The Cause of Gareth Bale’s Injuries

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Gareth Bale is the world’s most expensive soccer player to date. He was transferred in 2013 from the British team Tothenham to the Spanish powerhouse Real Madrid for a world record 139 million US$.

In 4 seasons, Bale has suffered 12 major injuries, resulting in 44 missed games and 256 days without been able to train. He is currently injured and unfit to play.

The majority of Bale’s injuries affect the muscles and tendons of one leg and the muscles that stabilize the pelvis and hips.

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The majority of Bale’s injuries affect muscles and tendons of one leg and the muscles involved in stabilizing the pelvis

What is the reason for these injuries?

Journalists have given their explanation: it is just a chronic bad luck that haunts him and bad athletic conditioning. Real Madrid has even accused of negligent physical training and fired one of his coaches – the 3 times Champions League winner Carlo Ancelotti.

A player who is regularly injured in postural muscles and tendons and mainly on the same side cannot just suffer chronic misfortune. There must be something else behind. Bale’s problem is not bad luck; it is rather a problem in his body that is not working properly and needs to be solved.

Why are Bale’s injuries concentrating on the left side? Why is it always muscles and tendons?

Bale gets injured because his body is not straight. It’s clear, it does not take a genius to figure it out. Just look at one of his pictures.

bale cranial mandibular analysis

Gareth Bales suffers from a postural collapse driven by a sinking skul. Lack of sufficient dental height on the left side causes the mandible to twist towards the left, the upper cervical vertebrae to to get misaligned,  the skull to sink forward and laterally towards the right. As a consequence, the whole spine gets twisted. The baricentre of the head is not centered on the body’s center of gravity.

It is a textbook case. Lack of sufficient dental height on the left side causes Bale’s mandible to twist towards the left, the upper cervical vertebrae to to get misaligned,  the left TMJ to be jammed, the left TMJ disk to be displaced medially, the skull to sink forward and laterally towards the right. As a consequence, the whole spine gets twisted. The weight of the head is not centered on the axis of the spine and on the body’s center of gravity.

The extent of the structural misalignment is even more evident when you compare Bale’s picture alongside his team mates Cristiano Ronaldo and Benzema – world class athletes with a remarkable cranial symmetry.

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Bale’s misaligned mandible, head and neck as compared to his team mates remarkable cranial symmetry.

The axis of the plane of occlusion of Bale is not aligned with the axis of the skull and cervical vertebrae.

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The axis of the plane of occlusion of Bale is not aligned with the axis of the skull and cervical spine.

Rx Evidence of TMJ-Mandibular Treatment

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And this is how we treated a case with very similar symptoms to the ones Gareth Bale is suffering from.

In the following pictures, you can see how 7 months of splint therapy can change the bone structure supporting the dental arches, maxilla, mandible, skull and cervical vertebrae.

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This patient suffered from chronic neck and back pain, difficulty in phonetic expression, broken voice, Chronic Fatigue Syndrome and neurological problems including difficulty to focus and concentrate. 7 months of treatment resolved all the symptoms. Before resorting to splint therapy, this patient had tried many sorts of treatment, traditional and alternative medicine, with no improvement in his condition.

The pictures on the left were taken before the treatment. Pictures on the right were taken 7 months later. All the described symptoms had disappeared.

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This is the Rx evidence of the result of 7 months of treatment with a Gelb-Rectifier dental splint of a patient with very similar symptoms to Bale’s. Splint therapy can align the mandible and the upper cervical vertebrae and reduce the jamming of the left TMJ and rotation of the skull. In the end the baricentre of the head will sit in the middle of the axis of the spine.

And here below, you can appreciate a model of how the skeletal structure and alignment was modified.

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With Gelb-Rectifier splint therapy it is possible to recover the asymetric lack of dental height, unjam the left TMJ and align the mandible an upper cervical vertebrae. In the end, the baricentre of the head will reover its centered position aligned with the axis of the spine.

Mandibular misalignemt caused by asymmetric lack of sufficent dental height brings about multiple bio-mechanical consecuences. Let’s analyze them.

Inside Bale’s Jammed Left TMJ and Displaced Disk

The TMJ (Temporo-Mandibular Joint) is the joint that connects the mandible to the head.

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The TMJ is the joint that connects the mandible to the head

The TMJ has a cartilage-meniscus that is normally referred to as TMJ disk. Bale’s uneven and asymmetric dentition forces the head of the left mandibular joint backwards and up, squeezing the TMJ disk out of its physiological position towards the front (anterior displacement)  and the inside (medial desplacement) or outside (lateral displacement) of the joint.

In the following pictures you can find examples of MRI images of TMJ derangement.

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MRI of anterior displacement of a TMJ disk. Anteriorly displced disks produce a ¨click¨ sound when they recover their right physiological position.

Anteriorly displced disks produce a ¨click¨ sound when they recover their right physiological position. I would not be surprised if Bale’s left TMJ clicks when he opens and closes the mouth.

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MRI of medial (towards the inside) displacement of a TMJ disk. Medially displced TMJ disks produce neurological symptoms such as Dystonia, Parkinson’s, and Tourette’s as they irritate and interfere in the normal function of the trigeminal nerve.

Medially displced TMJ disks produce neurological symptoms such as Dystonia, Parkinson’s, and Tourette’s as they irritate and intefere with the normal function of the trigeminal nerve. This is not (yet) Bale’s case. But the pressure on the TMJ disk and trigeminal nerve is definetely already causing  an imbalanced propiocetion of the alignment of the body and the spine with respect to the position of the head.

Bale’s Twisted Upper Cervical Vertebrae

Every time Bale clenches his teeth, chews or swallows, his twisted mandible is transmitting torsion forces on his upper cervical vertebrae. As a result, the two upper cervical vertebrae C1 (or Atlas) and C2 (or Axis) get twisted and misaligned with the base of the skul. The technical term for this condition is “subluxation.”

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The first two cervical vertabrae C1 (Atlas) and C2 (Axis) are subluxated and out of alignment with the base of the skull and the rest of the spine.

The Axis and Atlas allow the skull to move: forward, backward, left, right, up, down, sideways and tilt. When they are subluxated (out of their physiological position), the skull can not move freely and center its weight on the cervical spine.

Moreover, the Axis acts as the pivot point of the rotation of the mandible.

Courtesy of Dr. Lee. Functional Treatment of Dystonia

A twisted mandible caused by uneven dental occlusion will push the Axis and Atlas out of position every time teeth clench or chew.

And the following is an RX evidence of subluxation of Atlas and Axis.

Courtesy of Dr. Lee. Functional Treatment for Dystonia

Descending Twisting Strain on the Spine

Subluxation of the Atlas and Axis brings about a descending effect that twists the whole spine, all the way down to the pelvis.

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Subluxation of the upper cervical vertebrae bring about a descending twisting strain on the whole spine, all the way down to the pelvis.

The final result of a distorted and twisted TMJ, Atlas, Axis and mandible is that the weight of the head falls out of the center of gravity of the body, twisting the spine in the process.

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The weight of the head is out of the center of gravity of the body causing muscle strain, umbalance and compensatory torsion of the spine and pelvis.

Gareth Bale is at Phase 2 of Postural Collapse Driven by a Sinking Skull

In order to get a complete analysis of the process that brings about torsion of the spine through mandibular missalignment and lack of sufficient dental height on one side, you can read our post on Phases of Lateral Postural Collapse.

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The 4 phases of lateral posturla collapse driven by a sinking skull that does not find sufficient support on one side of the dental arches. Gareth Bale is at phase 2.

All human beings (the professional model, the athlete, the farmer, the office worker, etc.) are imbalanced, mostly to  the one side or the other. Some more, some less. Certainly the degree of asymmetry differs from case to case. There are people who because of their asymmetry remain disabled, people who all in all succeed in living a dignified life, and finally there are those who succeed in becoming life-long athletes. It all depends on the extent of the asymmetry.

The first thing that shows up with a loss of symmetry of the dental arches is asymmetrical work  of the masseter and temporal muscles (levator muscles of the jaw).

With the removal of dental height on the left dental arch, the skull loses its support on the left side. Conversely, the support of the skull remains unchanged on the right side.

In the picture, a reduction of dental height is carried out on the left dental arch. As a result the masseter muscle shortens, forcing the mandible to twist in order to find contact between the dental arches. As we have already said, teeth have to which counterbalance the force exerted by the masseter and temporal muscles. The result is that the skeleton, no longer perfect, begins to take on the aspect of a common asymmetrical skeleton.

Given the lack of dental height on the left side, the skull begins to give way somewhat on the left side as it is being pulled downward by the masseter and temporal muscles. Falling to the left, the skull alters its inclination in respect to the axes of reference and the cervical spine.

With an inclination to the left the skull begins sinking truly in this direction. As it sinks the musculature on the right extends, pulling the right shoulder towards it, which begins to rise. As a result, the entire right side of the body (left in the picture) raises itself, causing the pelvis to rotate in a clockwise direction.

The rotation of the pelvis draws the leg up and changes the arch support of the right foot.

Symptoms in Phase 1 are very mild. Muscle tension is not excessive, for which reason psychological tension is also limited. With progression of the fall of the skull we pass to Phase 2.

Phase 2

During Phase 2 we start to observe the first changes that take place in other parts of the skeleton. The descending nature of this phenomenon starts to become apparent.

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In Phase 2, due to the effect of the masseter and temporal muscles, the skull continues its clockwise rotation, changing its inclination in respect to the blue vertical line and comes closer to the jaw (to the left), there where it lacks support.

