more normal physiologic state can give long term relief to patients.
A diagnostic neuromuscular orthotic allows the jaw to function in an ideal physiologic position. This allows gradual restoration of normal head posture and a return to normal physiologic function of the neck. I work closely with Atlas Orthogonal and/or NUCCA Chiropracters to correct the first two vertebrae early in treatment. These areas are especially prone to problems in TMD patients. As the foward head posture occurs the patient must rotate their head on the Atlas and Axis (first to vertebrae) to maintain sight lines. This is well explained by the Quadrant Theorem of Guzay which shows that the actual center of rotation for the jaw when both rotation and traslation movements are calculated is on the odontoid process of the Axis (2nd vertebrae)
Patients with TMD who are in car accidents never recover fully if their jaw issues are not addressed.
Posturology is the study of whole body posture. Posturology recognizes the importance of the jaw position. The normal swallow is a neuromuscular resetting procedure but most TMD patients have deviant or reversed swallows and are not even aware they swallow wrong. This can lead to GI problems but is primarily a structural problems that makes long term successful treatment of pain impossible without correction of neuromuscular jaw issues. A diagnostic orthotic allows patients to experience relief of head and neck pain prior to and permenant occlusal alterations.
J Orofac Pain. 2008 Winter;22(1):57-64.
Treatment of acute orofacial pain with lower cervical intramuscular bupivacaine injections: a 1-year retrospective review of 114 patients.
Mellick LB, Mellick GA.
Source
Department of Emergency Medicine, Medical College of Georgia, Augusta, Georgia, USA. lmellick@mcg.edu
Abstract
AIMS:
To describe 1 year's experience in treating orofacial pain with intramuscular injections of 0.5% bupivacaine bilateral to the spinous processes of the lower cervical vertebrae.
METHODS:
A retrospective review of 2,517 emergency department patients with discharge diagnoses of a variety of orofacial pain conditions and 771 patients who were coded as having had an anesthetic injection between June 30, 2003 and July 1, 2004 was performed. The records of all adult patients who had undergone paraspinous intramuscular injection with bupivacaine for the treatment of an orofacial pain condition were extracted from these 2 databases and included in this retrospective review. Pain relief was reported in 2 different ways: (1) patients (n = 114) were placed in 1 of 4 orofacial pain relief categories based on common clinical experience and face validity and (2) pain relief was calculated based on patients' (n = 71) ratings of their pain on a numerical descriptor scale before and after treatment.
RESULTS:
Lower cervical paraspinous intramuscular injections with bupivacaine were performed in 118 adult patients. Four charts were excluded from review because of missing or inadequate documentation. Pain relief (complete or clinical) occurred in 75 patients (66%), and partial orofacial pain relief in 32 patients (28%). No significant relief was reported in 7 patients (6%). Overall, some therapeutic response was reported in 107 of 114 patients (94%). Orofacial pain relief was rapid, with many patients reporting complete relief within 5 to 15 minutes.
CONCLUSION:
This is the first report of a large case series of emergency department patients whose orofacial pain conditions were treated with intramuscular injections of bupivacaine in the paraspinous muscles of the lower neck. The findings suggest that lower cervical paraspinous intramuscular injections with bupivacaine may prove to be a new therapeutic option for acute orofacial pain in the emergency department setting.
There is a connection between the jaw and the neck that is incredibly important in the treatment of muscular headaches, facial pain, migraines, chronic daily headaches and TMJ disorders (TMD). The jaw acts as a counter-balance to the head and allows maintenance of head posture minimal excessive muscle adaptation. This is well described mathematically in engineering terms in the "Quadrant Theorem of Guzay". The jaw position is vital to body posture and abberations in jaw position can act as a descending disorder that can effect the entire body.
Forward head posture is frequently seen in TMJ and Headache patients. This forward posture cause exponential increases in muscle work just to maintain head posture.
Rcobado estimated that it takes double the muscle work from cervical muscles to low back for every centimeter of forward head posture, Three centimeters forward head posture would increase chronic muscle adaptation 8 fold (2X2X2=8) while a 5 centimeter forward head posture would increase it 32 times (2X2X2X2X2=32). The reason muscular injections work so well in relieving acute and chronic headaches and facial pain is that these muscles are grossly overworked in TMD patients.
Treating the muscles can give relief of acute pain but returning the system to a more normal physiologic state can give long term relief to patients.