Due to the alteration of the inclination of the skull, which moves from right to left, the right shoulder is drawn upward. The skull pulls the right shoulder towards itself because it is kept at that point through the participation of the rhomboid muscles and those of the neck.

The entire right side begins to tense up and as a result increases the clockwise rotation of the pelvis.

The first significant difference in Phase 2 in regard to Phase1 is to be found in the inclination of the jaw, which tends to come nearer to the skull there where it lacks dental height.

The entire jaw lifts itself momentarily only in this phase as it is pulled upward by a skull which is trying to remain straight on its vertical axis.

We can say that Phase 2 is an aggravation of Phase1. The significant difference remains the change in inclination of the jaw, which defers to the skull.

What is Happening to Bale’s Body?

Here below you can find animations that reproduce the full 4 phases of the process of postural collapse of the skeletal structure on different planes and its relation with the height and shape of the dental arches (marked in red in the animations).

This is what is happening to Garreth Bale’s body.

When TMJ-mandibular umbalance triggers postural collapse, the spine undergoes a twisting process. Unless the umbalance is treated, the spine continues to twist. Patients with similiar bio-mechanical umbances may end up developing Dystonia. and neurological symptoms.

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How to Cure Bale’s Injuries for Good?

It is obvious that Gareth Bale will continue to get injuries that will cripple his career as a professional soccer player unless he treats his underlying problem.

The bio-mechanical treatment of Gareth Bale’s problem is easier than treating a patient suffering from Dystonia, but is based on the same mechanism: centering and lifting the skull on the cervical vertebrae by means of dental splints that produce orthopedic forces that transmit the power the chewing muscles to stretch and align the Atlas, Axis and TMJ.

A detailed explanation of the working of splint therapy to treat and reverse postural collapse can be found in the post Principles of Splint Therapy.

The goal of splint therapy is to produce orthopedic forces that will progressively stretch and realign the upper cervical vertebrae (C1 – Atlas- and C2 – Axis) with the axis of the spine and the skull.

In the next picture you will see RX evidence of how the orthopedic forces produced by splint therapy can realign the upper cervical and eliminate pathologic compression strain on the brain stem over a period of a few months.

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The following picture describes how we  use orthopedic forces acting on dental occlusion to stretch and un-jam the upper cervical area.

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A Gelb-Rectifier dental splint uses the princples of lever machanics and a fulcrum to convey the forces of chewing muscles to stretch the upper cervical and TMJ. The harder the patient clenches, the further he will offload and stretch the TMJ.

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A Gelb-Rectifier dental splint uses the princples of lever machanics and a fulcrum to convey the forces of chewing muscles to stretch the upper cervical and TMJ. The harder the patient clenches, the further he will offload and stretch the TMJ.

The treatment for Bale includes:

  • A modified Gelb-Rectifier indexed lower splint that covers molar and premolar teeth.
  • Registration  of the splint’s bite directly in the mouth in the phonetic “O” position to achieve functional muscular symmetry and the Gelb 4/7 position of the condyles within the TMJ .
  • Registration of cusps on fresh Polimporh or self curing resin of inner molar and premolar cusps every 2 weeks.
  • Gradually increse vertical dimension (the height of the teeth) in the back of the mouth with new registrations of the splint every two weeks to lift the skull and straighten the spine.
  • Bale should use the splint to sleep and while training-playing matches for a year.
  • Upper ALF to promote cranial motion.
  • At the end of the year, when the correct alignment of the neck and skull is achieved, dental prosthetics should be done to adjust to the new position.
gelbrectifier

A modified Gelb-Rectifier is a lower dental appliance built on a base splint (manufactured by a dental lab) and covered with a thin layer of Polimorph, a material that melts at 66 degrees Celsius and is solid at body temperature. A new bite is registered every 2 weeks onto the soft polimorph with the splint directly in the mouth. While registering the bite, the patient should close the mouth with the shape that comes from speaking the leter “O” to achieve the Gelb 4/7 position of the condyles within the TMJ.

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The ALF (Advacned Light Force appliance) is a thin wire anchored to upper first molar and canine teeth. it produces very gentle but constant orthopedic forces that can expand the palate and level the maxillary bones by acting on palatal sutures.

Why Don’t the Medical Services of Real Madrid Know How to Treat Bale?

That is a very good question. Real Madrid is the most laurate soccer team in the world and counts with world class medical professionals. They should know about bio-mechanical treatments and dental splints to increase athletic performance and reduce risk of injuries. Real Madrid is the biggest sport team in the world by revenues.

Yet there seems to be nobody at Real Madrid that understands and diagnosed correctly Bale’s injuries and is knowledgeable of splint therapy to correct bio-mechanical imbalances.

It is worth noticing that many top atlethes and teams have been using dental appliances for decades.  For example, in the next picture you can see how Steph Curry, MVP of the NBA basketball league, uses a dental splint.

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Many top athletes and teams use dental splints to increase force, alignment and prevent injuries. Why does Real Madrid not?

And it is also well known that athletes who have a remarkable cranial symmetry have longer careeres and do not suffer from as many injuries. Please see some of the examples below.

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Usain Bolt is the 30 year old reigning world and Olympic champion in the 100 and 200 metres. He has excellent biomechanical, cranial, mandibular and neck symmetry.

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Giuseppe Rossi is an international soccer striker who played for the italian national team and top Spanish and Italian teams. His carreer was crippled by 3  surgeries on his right knee and multiple muscle injuires on his right side. The reason for the repeating injuries on the same side is apparent by looking at the bio-mechanical imbalance marked in the picture.

Moroever, the famous soccer team AC Milan created in 2002 a ground breaking medical program called Milan Lab. At the head of it, Dr. Meersseman applied principles of bio-mechanics and splint therapy to manufacture dental splints that correct dental-mandibular imbalances for top players. The results have been nothing short than amazing.  The Milan Lab bio-mechanical programme enabled Paolo Maldini and Alessandro Costacurta to play into their 40s, with Serginho and Cafu not far behind.

“Paolo Maldini was written off at 32 and he played another nine years,” Meersseman says. “And I remember when Cafu came in, somebody called me up – I won’t say who – and said I know for sure he is gone. He played another four years at a very high level.”

So… when will Bale and Real Madrid get serious about treating the cause of Gareth Bale’s injuries? They can contact me if they need help and advice.

Bio-Mechanichs of Dystonia

EXECUTIVE SUMMARY

In this post we will describe 10 bio-mechanical derangements, impairments and misalignments. Patients suffering from Dystonia (and other neurological movement disorders such as Parkinson’s and Tourette’s) tipically present some or all of the 10 described bio-mechanical impairments. 

We end the article by discussing how mainstream treatments for Dystonia recommended by  academic and clinical Neurology  are compatible and complement bio-mechanical treatments. 

For a complete bibliography of peer reviewed scientific reesearch papers, case studies and FDA approved clinical trials, please refer to the RESOURCES page of this blog. 
 
  

 

1) Cranial collapse and derangement

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Collapse and derangement of cranial bones can be graphically understood by thinking of a baloon loosing air. The skull collapses unevenly onto itself and affects the alignment of bones like the sphenoid, temporal and occiput. The palate gets narrower.

Cranial collapse results in the axis of the plane of dental occlusion being out of alignment with the axis of the skull and the spine. As a result, the forces that the mandible delivers on the skull are not at a right angle.

 And this is an MRI that shows clearly what cranial derangement is.

 

2) Twisted and side-bent sphenoid bone

The sphenoid bone is the key to cranial alignement. It sits in the middle of the skull and is connected to 20 different cranial bones.

Displacement of the sphenoid, occiput and temporal bones can be detected even just by the trained eye. As an example: the facial features described in the next picture.

The photograph of the patient’s natural head posture shows a significant amount of tipping to the left. In the right side of the picture, head tip has been corrected to make a more accurate description. 

The patient exhibits several facial features showing distortion which reflect the cranial base relationships. The left side of the face is visibly narrower than the right. The left eye is lower than the right. The left ear is lower and more flared than the right ear. The upper facial midline deviates to the right and the philtrum of the upper lip is also off to the right. The mouth angles slightly upward on the left. The chin is off to the left and the gonial angle is higher on the left compared to the right.

 
 

3) Postural collapse and lateral-frontal sinking skull

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The human body is inherently unstable. Its mass is distributed as an inverted pyramid: the heaviest part is the head at the top. To stand and to support the head, the body uses hundreds of bones connected by movable joints and muscles, fixed in place by ligaments. 

In order to stand and support the head, the body uses a combination of many simple levers. Bones, joints and muscles act as the arms, fulcrum and force of a combination of many simple lever machines.  

When the fulcri are out of alignment, the result is a forward head posture, twisted spine, rotated pelvis and one hip higher than the other. 

A twisted mandible and dental occlusion during the act of swallowing plays a key role in the mis-alignment of this combination of simple levers that support the head over the shoulders and the spine. Swallowing is an isometric and progressive contraction of all postural muscles centered around dental occlusion that occurs as the mandible closes in the position of Maximum Dental Intercuspation. 

 

4) Subluxation and misalignment of upper cervical vertebrae

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The first two cervical vertabrae C1 (Atlas) and C2 (Axis) are subluxated and out of alignment with the base of the skull and the rest of the spine.

The Axis and Atlas allow the skull to move: forward, backward, left, right, up, down, sideways and tilt. When they are subluxated (out of their physiological position), the skull can not move freely and center its weight on the cervical spine. 