A diagnostic neuromuscular orthotic allows the jaw to function in an ideal physiologic position. This allows gradual restoration of normal head posture and a return to normal physiologic function of the neck. I work closely with Atlas Orthogonal and/or NUCCA Chiropracters to correct the first two vertebrae early in treatment. These areas are especially prone to problems in TMD patients. As the foward head posture occurs the patient must rotate their head on the Atlas and Axis (first to vertebrae) to maintain sight lines. This is well explained by the Quadrant Theorem of Guzay which shows that the actual center of rotation for the jaw when both rotation and traslation movements are calculated is on the odontoid process of the Axis (2nd vertebrae)
Patients with TMD who are in car accidents never recover fully if their jaw issues are not addressed.
Posturology is the study of whole body posture. Posturology recognizes the importance of the jaw position. The normal swallow is a neuromuscular resetting procedure but most TMD patients have deviant or reversed swallows and are not even aware they swallow wrong. This can lead to GI problems but is primarily a structural problems that makes long term successful treatment of pain impossible without correction of neuromuscular jaw issues. A diagnostic orthotic allows patients to experience relief of head and neck pain prior to and permenant occlusal alterations.
J Orofac Pain. 2008 Winter;22(1):57-64.
Treatment of acute orofacial pain with lower cervical intramuscular bupivacaine injections: a 1-year retrospective review of 114 patients.
Mellick LB, Mellick GA.
Source
Department of Emergency Medicine, Medical College of Georgia, Augusta, Georgia, USA. lmellick@mcg.edu
Abstract
AIMS:
To describe 1 year's experience in treating orofacial pain with intramuscular injections of 0.5% bupivacaine bilateral to the spinous processes of the lower cervical vertebrae.
METHODS:
A retrospective review of 2,517 emergency department patients with discharge diagnoses of a variety of orofacial pain conditions and 771 patients who were coded as having had an anesthetic injection between June 30, 2003 and July 1, 2004 was performed. The records of all adult patients who had undergone paraspinous intramuscular injection with bupivacaine for the treatment of an orofacial pain condition were extracted from these 2 databases and included in this retrospective review. Pain relief was reported in 2 different ways: (1) patients (n = 114) were placed in 1 of 4 orofacial pain relief categories based on common clinical experience and face validity and (2) pain relief was calculated based on patients' (n = 71) ratings of their pain on a numerical descriptor scale before and after treatment.
RESULTS:
Lower cervical paraspinous intramuscular injections with bupivacaine were performed in 118 adult patients. Four charts were excluded from review because of missing or inadequate documentation. Pain relief (complete or clinical) occurred in 75 patients (66%), and partial orofacial pain relief in 32 patients (28%). No significant relief was reported in 7 patients (6%). Overall, some therapeutic response was reported in 107 of 114 patients (94%). Orofacial pain relief was rapid, with many patients reporting complete relief within 5 to 15 minutes.
CONCLUSION:
This is the first report of a large case series of emergency department patients whose orofacial pain conditions were treated with intramuscular injections of bupivacaine in the paraspinous muscles of the lower neck. The findings suggest that lower cervical paraspinous intramuscular injections with bupivacaine may prove to be a new therapeutic option for acute orofacial pain in the emergency department setting.
Friday, September 24, 2010
Headaches and TMJ Disorders are related to whole body health.
A new article in Practical Pain Management "Head and Neck: Kinetic Chain from the Toes Influences the Craniofacial Region " discusses the kinetic chain and how what happens in the body effects the craniofacial region and how jaw problems, bite stability and joint stability influences the entire body as well. These postural changes are a major cause of Tension-type headaches, neck pain and other types of myalgias.
The field of Posturology is how our posture affects the entire body. Posture includes how we stand, sit, lay down, sleep, work out and more. If we overwork muscles we can cause repetitive strain injuries that lead to myofascial pain and dysfunction.
There are three set points in the body that serve as neuromuscular resetting mechanisms. The teeth when we bite and swallow, our hips when we sit and our feet-legs-hips when we stand.
A second article in the Clinical Journal Pain. 2010 Aug 20. "The Influence of Cranio-cervical Posture on Maximal Mouth Opening and Pressure Pain Threshold in Patients With Myofascial Temporomandibular Pain Disorders." found that their data "supports the biomechanical relationship between the cranio-cervical region and the dynamics of the temporomandibular joint, as well as trigeminal nociceptive processing in different cranio-cervical postures." The trigeminal nociceptive system is integral in almost all chronic headaches and migraines. (abstract below)
Another recent article "Prevalence of temporomandibular disorder-related findings in violinists compared with control subjects" in Oral Surg Oral Med Oral Pathol Oral Radiol looks at the posture of violinists and how it affects TM Joint stability and symptoms. This is a special case of postural distortion. (abstract below)
Head and Neck: Kinetic Chain from the Toes Influences the Craniofacial Region
Practical Pain Management, 08/04/2010
Rubenstein D – This article on plantar toe flexion and the kinetic chain is very interesting and offers an insight that may play a clinical role in diagnosis of TMJ and facial pain of kinetic postural and muscular origin. It serves to demonstrate that the TMJ and cervico/mandibular regions are both influencers of, and are influenced by, postural stresses, degenerative changes and dysfunctions that are often unrecognized by pain management clinicians.