Moreover, the Axis acts as the pivot point of the rotation of the mandible.

Courtesy of Dr. Lee. Functional Treatment of Dystonia

A twisted mandible caused by uneven dental occlusion will push the Axis and Atlas out of position every time teeth clench or chew. 

And the following is an RX evidence of subluxation of Atlas and Axis. 

Courtesy of Dr. Lee. Functional Treatment for Dystonia

 
 

5) Unstable Centric Dental Relation shifted midline and tipped teeth

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The midline of the upper and lower dental arches is shifted and the mandible does not find a stable position to close when swallowing.

The teeth are tipped in and out of alignment with the vertical axis of the skull.

The above picture shows the dental consequences of the sidebend pattern from an anterior view. The molar position, facial and dental midlines, occlusal cant and palatal slope are shown in this sketch. The maxilla is to the right and mandible to the left of the facial midline. The upper left molar is more vertical and closer to the midline. The lower left molar is tilted lingually as a consequence of the opposing dentition’s internal rotation. The lateral occlusal plane is shown canted upward on the left.

 
 

6) Twisted Sutures of the Palate

 

Sutures are the connections between the bones that make up the palate and the maxilla. They are marked in blue in the picture above.

In the picture you can clearly appreciate how sutures are twisted, asymmetric and form asymmwtric slopes on the two sides of the palate. This situation is often a result of orthodontic treatments, specially in adults.

 
 

7) Displaced condylar disks

The TMJ is the joint that connects the mandible to the skull. Each TMJ has a disk that covers the condyle, the upoer part of the mandible bone.

In people suffering from Dystonia, these disks are out of their normal physiological position. In particular: ONE CONDYLAR DISK IS ANTERIORLY DISPLACED and the OTHER IS POSTERIORLY DISPLACED.

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7) A pathologic ocular tilt reaction

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Resulting in asymmetric input to the central nervous system and a tilt in the subjective visual vertical perception.

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8) Scoliosis and deformed rib cage

A sinking and twisting skull will, over time, cause deformation of the spine and the rib cage, scoliosis and a reduced lung capacity.

This postural collapse usually evolves progressively in 4 phases described above.

 
 

9) Compression and twisting strain on the brain stem

The brain stem is the upper part of the spinal cord. It is the connection of the spinal cord with the brain.

When upper cervical vertebrae are out of their physiological position and the skull sinks and twists, the brain stem gets compressed and undergoes twisting strain.

Here is what twisting strain on the brain stem looks like in MRI scans:


 

10) Herniation and twisting of cerebral mass

Cranial derangement and twisting strain on the brain stem and postural collapse will, over time, produce herniation and twisting of cerebral mass.

 Here is what torsion and hernyation of cerebral mass looks like on MRI scans.


 
 

Treatment: combining bio-mechanical with bio-chemical/electrical

What came first? The chicken or the egg?

Mainstream academic Neurology approaches Dystonia as a neurological disorder with physical movement consequences.

From a bio-mechanical approach, Dystonia is a combination of physical impairments that produce neurological consequences.

The approach of mainstream clinical neurology can be described as bio-chemical/electrical: aberrant function of a part of the brain called the basal ganglia is believed to produce faulty electrical messages from the brain to the muscles that makes them contract in an uncoordinated way. Prescribed treatments include: botox injections to inhibit muscle activity; Deep Brain Stimulation surgery to implant electrodes in the brain that produce balanced electrical currents. The cause of the misfiring of the basal ganglia is not understood and research deals with possible genetic correlations.

A bio-mechanic approach to dystonia prescribes a treatment that addresses and corrects the 10 above mentioned derangements, impairments and misalignments. It considers these derangemenets as the cause of neurological symptoms. 

Even though the bio-mechanical and the bio-chemical approaches stem from opposite principles, it is important to understand that:

Bio-mechanical and bio-chemical/electrical treatments are compatible and complement one another. 

It is possible to carry out splint therapy while receiving botox injections, DBS surgery and any drug treatment. 

On the other hand, often and in many cases, a bio-mechanical treatment results in discontinuance of neurological symptoms and makes it unnecessary to use prescription drugs. 

This bio-mechanic approach has been around for decades with proven results. It is not mainstream because of the way medical academia organizes research and teaching in separate systems.

From a bio-mechanic approach, the treatment of Dystonia sits between Traumatology, Dentistry, TMD, Orthopedics and Neurology. It is considered a combination of several physical injuries of the upper cervical, lower cranial area.
For a detailed description of the treatment, please read the Protocol for the Bio-mechanic Treatment of Dystonia that we developed. 

The protocol we developed does not invent anything new. In the Resources section of this blog you can find 100 downloadable peer reviewed academic research papers, case studies and FDA approved clinical trials that deal with the biomechanics of neurological movement disorders.

The basic tools that are used to treat and correct the above described 10 postural, cranial, occlusal, vertebral and neurological derangements are the intra-oral appliances shown in the picture below:

  1. Maxillary ALF dental appliance
  2. Mandibular Gelb-Rectifier dental splint

    A bio-mechanical treatment of Dystonia can be long but remarkably inexpensive and effective. And it can improve the quality of life of patients to the point that they do not need lifelong drug treatments and can live a normal active, working and family life. 

     
     

    How can mechanical derangements cause neurological symptoms?

    The short answer is: the Trigeminal Nerve.

    The trigeminal nerve is the largest of the cranial nerves.  It is a nerve responsible for many functions, including sensation in the face and the activation of all the muscles of biting and chewing. 

    Its name (“trigeminal” = tri-, or three and -geminus, or twin; thrice-twinned) derives from the fact that each side of the trigeminal nerve (one on each side of the body) has three major branches connected to:

    • the eyes
    • the maxillae
    • the mandible

    Another important connection of the Trigeminal nerve reaches the ears, where the organs of balance are located.

    Its mandibular and maxillary branches are the ones that get anesthetized by dentists to avoid pain during dental procedures. Teeth play an active role in the sensory function of this nerve.

    Sensory information from the two sides of the trigeminal nerve is processed by parallel pathways in the central nervous system.

    Without entering into a complex analysis (which goes beyond the scope of this article), it is clear that this nerve feeds the brain with two sets of electrical signals (from each side of the body) related to balance, the horizon, verticality and the position of the skull with respect to the mandible and the body.

    In order to reach alignment of the body, the electrical impulses that come from both sides of the body to the brain through the trigeminal nerve have to be coherent and symmetric. The brain will adjust the body with involuntary muscles movements until it reaches coherence and minimizes discrepancy between the signals received from the two sides.

    Asymmetric cranial darangement and asymmetrical mechanical impairments of the TMJ, mandible, maxillae and teeth have a direct impact on the coherence of the electrical input the brain gets through the trigeminal nerve. 

    Lack of coherence in the electric signals received through the trigeminal nerve have the ability to trigger involuntary asymmetric muscle contractions. In short, they can trigger Dystonia

     
     

    Navigate Through this Blog

    To further understand our reasearch, approach and method, please read:

    A Bio-Mechanical Approach to Dystonia
    An introduction to the theory and analysis that support the pilot research project to use an adaptive intraoral appliance to treat and possibly cure Secondary Idiopatic Cervical Dystonia.

    Principles of Splint Therapy
    A description of the principles on which we base our protocol for the treatment of Cervical Dystonia and other occlusion realated movement disorders with varying degrees of neurological symptoms (from Tourette’s, to postural collapse, Parkinson’s and Generalized Dystonia).

    Protocol for the Treatment of Cervical Dystonia

    A step by step description of the 3 phases of the DIY protocol that we have developed for the treatment of Cervical Dystonia.

    The Molar Lever

    Our analysis of the bio-machinics of the Molar Lever and how dental occlusion is related to posture and skeletal allignment.>

    Phases of Lateral Postural Colapse

    Our analysis of the descending skeletal and postural effects of a collapsing and twisting skull that does not find adequate support in the dental arches.

    The Rectifier

    A description of the adaptive intra-oral aplliance -dental splint – that we use to treat Cervical Dystonia and the orthopedic forces that it produces by progressively pushing the mandible in retrusion, maxila in extrusion and elevating the skull by stretching and aligning the cervical vertebrae.

    Resources

    Bibliography and links to scientific research on the treatment of Dystonia and other neurological movement disorders with a bio-mechanical approach.

    Postural Colapse and Dental Arches

    A set of animations that present grafically the type of skeletal and postural effects that we intend to produce over a few months by modifying occlusion and the direction of forces between the skull and the mandible.

    Cervical Dystonia or Spasmodic Torticollis: Positive Evolution after Neurophysiological Treatment

    Guest post by Dr. Lidia Yavich.

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    The patient of this post contacted me through a derivation from a colleague from abroad.

    Soon after he sent an email, where he explained the reason for his consultation on Cervical Dystonia or Spasmodic Torticollis, I answered that it was not my area and that I treated TMJ Pathologies and Orthodontics and Facial Orthopedics.

    The patient insisted, commenting that the colleague that recommended me and knew me from the AACP meeting where I was invited as a lecturer explained to him that he didn´t know if I treated Dystonia, but he thought that considering what he had watched I could help him.

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    I began to study more on the published articles in this field. One of the articles that impacted me was: Spasmodic Torticollis: The Dental Connection. Anthony B. Sims, D.D.S.; Brendan C. Stack, D.D.S., MS.; Gary Demererjian, D.D.S.

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    Dystonia is a neurological movement disorder, which sustained muscle contractions causing twisting and repetitive movements or abnormal postures. The movements may resemble a tremor. Dystonia is often initiated or worsened by voluntary movements, and symptoms may “overflow” into adjacent muscles.There are multiple types of dystonia, and numerous diseases and conditions may cause dystonia.

    Focal dystonia: affects a muscle or group of muscles in a specific part of the body causing involuntary muscular contractions and abnormal postures, like eyes, neck or hands.The precise cause of primary dystonia is unknown. It is suspected to be caused by a pathology of the central nervous system, likely originating in those parts of the brain concerned with motor function, such as the basal ganglia.

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    Most common dystonia denomination are:

    A blepharospasm (from Greek: blepharon, eyelid, and spasm, an uncontrolled muscle contraction), is any abnormal contraction or twitch of the eyelid.

    Oromandibular dystonia is a form of focal dystonia affecting the mouth, jaw and tongue, and in this disease it is hard to speak.

    Cervical dystonia (spasmodic torticollis) affects the muscles of the neck. Causes the head to rotate to one side, to pull down towards the chest, or back, or a combination of these postures.

    Pasmodic dysphonia (or laryngeal dystonia) is a voice disorder characterized by involuntary movements or spasms of one or more muscles of the larynx (vocal folds or voice box) during speech.

    Patient Testimony: Iatrogenic Dental Implants Caused Dystonia

    Everything began approximately after the placement of the lower implants.

    One year after that, I began to feel uncomfortable.

    I felt a back and neck stiffness, a strong weight in the back of the head and pain.

    I began to make a lot of examination tests with neurologists, physical therapist, rheumatologists, orthopedists and all of them followed the same line, saying that it could be a stress problem and fatigue.

    Later I began to feel a twist movement in my neck towards the left. It was not so strong but I felt I had no control on my neck.

    My neck always tried to rotate to the left, especially when I walked, and when I tried to hold an object.

    After doing physical therapy, quiropraxia, acupuncture and all those techniques I began to research and finally with another neurologist I had a diagnosis of CERVICAL DYSTONIA. He asked for many exams to eliminate the possibility of being a trauma or other problem related to Wilson disease. That hypothesis was soon discarded.

    I searched for another neurologist that confirmed the same diagnosis of CERVICAL DYSTONIA.

    The neurologist initiated a treatment with Botox, to alleviate, and relax some muscles, trapeziums, esternocleidomastoideo, and splenius. I was also oriented to have three applications of miorelaxants.

    I began to investigate more on the subject and I found some videos about TMJ and some treatments with dental appliances.

    The situation is very bad because the diagnosis is neurological: we don´t know the etiology and it has no cure until today..

    I believe all of this must have a relation with the implants, because I passed more than 30 years without these teeth, maybe  the position of my mouth could have provoked some slow alteration that end up in this situation. I´m not an specialist to affirm that this is the real situation, but I believe that it is worthy to investigate because there is the existence of written articles. Moreover Dr. Anthony Sims, and other doctors in the dentistry field point for possible head and neck disturbance, motor coordination, Tourette disease or something like that, so many things could provoke changes in that TMJ region, the temporomandibular joints.

    image

    Intra oral pictures of the patient before treatment in habitual occlusion.

    image

     
     

    Patient Report: Detail of Main Symptoms

     

    – Impossibility of head stabilization

    – Ringing ears

    – Ear compression sensation

    – Muscle spasm when trying to move the head down and to the right.

    – Noises in the vertebras in the back of the neck region, C1 and C2, and noises in the spine.

    – Noises in the TMJ, specially when yawning.

     
     

    RX and MRI Evidence Before the Treatment

     

    image

    Patient’s panoramic radiograph before treatment.

    image

    Patient’s frontal radiograph where it is clearly seen the impossibility for straight posture of the head.

    image

    Patient’s initial laminography, in habitual occlusion where we can observe the retro position of both mandibular heads.

    image

    Patient’s initial lateral radiograph in habitual occlusion before treatment.

    image

    We can observe in this lateral radiograph and cervical spine radiograph the total lack of space between the ATLAS posterior arc and the Occipital base. I suspected adherences so I solicited a lateral radiograph in flexion.

    image

    In the Cervical Spine radiograph in flexion we can observe a REDUCED space between the ATLAS posterior arc and the base of the occipital. THE SPACE IS REDUCED, BUT EXISTS.

    image

    The MRI in closed mouth shows a small disc, superior facets in both mandibular condyles and bilateral retro discal compression. The patient has no limitation in opening the mouth and the discs are well situated on the mandibular heads when opening. I didn’t consider important to include the image of open mouth for this clinic case.

    image

    The Semg dynamic record shows an important asymmetry between superficial right and left temporalis, low activity of both masseters muscles. The trapezius doesn’t show activity during mandibular closing, which is physiologically correct. Important activity from the digastrics muscles in closing movement, which is not physiologically correct.

    image

    The Semg dynamic record shows an important asymmetry between superficial right and left temporalis, low activity of both masseters muscles. The sternocleidomastoid muscles show activity during mandibular closing, which is NOT physiologically correct (the sternocleidomastoid muscle is not a masticatory muscle). Important activity from the digastrics muscles in closing movement, which is NOT physiologically correct.

     
     

    Treatment with the Intraoral Device 

     

    His masticatory muscles were electronically deprogrammed with TENS (Transcutaneal Electronic Neural Stimula­tion). A jaw tracker then registered a neurophysiologic position from where an intraoral appliance was constructed and tested with SEMG (Surface Electromyography.)

    image

    Intraoral appliance built and fitted inthe mouth

    For this record we used the neurophysiologic technique of Dr. Learreta.

     
     

    4 Months after the Initiation of Treatment with the Intraoral Device 

     

    image

    Patient’s frontal comparative images: initial and four months after IOD (Intra Oral Device) wear. Notice the important improvement of head and shoulder posture.

    image

    Patient’s left profile comparative images: initial and four months after IOD (Intra Oral Device) wear. Notice the important improvement of head and shoulder posture.

    image

    Patient’s right profile comparative images: initial and four months after IOD (Intra Oral Device) wear. Notice the important improvement of head and shoulder posture.

    image

    Patient’s lateral radiograph with the device in neurophysiological position. Notice the space between the posterior arc of the atlas and the occipital base that didn´t exist before.

    image

    Patient’s frontal comparative radiograph: before the treatment and with the IOD (Intra Oral Device), the patient manages now to have a straight posture of the head.

    image

    Patient’s lateral and cervical spine comparative radiograph: before the treatment and with the IOD. Notice the space between the posterior arc of the Atlas and the occipital base that did not exist before.

    image

    Patient’s comparative laminographies: initial in habitual occlusion where we can observe the retro position of the mandibular heads and with the intraoral device with retrodiscal decompression.

     
     

    9 Months after the Initiation of Treatment with the Intraoral Device 

     

    image

    Patient’s frontal comparative images: initial, four months and nine months after IOD wear. The patient had a physiological posture recovery.

    image

    Patient’s right profile comparative images: initial, four months and nine months after IOD wear. The patient had a physiological posture recovery.

    image

    Patient’s left profile comparative images: initial, four months and nine months after IOD wear. The patient had a physiological posture recovery.

    image

    The patient also sent videos where he shows his initial incapacity to rotate the head and also comparative videos where he could do that again. The videos are not in the post to preserve patient’s identity.

     

     

    Navigate Through this Blog

    To further understand our reasearch, approach and method, please read:

    A Bio-Mechanical Approach to Dystonia
    An introduction to the theory and analysis that support the pilot research project to use an adaptive intraoral appliance to treat and possibly cure Secondary Idiopatic Cervical Dystonia.

    Principles of Splint Therapy
    A description of the principles on which we base our protocol for the treatment of Cervical Dystonia and other occlusion realated movement disorders with varying degrees of neurological symptoms (from Tourette’s, to postural collapse, Parkinson’s and Generalized Dystonia).

    Protocol for the Treatment of Cervical Dystonia
    A step by step description of the 3 phases of the DIY protocol that we have developed for the treatment of Cervical Dystonia.

    The Molar Lever
    Our analysis of the bio-machinics of the Molar Lever and how dental occlusion is related to posture and skeletal allignment.>

    Phases of Lateral Postural Colapse
    Our analysis of the descending skeletal and postural effects of a collapsing and twisting skull that does not find adequate support in the dental arches.

    The Rectifier
    A description of the adaptive intra-oral aplliance -dental splint – that we use to treat Cervical Dystonia and the orthopedic forces that it produces by progressively pushing the mandible in retrusion, maxila in extrusion and elevating the skull by stretching and aligning the cervical vertebrae.

    Resources
    Bibliography and links to scientific research on the treatment of Dystonia and other neurological movement disorders with a bio-mechanical approach.

    Postural Colapse and Dental Arches
    A set of animations that present grafically the type of skeletal and postural effects that we intend to produce over a few months by modifying occlusion and the direction of forces between the skull and the mandible.

    Chronic Pain, Posture and the Dentist 

    Guest post by Dr. Curtis Westersund

    The video shows a patient of Dr. Curtis Westersund suffering from Dystonia who gets relief from an anatomical dental orthotic as a part of her therapy. There were many steps to get to this point and many steps subsequent

    Everyone knows what dentists do. Fillings, crowns, root canals, tooth extractions. Practically the last person you want to have to visit. And while for many dentists, this is the limit of the services they offer, there are a growing number of dentists who have a passion for something more. A passion for helping patients with complicated conditions that have caused chronic pain, limited normal function and producing long term damage.