Clin J Pain. 2010 Aug 20. [Epub ahead of print]
The Influence of Cranio-cervical Posture on Maximal Mouth Opening and Pressure Pain Threshold in Patients With Myofascial Temporomandibular Pain Disorders.
La Touche R, París-Alemany A, von Piekartz H, Mannheimer JS, Fernández-Carnero J, Rocabado M.
*School of Health Science, Department of Physical Therapy daggerGroup for Musculoskeletal Pain and Motor Control Clinical Research double daggerOrofacial Pain Unit of the Policlínica Universitaria, Universidad Europea de Madrid, Villaviciosa de Odón paragraph signDepartment of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain section signFaculty of Business, Management and Social Science, University of Applied Science Osnabrück, Osnabrück, Germany parallelProgram in Physical Therapy, Columbia University, New York, NY musical sharpSchool of Rehabilitation Science, Universidad Andres Bello, Santiago, Chile.
Abstract
OBJECTIVE: The aim of this study was to assess the influence of cranio-cervical posture on the maximal mouth opening (MMO) and pressure pain threshold (PPT) in patients with myofascial temporomandibular disorders pain.
MATERIALS AND METHODS: A total of 29 patients (19 females and 10 males) with myofascial temporomandibular disorders pain participated in the study, aged 19 to 59 years (mean years+/-SD; 34.69+/-10.83 y). MMO and the PPT (on the right side) of patients in neutral, retracted, and forward head postures were measured. A 1-way repeated measures analysis of variance followed by 3 pair-wise comparisons were used to determine differences.
RESULTS: Comparisons indicated significant differences in PPT at 3 points within the trigeminal innervated musculature [masseter (M1 and M2) and anterior temporalis (T1)] among the 3 head postures [M1 (F=117.78; P<0.001), M2 (F=129.04; P<0.001), and T1 (F=195.44; P<0.001)]. There were also significant differences in MMO among the 3 head postures (F=208.06; P<0.001). The intrarater reliability on a given day-to-day basis was good with the interclass correlation coefficient ranging from 0.89 to 0.94 and 0.92 to 0.94 for PPT and MMO, respectively, among the different head postures.
CONCLUSIONS: The results of this study shows that the experimental induction of different cranio-cervical postures influences the MMO and PPT values of the temporomandibular joint and muscles of mastication that receive motor and sensory innervation by the trigeminal nerve. Our results provide data that supports the biomechanical relationship between the cranio-cervical region and the dynamics of the temporomandibular joint, as well as trigeminal nociceptive processing in different cranio-cervical postures.
PMID: 20733480 [PubMed - as supplied by publisher]
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jan;109(1):e15-9.
Prevalence of temporomandibular disorder-related findings in violinists compared with control subjects.
Rodríguez-Lozano FJ, Sáez-Yuguero MR, Bermejo-Fenoll A.
TMD and Orofacial Pain Unit, Faculty of Medicine and Odontology, University of Murcia, Murcia, Spain. fcojavier@um.es
Abstract
OBJECTIVE: The aim of this study was to determine if there is an association between violin playing and the presence of signs and symptoms of temporomandibular disorder (TMD).
STUDY DESIGN: We studied a group of violinists in the Murcia region of Spain, who were examined for TMD. The results were compared with those from a random control group who did not play any musical instrument. The groups were matched by age and gender. Statistical analysis was carried out using SPSS 15.0 statistical software.
RESULTS: Compared with the control subjects, the violinists as a group had significantly more pain in maximum mouth opening (P < .005), parafunctional habits (P = .001), and occurrence of temporomandibular joint sounds (P < .005) as determined by chi-squared.
CONCLUSIONS: Violin playing appears to be a factor associated with TMD-related findings.
PMID: 20123363 [PubMed - indexed for MEDLINE]
The field of Posturology is how our posture affects the entire body. Posture includes how we stand, sit, lay down, sleep, work out and more. If we overwork muscles we can cause repetitive strain injuries that lead to myofascial pain and dysfunction.
There are three set points in the body that serve as neuromuscular resetting mechanisms. The teeth when we bite and swallow, our hips when we sit and our feet-legs-hips when we stand.