    It is these dentists who are looking at how the simple act of someone bringing their upper and lower teeth together can create long term and far reaching painful consequences. 

    Medical doctors are great at dealing with acute pain. Break your leg skiing and the medical profession would have you walking again in not time.

    But chronic pain patients were a different matter. The medical profession looks for advancement in pharmaceutical options to deal with their chronic pain patients. Or they determine that a problem is ‘idiopathic’ meaning the doctor has no knowledge of the cause of the pathology.

    The other tactic is to label chronic pain patients into poorly defined groups. In the 1970’s and 1980’s there were increasing numbers of women diagnosed with Fibromyalgia and Chronic Fatigue Syndrome coming to my dental practise. They were frustrated, in pain and often depressed. All of them had been provided numerous prescriptions to overcome their problems. 

    In truth these chronic pain patients were all exhibiting their own personal expression of various forms of stress. Stress that they have dealt with for many years. Stress is not limited to being emotional. Stress can be structural, muscular, neural, physiologic, and nutritional. Stress can be long term, starting with altered growth patterns from early childhood. Stress can increase with age, disease and injuries.

    The head bone is connected to the neck bones

    In Canada, mothers use to sing a song to their children that went “The head bone is connected to the neck bones; the neck bones are connected to the shoulder bones; the shoulder bones are … “.

    The song, while simple, shows that all of the body parts are connected and it follows that adding stress in any one area of the body will have affects that can show up far from the cause. Symptoms are not helpful in locating the true cause of pain and stress. 

    The human body is like a glass and stress to the body is like water being poured into that glass. As you add water (stress to the body) all is good until the volume of water overflows the top of the glass. In the human body the analogy means that if too much stress is added to the body symptoms appear.

    Since there are so many ways stress can be experienced, signs and symptoms of pain and dysfunction are varied. In fact there are so many factors adding to stress, so many options of chronicity and intensity, the way that chronic pain can be expressed in any one individual is unique. The chance of any one person having the exact same symptoms as any other person has the odds of drawing a winning lottery ticket. 

    The patient with Dystonia

    My patient in the two videos attached had her own unique path to her problem.

    The patient, SK, presented with Cervical Dystonia (CD) that had begun several months prior to my consult with her.

    She could not turn her head right, could not hold her head straight and was frustrated and angry with her condition. She had been to two neurologists seeking treatment. Neither medical doctor had been able to help her. She was told that if the Botox treatment one doctor gave her did not work, there was no help for her. 

    SK had seen another dentist’s treatment of a CD patient online and was hoping that I could do the same for her.

    Her history showed that she had just had her second child two months prior to developing her CD. She had been a figure skater as a young girl. She had no other obvious relevant history. The cause of SK’s problem became obvious at this point. SK had  a malocclusion or bad bite. She had a deep overbite and compressed TMJ spaces. Her malocclusion would created a misalignment between her head and neck vertebrae.

    She had long term misalignment of her hips due to the many falls she took in her figure skating career. When SK was coming to term in her pregnancy, hormonal changes in her body loosened ligaments in her body, part of the preparation for the birth process.  At two months post-partum, SK’s hips reset to an even more imbalance position. The resulting structural stress moved up to her neck and skull, altering muscle stress and creating the final expression was CD. 

    SK’s treatment started with upper cervical care with a NUCCA (National Upper Cervical Chiropractic Association) practitioner. NUCCA doctors only deal with the alignment of the first two vertebrae (the Atlas and Axis) and the skull. They use a non-balistic adjustment that is akin to a gentle massage at the base of the skull to align the head and neck.

    This is key for my work as a dentist as the alignment of the head and neck is intimately connected to the pattern of occlusion (the way teeth bite).

    Added to her treatment protocol was a registered massage therapist (RMT) who worked to realign SK’s hips.

    The goal of the efforts of the RMT, the NUCCA Chiropractor and my own intervention with a removable lower anatomical dental orthotic was to decrease the level of stress SK was under and the removal of the CD. 

    The Take Home

    The take home here is that we are not separate systems that require isolated therapies. The health care professionals have arbitrarily separated themselves from each other due to their individual training and focus. The problem for chronic pain sufferers is that their condition is not broken up into dental, chiropractic, and medical segments. I am a dentist. I do teeth and occlusion. I don’t do necks. I don’t do hips. I don’t do feet.

    Chronic pain sufferers require health care providers that can communicate with other health care providers to find the solution to decrease or eliminate the stress they suffer from.

    My advice for chronic pain sufferers is avoid the Doctor who says he or she can do it all themselves. Find the Doctor that works well with others and understands the limitations of their training and therapies. It is never just one problem. Humans function as a sum of systems.  Remember that pain is a poor metric of health. Health is not the absence of pain.

    Health is being healthy. We do not ignore cancers that are not painful. We do not ignore partially occluded coronary arteries that are not painful.

    Seek balance and health.

    Neurological Rehab for Dystonia

    In this post we will describe a basic Eye Tracking Exercise that helps balance and rehabilitate the nervous system in case of Dystonia, scoliosis and postural collapse.

    Neurological Rehabilitation is one of the most important parts of the Protocol for the Treatment of Dystonia that we have developed.

    In order to learn more about the protocol that we have developed for the treatment of Dystonia, you should be familiar with the theory that we set out to test as we describe in the post A Bio-Mechanical Approach to Cervical Dystonia.

    This bio-mechanical protocol has shown to be effective also for the treatment of other occlusion related movement disorders, with varying levels of neurological symptoms (from postural collapse driven by a sinking skull to Parkinson’s, Generalized Dystonia, Oromandibular Dystonia and Tourette’s).

    Posture, Alignment and Balance

    The human body is a bio-mechanical machine with 640 moving parts. Each part is unstable and requires 70 precise controls each second to keep it functioning in the correct way. If it does not get these controls, the entire machine does not run efficiently and gets damaged, either immediately or over time.

    Dystonia is an impairment of the ability of the body to maintain proper balance and alignment on 3 planes.

    alignment

    Dystonia is an impairment of the ability of the body to maintain alignment and balance on 3 planes.

    Alignment and balance are a challenge that the body has to overcome continuously just to stay upright against gravity. The brain needs to send about 70 signals per second to 640 different muscles.

    The muscles that determine posture are generally the deeper, less visible muscles. These are controlled by the subconscious part of your brain, mostly in the area called the cerebellum.

    cerebellum

    Postural nervous sytems are coordinated in the Cerebellum

    The control needs to be subconscious because posture requires precise and constant input – about 70 inputs per second as mentioned at the start of this post. That is far more precision, and far too frequent for our conscious brain to handle.

    Eye Tracking

    The eyes are one of the most important sensors which feed continuous information to the brain. The brain compiles all that and computes what signals to send, and then fires out the signals to your muscles through your nerves.

    The eyes provide the brain with information about the level of the horizon. If they are not tracking well, the result is faulty propioception, unbalance, uneven shoulders, torsion and  scoliosis.

    The following test can show the extent of the imbalance. It is done by placing a pen vertically with the tip at the level of the eyes and the body of the pen touching the nose. When the eyes focus on the tip of the pen, the result might be like like picture 1 or picture 2.

    eyetracking

    Picture 1: Poor eye tracking with one eye turned in, while the other is not able to do so. This pattern is tipical of scoliosis and postural collapse.

    eyetracking2

    Picture 2: Good eye tracking with both eyes turned in equally. This result can be achieved with training.

    A very powerful tool to improve eye tracking, is the exercise shown in the video below. The effects on posture, skeletal alignment and propioception are nothing short than amazing.

    It takes 1 minute to carry out the eye tracking exercise described in the video. We recommend doing 7 repetitions per day, every day during a dew months.

     

    Looking into the Black Box

    Why is there such a strong relationship between eyes, posture and neurological balance?

    The first thing we need to do when we want to unravel the intricacies of vision and posture and the central nervous system is realize we are all experiments of one. When we make assertions about their relationship, it has to be taken with that disclaimer in mind. All we can hope to do is design a good enough map to navigate this mysterious territory.

    The visual cortex takes up a quarter of the entire brain and a full 90% of the brain’s sensory input comes from visual sources. So when an image is processed it impacts the way the eye and body relate functionally by design.

    Moreover, the muscles that control the eye movement arise from the same core of somites that form the paraspinal muscles.

    The visual field and pathway are important regulators of postural control. Visual input for postural control helps to fixate the position of the head and upper trunk in space, primarily so that the center of mass of the trunk maintains balance over the well-defined limits of foot support.

    Although postural control is highly dependent upon visual status, higher cortical functions are necessary to differentiate between a fixed person within a moving environment, or a moving person within a fixed environment. 

    The eyes are a matched pair of brightness meters. They are capable of triggering an array of real or symbolic actions in response to significant light patterns occurring within their field of awareness. Before the light patterns to which the eyes are sensitive can become accurate and meaningful sources of information about the environment, the following must occur.

    The head which houses the eyes and the neck and the body which responds to what the eyes see, must come to balance both with the light patterns and also with gravity.

    Unless the organism establishes a balanced equilibrium with the light patterns, they are likely to be inaccurately organized by the eye’s receptors in the retina, and the receptors then are likely to trigger distorted neural signals.

    Therefore one of the organism’s first responses to a light pattern is to turn the eyes, neck and body until there is an equal amount of light on each retina.

    Coming to a balance with the light patterns simultaneously aligns the organism with gravity, thereby providing a stable base from which to respond.

    The organism’s balanced equilibrium both with light and gravity results in reciprocal feedback among the eyes, neck, and trunk as each tries to equate its activity with the other.

    That feedback provides the organism with the opportunity for optimal freedom to perform whatever is required to cope with the task at hand.

    Pathological Tilting of the Eyes

    image

    A pathologic ocular tilt reaction will result in asymmetric input to the central nervous system (CNS): a tilt in the subjective visual vertical perception.

    It will produce a perception by the patient that vertical orientation is different from what is true gravitational vertical.

     

     

     

     

    Navigate Through this Blog

    To further understand our reasearch, approach and method, please read:

    A Bio-Mechanical Approach to Dystonia
    An introduction to the theory and analysis that support the pilot research project to use an adaptive intraoral appliance to treat and possibly cure Secondary Idiopatic Cervical Dystonia.

    Principles of Splint Therapy
    A description of the principles on which we base our protocol for the treatment of Cervical Dystonia and other occlusion realated movement disorders with varying degrees of neurological symptoms (from Tourette’s, to postural collapse, Parkinson’s and Generalized Dystonia).

    Protocol for the Treatment of Cervical Dystonia
    A step by step description of the 3 phases of the DIY protocol that we have developed for the treatment of Cervical Dystonia.

    The Molar Lever
    Our analysis of the bio-machinics of the Molar Lever and how dental occlusion is related to posture and skeletal allignment.>

    Phases of Lateral Postural Colapse
    Our analysis of the descending skeletal and postural effects of a collapsing and twisting skull that does not find adequate support in the dental arches.

    The Rectifier
    A description of the adaptive intra-oral aplliance -dental splint – that we use to treat Cervical Dystonia and the orthopedic forces that it produces by progressively pushing the mandible in retrusion, maxila in extrusion and elevating the skull by stretching and aligning the cervical vertebrae.

    Resources
    Bibliography and links to scientific research on the treatment of Dystonia and other neurological movement disorders with a bio-mechanical approach.

    Postural Colapse and Dental Arches
    A set of animations that present grafically the type of skeletal and postural effects that we intend to produce over a few months by modifying occlusion and the direction of forces between the skull and the mandible.

    The ALF

    EXECUTIVE SUMMARY:

    In this post we will describe the appliance that can be used to unravel cranial distortions and collapse: the ALF.

    screenshot_2016-01-09-19-12-51-1.png

    ALF is an acronym for Advanced Lightwire Functional Appliances.  In this post we will describe the use and purpose of the ALF device based on the work of  Dr. Gerald H. Smith.

    upper lower alf

    Our Protocol for the treatment of Cervical Dystonia is based on the use of an upper ALF and a lower Gelb-Rectifier

    ALF treatment is one of the main parts of of the Protocol for the Treatment of Cervical Dystonia that we have developed, alongiside  the Splint Therapy with a modified Gelb-Rectifier lower dental appliance.

     

    Video Introduction to ALF Orthodontics/Orthopedics

    The following video will provide an introduction to ALF in 2 minutes.

     

    ALF History

    The ALF appliance was originally designed in 1983 by Dr. Darick Nordstrom to be a vehicle in a comprehensive dental orthopedic/orthodontic treatment approach. What Dr. Nordstrom initially discovered and later a handful of his disciples is that the ALF proved to be the best instrument to unravel the structural distortions of the skull bones and stabilize the cranial/dental complex.

    cranial derangement

    ALF treatment is designed to correct cranial assymetries and derangement

    The ALF System represents the missing link between conventional orthodontics and the more progressive functional orthopedic/orthodontic concepts. In reality, the ALF concept goes beyond the dental realm and supplies many answers to solving the age old problems of chronic somatic pain and generalized ill health.

    The ALF appliance allows to:

    • Correct cranial bone distortions
    • Correct maxillary cant
    • Align teeth to stabilize the cranium

    This is how an ALF device looks like when positioned on the maxillary teeth.

    ALF in place

    An ALF device placed on the maxillary arch. Note the Omega Loops that activate orthopedic forces.

    ALF is little more than a wire anchored on first molars and upper canines. It is activated and creates orthopedic forces by expanding the omega loops. In essence, it takes advantage of the force of the tongue when swolloing to expand and align the maxillary arch, palate and teeth. The force that it uses is extremely limited and light but constant.

    The fact that the ALF is not anchored to teeth (unlike traditional brackets for orthodontics) allows for the maximization of cranial movement.

    The final goal of ALF treatment is to achieve balance of the dental planes:

    • Vertical
    • Transverse
    • Sagittal

    The key to making the ALF appliance work is to adjust the appliance so that it balances four cranial indicators. Only by correcting crania bone alignment will the patient experience a cure.

     

    Aligning the Cranial Base

    When used properly, the ALF appliance enables orthodontists to correct cranial base abnormalities, which in turn corrects bodily function.

    cranial base

    The maxillae represents the anterior 2/3 of the cranial base

    Since the maxillae represents the anterior 2/3 cranial base and functions as the balancing mechanism for the entire skull, foramen magnum and atlas, it must be corrected first. By aligning the maxillae, it provides the foundation or template to build into.

    From a clinical perspective, if the maxillae is distorted so goes the rest of the body. Since 46% of the motor and sensory neurons of the cerebral cortex of the brain relate to the face and mouth, maxillary distortions have the potential of disrupting the central nervous system and changing neurological function throughout the entire body.

     

    cranial otrhogonal

    The body functions best when its structures are aligned at right angles

     

    Balance of the maxillae is critical for maintaining total structural integrity of the entire craniosacral mechanism. The dental complex via the occlusion provides the self-correcting mechanism for balancing the skull bones.

    When the maxillae is crooked and teeth alignment is faulty the entire body goes into a compensation mode. This fact is exemplified by patient feedback that their structural manipulations do not hold. Invariably a dental component exists when there is strutural instability. No amount of symptomatic treatment will correct the underlying dental problem. It is for this reason that patient problems linger.

     

    Adjusting the ALF

    The following video will provide a description of how to carry out adjustments of the ALF appliance to correct cranial derangement.

     

    Case Study

    The following case study drives home the importance of employing ALF Principles in orthodontic treatment.

    case study alf

    Case Study:  27-years-old school teacher. The chief complaints were: severe facial pain. Had to applied hot compresses on face to ease the pain before bedtime, difficulty talking, neck and shoulder pain, TMJ pain, headaches, unable to sleep through the night because of pain, fatigue

    All symptoms started after conventional orthodontics were completed at age 17. Fifty doctors were seen during the 10 year period.

    alfcasestudy

    ALF appliance in place

    The ALF appliance is designed to correct the maxillary horizontal plane as well as help realign the teeth. The foundation must be corrected first before the lower teeth are moved.

    alfcantedmaxilla

    Pre-Tx model exhibits canted maxillary transverse plane. The cranial base was distorted and the mandible over closed on the left setting up compression of the left TM joint and a structural domino effect.

    preposttx.png

    The patient’s 10 years of pain were resolved when the distorted planes were corrected

    RX Evidence

    The following picture is a case treated by Dr. Jeffrey Brown. It shows the pre and post treatment RX of a young man who could not attend college, had severe arm spasms/tics, could not see straight, and experienced dizziness.

    image

    Results of 1 year of ALF treatment

    As the film shows, following 1 year of ALF treatment, the nasal septum is straighter, the palate more even, the cervical spine is better aligned, his eyes are more even, the mastoid bones (by the ears) are more level, the neck straighter, the zygomatic arches more level and he can open the mouth more. He is back in school too.

     

    BIBLIOGRAPHIC REFERENCE

    Cranial Strains and Maloclusion: Palatal Expansion. By Gavin James, MDS, FDS and Dennis Stroken, DDS. International Journal of Orthodontics, 2009.

    ALF Advanced Lightwire Functional Appliances. By Dr. Gerald H. Smith.

    Dental Distress Syndrome Quantified. By Dr. Aelred C. Fonder.

    Osteopathic Manipulative Treatment to Resolve Head and Neck Pain After Tooth Extraction. By Patricia M. Meyer, DO, MS and Sharon M. Gustowski, DO, MPH

     
     
     

    Navigate Through this Blog

    To further understand our reasearch, approach and method, please read:

    A Bio-Mechanical Approach to Dystonia
    An introduction to the theory and analysis that support the pilot research project to use an adaptive intraoral appliance to treat and possibly cure Secondary Idiopatic Cervical Dystonia.

    Principles of Splint Therapy
    A description of the principles on which we base our protocol for the treatment of Cervical Dystonia and other occlusion realated movement disorders with varying degrees of neurological symptoms (from Tourette’s, to postural collapse, Parkinson’s and Generalized Dystonia).

    Protocol for the Treatment of Cervical Dystonia
    A step by step description of the 3 phases of the DIY protocol that we have developed for the treatment of Cervical Dystonia.

    The Molar Lever
    Our analysis of the bio-machinics of the Molar Lever and how dental occlusion is related to posture and skeletal allignment.>

    Phases of Lateral Postural Colapse
    Our analysis of the descending skeletal and postural effects of a collapsing and twisting skull that does not find adequate support in the dental arches.

    The Rectifier
    A description of the adaptive intra-oral aplliance -dental splint – that we use to treat Cervical Dystonia and the orthopedic forces that it produces by progressively pushing the mandible in retrusion, maxila in extrusion and elevating the skull by stretching and aligning the cervical vertebrae.

    Resources
    Bibliography and links to scientific research on the treatment of Dystonia and other neurological movement disorders with a bio-mechanical approach.