A second article in the Clinical Journal Pain. 2010 Aug 20. "The Influence of Cranio-cervical Posture on Maximal Mouth Opening and Pressure Pain Threshold in Patients With Myofascial Temporomandibular Pain Disorders." found that their data "supports the biomechanical relationship between the cranio-cervical region and the dynamics of the temporomandibular joint, as well as trigeminal nociceptive processing in different cranio-cervical postures." The trigeminal nociceptive system is integral in almost all chronic headaches and migraines. (abstract below)
Another recent article "Prevalence of temporomandibular disorder-related findings in violinists compared with control subjects" in Oral Surg Oral Med Oral Pathol Oral Radiol looks at the posture of violinists and how it affects TM Joint stability and symptoms. This is a special case of postural distortion. (abstract below)
Head and Neck: Kinetic Chain from the Toes Influences the Craniofacial Region
Practical Pain Management, 08/04/2010
Rubenstein D – This article on plantar toe flexion and the kinetic chain is very interesting and offers an insight that may play a clinical role in diagnosis of TMJ and facial pain of kinetic postural and muscular origin. It serves to demonstrate that the TMJ and cervico/mandibular regions are both influencers of, and are influenced by, postural stresses, degenerative changes and dysfunctions that are often unrecognized by pain management clinicians.
Clin J Pain. 2010 Aug 20. [Epub ahead of print]
The Influence of Cranio-cervical Posture on Maximal Mouth Opening and Pressure Pain Threshold in Patients With Myofascial Temporomandibular Pain Disorders.
La Touche R, París-Alemany A, von Piekartz H, Mannheimer JS, Fernández-Carnero J, Rocabado M.
*School of Health Science, Department of Physical Therapy daggerGroup for Musculoskeletal Pain and Motor Control Clinical Research double daggerOrofacial Pain Unit of the Policlínica Universitaria, Universidad Europea de Madrid, Villaviciosa de Odón paragraph signDepartment of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain section signFaculty of Business, Management and Social Science, University of Applied Science Osnabrück, Osnabrück, Germany parallelProgram in Physical Therapy, Columbia University, New York, NY musical sharpSchool of Rehabilitation Science, Universidad Andres Bello, Santiago, Chile.
Abstract
OBJECTIVE: The aim of this study was to assess the influence of cranio-cervical posture on the maximal mouth opening (MMO) and pressure pain threshold (PPT) in patients with myofascial temporomandibular disorders pain.
MATERIALS AND METHODS: A total of 29 patients (19 females and 10 males) with myofascial temporomandibular disorders pain participated in the study, aged 19 to 59 years (mean years+/-SD; 34.69+/-10.83 y). MMO and the PPT (on the right side) of patients in neutral, retracted, and forward head postures were measured. A 1-way repeated measures analysis of variance followed by 3 pair-wise comparisons were used to determine differences.
RESULTS: Comparisons indicated significant differences in PPT at 3 points within the trigeminal innervated musculature [masseter (M1 and M2) and anterior temporalis (T1)] among the 3 head postures [M1 (F=117.78; P<0.001), M2 (F=129.04; P<0.001), and T1 (F=195.44; P<0.001)]. There were also significant differences in MMO among the 3 head postures (F=208.06; P<0.001). The intrarater reliability on a given day-to-day basis was good with the interclass correlation coefficient ranging from 0.89 to 0.94 and 0.92 to 0.94 for PPT and MMO, respectively, among the different head postures.
CONCLUSIONS: The results of this study shows that the experimental induction of different cranio-cervical postures influences the MMO and PPT values of the temporomandibular joint and muscles of mastication that receive motor and sensory innervation by the trigeminal nerve. Our results provide data that supports the biomechanical relationship between the cranio-cervical region and the dynamics of the temporomandibular joint, as well as trigeminal nociceptive processing in different cranio-cervical postures.
PMID: 20733480 [PubMed - as supplied by publisher]
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jan;109(1):e15-9.
Prevalence of temporomandibular disorder-related findings in violinists compared with control subjects.
Rodríguez-Lozano FJ, Sáez-Yuguero MR, Bermejo-Fenoll A.
TMD and Orofacial Pain Unit, Faculty of Medicine and Odontology, University of Murcia, Murcia, Spain. fcojavier@um.es
Abstract
OBJECTIVE: The aim of this study was to determine if there is an association between violin playing and the presence of signs and symptoms of temporomandibular disorder (TMD).
STUDY DESIGN: We studied a group of violinists in the Murcia region of Spain, who were examined for TMD. The results were compared with those from a random control group who did not play any musical instrument. The groups were matched by age and gender. Statistical analysis was carried out using SPSS 15.0 statistical software.