    Postural Colapse and Dental Arches
    A set of animations that present grafically the type of skeletal and postural effects that we intend to produce over a few months by modifying occlusion and the direction of forces between the skull and the mandible.

    Protocol for the Treatment of Dystonia

    6 months

    Results of 6 months of splint therapy with the protocol described below

    EXECUTIVE SUMMARY:

    In this post we will outline the DIY (do it yourself) protocol that we have developed for the treatment of Cervical Dystonia.

    This protocol does not invent anything new. It is the result of extensive study and integration of decades of previous research, experiments and practice  of medical professionals, professors, dentists, orthodontists, technicians and parcticioners such as: Dr. Gelb (father and son), Dr. Gerber, Dr. Bennet, Dr. Stacks, Dr. Brown, Dr. Mew (father and son), Starecta, Dr. Lee, Dr. Nordstrom, Dr. Sims.

    A complete bibliography of the relevant research papers is published in the page of this blog dedicated to Resources

    CONTENTS

    We will start this exposition by describing the symptoms of the tipical case that we wish to treat with this protocol.

    Next, we will describe the 3 phases that make up the protocol:

    1) Phase 1: Stabilization of TMJ
    2) Phase 2: Structural Alignment
    3) Phase 3: Finishing Prosthetics

    In order to implement this protocol correctly, you should be familiar with the concepts and procedures we introduced in the post dedicated to Principles of Splint Therapy and with the theory that we set out to test as we describe in the post A Bio-Mechanical Approach to Cervical Dystonia.

    This protocol has shown to be effective also for the treatment of other occlusion related movement disorders, with varying levels of neurological symptoms (from postural collapse driven by a sinking skull to Parkinson’s, Generalized Dystonia, Oromandibular Dystonia and Tourette’s).

    We do not claim to have found a cure. We have just observed empirically that the application of this protocol results in a major improvement of the quality of life – and often full discontinuance of neurological symptoms – for the patients who applied it.

    The characteristics of this protocol are:

    – Non invasive
    – Non traumatic
    – Fully reversible
    – Inexpensive – it can be carried out for as little as 100$
    – Compatible with every other drug based treatment that may have been prescribed by neurologists or dentists.

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    WHAT IS THIS PROTOCOL FOR?

    This protocol is directed and recommend for the treatment of cases which present all or some of symptoms like the ones described below.

    Neurological symptoms such as movement disorders of different levels of intensity: from Postural Collapse to Cervical Dystonia, Oromandibular Dystonia, or Generalized Dystonia, or Tourette’s or Parkinson’s.

    – Cranial collapse and derangement

     

    screenshot_2016-01-09-19-12-51-1.png

    Collapse and derangement of cranial bones results in the axis of the plane of dental occlusion being out of alignment with the axis of the skull and the spine

    image

    – Twisted and side-bent sphenoid bone

    The sphenoid bone is the key to cranial alignement. It sits in the middle of the skull and is connected to 20 different cranial bones. 

    Postural collapse and lateral-frontal sinking skull

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    Subluxation and misalignment of upper cervical vertebrae

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    Unstable Centric Relation lateral to Max Intercuspation

    image

    Displaced condylar disk

    image

    Torsion of the spine, postural collapse, scoliosis, neurological movement disorders (dystonia, Tourette, Parkinson, blepharism, etc.) happen when ONE CONDYLAR DISK IS ANTERIORLY DISPLACED and the OTHER IS POSTERIORLY DISPLACED.

    image

    A pathologic ocular tilt reaction

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    Resulting in asymmetric input to the central nervous system and a tilt in the subjective visual vertical perception.

    image

     

    Please be advised that the great majority of dentists (even self proclaimed experts in TMJ disfunction) do NOT have experience with this sort of neurological symptoms and skeletal imbalances and instability. They do NOT understand the relation between neurological symptoms, cranial collapse and dental occlusion.

    That is due to the fact that traditional mainstream dental school teachings are based on an oversimplified model (the articulator model) that considers the skeletal relation of skull bones and cervical vertebrae as FIXED and INDEPENDENT of dental occlusion.

    Most of the patients who present these symptoms are likely to have been diagnosed by a neurologist with a specific kind of neurological movement disorder (be it Dystonia, Tourette’s, Parkinson’s, etc…) and are likely to have received prescriptions for Botox injections to paralyze specific muscles, systemic antiepilieptic, antidepressant drugs and pain killers. Many may have varying levels of functional disability.

    This protocol will not “cure” and “heal” them of their condition, but it has empirically proven to be effective in the great majority of cases in massively improving their quality of life by reducing the intensity and range of neurological symptoms.

    In particular, for many cases of Cervical Dystonia, this protocol has resulted in the complete discontinuance of neurological symptoms

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    THE PROTOCOL

    The protocol that we recommend has 3 different phases:

    1. Phase 1: Stabilization of TMJ
    2. Phase 2: Structural Alignment
    3. Phase 3: Finishing Prosthetics

    In order to implement this protocol correctly, you should be familiar with the concepts and procedures we introduced in the post dedicated to Principles of Splint Therapy, the Rectifier, the ALF and with the theory that we set out to test as we describe in the post A Bio-Mechanical Approach to Cervical Dystonia.

     

    PHASE 1 – STABILIZING THE TMJ

     

    rectifier

    In the first phase of the protocol we will deal with stabilizing the TMJ and recaptureing the condylar articulation meniscus. We will use a Gelb-Rectifier, partial coverage, indexed lower splint is used to stabilize the TMJs in the first phase of the treatment.

     

    The derangement of the Temporomandibular Joint (TMJ) has been associated to neurological symptoms and neurological movement disorders like Dystonia, Tourette’s and Parkinson’s, as well as chronic pain conditions like Occipital Neuralgia.

    TMJimage

    In the following video you will be able see inside a deranged Temporo-Mandibular joint and appreciate how a displaced condylar disk moves.

    Manufacturing the Splint

    We will use a Gelb – Rectifier partial coverage (i.e. covering only lower molars and premolars) lower splint and proceeded to “O” phonetic bite registration.

    The patient will need a base splint for the lower dental arch. What works best is a clear orthodontic retainer of 2 mm of thickness. You can ask any dental lab (or even a dental technician student) to make one for as little as 32$. They will take an impression of the patient’s lower teeth and in 7 minutes (!!) produce a clear retainer. Please watch this video to see the whole process, lasting 7 minutes.

    Polimorph to Register the Bite

    On top of the base splint it necessary to register a new bite – whenever needed –
    with polimorph (a plastic that melts at 66 degrees Celsius). Please watch this video to understand how to place polimorph on the base splint.

    Polimorph is a non-toxic plastic material that melts at 66 degrees Celsius. It is possible to find it by googling “buy polimorph”. With 9 US$ you can get by mail delivery a bag with enough polimorph to make thousands of splints.

    Phonetic Bite Registration

    Bite registeration is carried out by closing the mouth on the fresh polimorph diretly in the patient´s mouth.  The cusps of the upper molars and premolars will leave “pits” on the  polimorph. We wil let the polimorph harden in the patients mouth (30 seconds).

    image

    The upper cusps will leave «pits» on the polimorph when we close out mouth on it

    In the picture above, the upper cusps have registered «pits» that fully embrace them on the polimorph. You can clearly notice the registration of both external (vestibular) and internal (palatal) cusp. For the purpuse of this protocol, we nees to have contact only on internal cusps and only between molar and premolar teeth.

    image

    4 internal upper cusps have registered 4 pits on a lower modified Gelb splint.

    Bite registrations have to be taken while the patient is standing or sitting straight and adopting the position of the mouth and lips that is the result of pronouncing the letter “O”.

    “O” phonetic bite registration will produce an anterior, protruded and lowered position of the mandible and condyles which is referred to as “Gelb 4/7” in the scientific literature.

    Gelb47

    Various scientific papers published on academic journals describe how this method and condylar position is highly effective to recapture the condylar disks.

    Cross Bite Splints

    Due to the twisted and collasped skull, it may be necessary to use a “cross bite” splint to achieve stability.

    first splint

    A cross-bite splint is registered by imprinting on the polimorph pits that fully embrace upper cusps, leaving internal cusps on one side and external cusps on the other. Cross bite splints produce orthopedic forces that act on the canted maxillary bone and the sphenoid bone.

    Vertical Dimension

    The splint should have a high vertical dimension (5-9 mm) to produce strong orthopedic forces by means of a lever effect centered on molar teeth to transform the force of swallowing and chewing muscles into a stretching force on different sides of the upper cervical. The process is described in the post dedicated to Treating TMD with the Molar Lever

    The harder you clench... the further you stretch the TMJ

    The Molar Lever at work: the harder you clench… the further you stretch the TMJ.

    The high vertical dimension is also necessary in order create enough room within the TMJ to unjam the articulation and allow the disks to recover a healthy physiological position.

    In order to find additional information and how-to videos about the specifications of the base splint and the procedure for bite registration, please refer to the following posts on this blog: Principles of Splint Therapy and The Rectifer.

    Re-iterative bite registration

    We would use two splints to make sure that each time we register a new bite in the splint, it works better than the previous splint (by the patient’s assessment) or we can go back to the previous splint.

    Over a few cycles of phonetic bite registration in a few days (only changing to a new splint if it is better than the previous one), we will get a fully functional Gelb – Rectifier that stabilizes the TMJ as much as possible given the circumstances.

    In order to promote movement of cranial bones, we recommen that bite registration should be carried out very frequently – even daily.