RESULTS: Compared with the control subjects, the violinists as a group had significantly more pain in maximum mouth opening (P < .005), parafunctional habits (P = .001), and occurrence of temporomandibular joint sounds (P < .005) as determined by chi-squared.
CONCLUSIONS: Violin playing appears to be a factor associated with TMD-related findings.
PMID: 20123363 [PubMed - indexed for MEDLINE]
Saturday, June 12, 2010
Chicago Neuromuscular Dentistry: Correction of Jaw position helps correct entire body posture.
Patients with posture problems and chronic pain may benefit tremendously from a diagnostic neuromuscular orthotic. There are two main causes of forward head posture more accurately referred to as forward neck posture with cranial rotation at C1 and C2 or the Atlas and Axis. The first reason is that the jaw acts as a counterbalance to the head through a complicated series of connections. In general if the jaw closes too far, ie decreased vertical dimension or is pushed to far back, posterior displacement . This causes stretching of the supra and infrahyoid. When this occurs for extended period of time it will cause the cranium to tip forward and down. To correct visual line of site the head then rotates at the joint of the first vertebrae (Atlas ) to the head or occiput.
The second cause is to open the pharyngeal airway. Patients attempting to correct their head position will always fail if they do not address the airway.
Airway and jaw position are tied together so closely that most patients with TMJ disorders (TMD or Temporomandibular Disorders) actually have both conditions. The National Heart Lung and Blood Institute (NHLBI) has a report "CQRDIOVSCULAR AND SLEEP RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS"
IT IS WELL ESTABLISHED THAT MOST PATIENTS WITH OBSTRUCTIVE SLEEP APNEA (SNORING, HYPOPNEA, UARS, RERA) HAVE SMALL AIRWAYS WHEN THEY ARE AWAKE AS WELL AS ASLEEP. WHEN AWAKE THEY PROTECT THEIR AIRWAY BY NEUROMUSCULAR COMPENSATION. FOWARD HEAD POSITION AND ABERRANT JAW POSITIONS ARE A DIRECT RESULT OF PROTECTING THE AIRWAY.
CORRECTION OF ABERRANT HEAD POSITION SHOULD ALWAYS ADDRESS THE AIRWAY.
SYMPTOMS RELATED TO AIRWAY AND FORWARD HEAD POSITION MAY INCLUDE:
HEADACHES
MIGRAINES
NECK PAIN
BACK PAIN
HIGH BLOOD PRESSURE
CORONARY ARTERY DISEASE
SHORT TERM MEMORY LOSS
SLEEP APNEA
FACIAL PAIN
ARM PAIN AND WEAKNESS
ARM NUMBNESS AND TINGLING OR SENSATION OF FALLING ASLEEP
POSTURAL DISTORTION
SLEEP APNEA
SNORING
AND ADDITIONAL AUTONOMIC AND PHYSICAL SYMPTOMS TO NUMEROUS TO COVER IN THIS BLOG
The second cause is to open the pharyngeal airway. Patients attempting to correct their head position will always fail if they do not address the airway.
Airway and jaw position are tied together so closely that most patients with TMJ disorders (TMD or Temporomandibular Disorders) actually have both conditions. The National Heart Lung and Blood Institute (NHLBI) has a report "CQRDIOVSCULAR AND SLEEP RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS"
IT IS WELL ESTABLISHED THAT MOST PATIENTS WITH OBSTRUCTIVE SLEEP APNEA (SNORING, HYPOPNEA, UARS, RERA) HAVE SMALL AIRWAYS WHEN THEY ARE AWAKE AS WELL AS ASLEEP. WHEN AWAKE THEY PROTECT THEIR AIRWAY BY NEUROMUSCULAR COMPENSATION. FOWARD HEAD POSITION AND ABERRANT JAW POSITIONS ARE A DIRECT RESULT OF PROTECTING THE AIRWAY.
CORRECTION OF ABERRANT HEAD POSITION SHOULD ALWAYS ADDRESS THE AIRWAY.
SYMPTOMS RELATED TO AIRWAY AND FORWARD HEAD POSITION MAY INCLUDE:
HEADACHES
MIGRAINES
NECK PAIN
BACK PAIN
HIGH BLOOD PRESSURE
CORONARY ARTERY DISEASE
SHORT TERM MEMORY LOSS
SLEEP APNEA
FACIAL PAIN
ARM PAIN AND WEAKNESS
ARM NUMBNESS AND TINGLING OR SENSATION OF FALLING ASLEEP
POSTURAL DISTORTION
SLEEP APNEA
SNORING
AND ADDITIONAL AUTONOMIC AND PHYSICAL SYMPTOMS TO NUMEROUS TO COVER IN THIS BLOG
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