    Indexed versus flat splints

    It s worth noticing that the protocol that Dr. Brendan Stack s and Dr. Jeffrey Brown reccomands call for the use of a flat plane Gelb splint for this phase. And they reccomand a registration of a new bite on the splint every 2 months. The reason of their recommendation of flat plane Gelb splints is to avoid the blockage of cranial bones.

    We recommend the use of an indexed splint (where the splint has lower pits that fully embrace upper cusps). We  found that the use of the polimorph DIY technique to register new bites on a splint allows for very frequent (even daily) bite registrations conducted by the patient in his own home and without any cost.

    We find that the frequent registration of new bites on the splints promotes suficient cranial motion while at the same time maximizing the strenght of the masticatory muscles and stimjulating muscle tone in the body in general. Lower indexed Gelb-Rectifier splints have a proven record in stimulating muscle tone of the neck and upper body.

    In essence, we consider that Cervical Dystonia is an impairment of the mechanism that the body has to support the skull. Therefore, we find that there is a therapeutic advantage in stimulating muscle activity and tone through the use of an indexed splint while recapturing the TMJ disk in this phase.

    Myofunctional Therapy

    The second essential part of the treatment for this phase that we recommend involves specific tongue exercises: it is necessary to train the tongue to support the skull and reshape the palate.

    The tongue is one of the biggest and strongest muscles in the body. Morover, it is one of the very few muscles that is built to push. The great majority of muscles are built to pull.

    Whenever the patient is not speaking or eating, he should use the tongue to support the skull and reshape the palate.

    Support of the skull can be achieved by using the tongue to push up on the palate pronouncing the letter “N.”

    Reshaping of the palate can be achieved by sealing the tongue against the roof of the mouth with suction.

    In all cases, the patient has to train to keep the lips closed, teeth in slight contact and breeth through the nose.

    The following video by Dr. John Mew explains the basics of Myofunctional Therapy. We recommend it as a starting point. The patient should do his own research on Google Videos to continue this essential part of the protocol.

    It takes 21 days to develop a habit. At first, it may be cumbersome for the patient to keep consciously an active tongue most of the day. By the end of 21 days, it will become an unconscious habit. It is just like learning to ride a bike or drive: when it becomes a habit, the patient will not even realize that he is doing it.

    Duration of Phase 1

    The splint will be used almost 24/7 for a month. The succes in stabilizing the TMJ will be judged by the personal assessment of the patient of being symptom and pain free.

    In the second phase of the treatment (which we describe here below), the splint will only be used to sleep and to do sports and stretching exercises.

    Cost

    Cost: 32$ x 2 lower clear orthodontic retainers + 9$ of polimorph. Total: 71$

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    PHASE 2 – STRUCTURAL RE-ALIGNMENT

    upper lower alf

    In the second phase of the protocol we deal with structural alignment. The dental-othopedic appliances tha we use are: an upper-maxillary ALF (advanced lightforce functional appliance) to correct cranial derangement and a lower-mandibular Rectifer to stretch and untist the spine

    ALF TO UNTWIST AND EXPAND THE SKULL AND PALATE

    In the post dedicated to ALF Orthodontic/Orthopedic Aplliance you will be able to find a longer explanation of the working of the ALFas well as photograpich and RX evidence of case studies and a bibliographic reference.

    The following video will provide you an introduction to ALF in 2 minutes.


    The ALF appliance was originally designed in 1983 by Dr. Darick Nordstrom to be a vehicle in a comprehensive dental orthopedic/orthodontic treatment approach. What Dr. Nordstrom initially discovered and later a handful of his disciples is that the ALF proved to be the best instrument to unravel the structural distortions of the skull bones and stabilize the cranial/dental complex.

    cranial derangement

    ALF treatment is designed to correct cranial assymetries and derangement

    The ALF System represents the missing link between conventional orthodontics and the more progressive functional orthopedic/orthodontic concepts. In reality, the ALF concept goes beyond the dental realm and supplies many answers to solving the age old problems of chronic somatic pain and generalized ill health.

    The ALF appliance allows to:

    • Correct cranial bone distortions
    • Correct maxillary cant
    • Align teeth to stabilize the cranium

    This is how an ALF device looks like when positioned on the maxillary teeth.

    ALF in place

    An ALF device placed on the maxillary arch. Note the Omega Loops that activate orthopedic forces.

    ALF is little more than a wire anchored on first molars and upper canines. It is activated and creates orthopedic forces by expanding the omega loops. In essence, it takes advantage of the force of the tongue when swolloing to expand and align the maxillary arch, palate and teeth. The force that it uses is extremely limited and light but constant.

    The fact that the ALF is not anchored to teeth (unlike traditional brackets for orthodontics) allows for the maximization of cranial movement.

    The final goal of ALF treatment is to achieve balance of the dental planes:

    • Vertical
    • Transverse
    • Sagittal

    The key to making the ALF appliance work is to adjust the appliance so that it balances four cranial indicators. Only by correcting crania bone alignment will the patient experience a cure.

    When used properly, the ALF appliance enables orthodontists to correct cranial base abnormalities, which in turn corrects bodily function.

    cranial base

    The maxillae represents the anterior 2/3 of the cranial base

    Since the maxillae represents the anterior 2/3 cranial base and functions as the balancing mechanism for the entire skull, foramen magnum and atlas, it must be corrected first. By aligning the maxillae, it provides the foundation or template to build into.

    From a clinical perspective, if the maxillae is distorted so goes the rest of the body. Since 46% of the motor and sensory neurons of the cerebral cortex of the brain relate to the face and mouth, maxillary distortions have the potential of disrupting the central nervous system and changing neurological function throughout the entire body.

    cranial otrhogonal

    The body functions best when its structures are aligned at right angles

    Balance of the maxillae is critical for maintaining total structural integrity of the entire craniosacral mechanism. The dental complex via the occlusion provides the self-correcting mechanism for balancing the skull bones.

    When the maxillae is crooked and teeth alignment is faulty the entire body goes into a compensation mode. This fact is exemplified by patient feedback that their structural manipulations do not hold. Invariably a dental component exists when there is strutural instability. No amount of symptomatic treatment will correct the underlying dental problem. It is for this reason that patient problems linger.

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    The following video will provide a description of how to carry out adjustments of the ALF appliance to correct cranial derangement.

     

     

     

    RECTIFIER SPLINT THERAPY

    While the ALF takes care of the structural alignment above the neck, the structural alignment below the neck is carried out by menas of a  Rectifier-Gelb lower splint therapy to stretch the spine and untwist the upper cervical and bring the barycentre of the skull back on the axis of the body.

    wpid-screenshot_2015-11-03-17-53-56-1.png

    The Starecta Facebook Group is an open, voluntary, online clinical trial. Around 100 people are sharing their RX and MRI evidence of the application of the same protocol to straighten the spin with the use of the Rectifier.

    A full description of the function and procedures to use the rectifier can be found in the posts dedicated to Principles of Splint Therapy and the Rectifer.

    The Goal of Splint Therapy

    The research line that we are following is based on the hypothesis that Dystonia and other neurological symptoms that bring about movement disorders are strictly related to a postural collapse driven by a sinking skull that does not find adequate support in the dental arches. To learn more about the rationale behind our bio-mechanical approach, please read this post: A Bio-mechanical Approach to Cervical Dystonia

    The sinking skull creates compression and subluxation of the upper cervical vertebrae that result in twisting strain on the brain stem.

    stage5

    Cervcal Dystonia: postural colapse affects the Brain Stem

    The pressure can distort and limit the transmission of the nervous signals between brain and body. Moreover, compression of the brain stem will trigger automatic, involuntary and asymmetric muscle movements to ease the twisting strain. In short, it triggers Dystonia.

    Picture1

    Lee, Young Jun. “FCST (Functional Cerebrospinal Technique).” Lecture

    Therefore, the goal of splint therapy is to produce orthopedic forces that will progressively stretch and realign the upper cervical vertebrae (C1 – Atlas- and C2 – Axis) with the axis of the spine and the skull.

    In the next picture you will see RX evidence of how the orthopedic forces produced by splint therapy can realign the upper cervical and eliminate pathologic compression strain on the brain stem over a period of a few months.

    image

    All cases of Secondary Idiopatic Cervical Dystonia that we have treated with this method have resulted in complete discontinuance of neurological symptoms.

    The following picture describes how we  use orthopedic forces acting on dental occlusion to stretch and un-jam the upper cervical area.

    wpid-craniobiancobig1.gif

    It is also worth highlighting that this approach has resulted in the radical improvement – in some cases complete solution – of other occlusion related disorders like TMJ pain, clicking, disk displacement and bruxism in a matter of days from the beginning of treatment. In all cases, general body posture and symmetry improved dramatically.

    And the next picture shows the skeletal and postural effects of 6 months of splint therapy.

    6 months

    Vertical Dimension

    The splints would start with a high vertical dimension to produce strong orthopedic forces in different sides of the upper cervical vertebrae by means of a lever effect centered on molar teeth to transform the force of swallowing and chewing muscles into a stretching force on different sides of the upper cervical.

    The Starecta “O” shaped incremental bite registration would be used to stretch the spine vertically. “AH”, “E” phonetic bite registrations would be used to reduce the subluxation and untwist of the upper cervical vertebrae (with normal and cross bite splints to produce twisting force on the upper cervical and sphenoid).

    Each splint would be used at least a week and we would still use the double splint system to make sure that each new splints produces better effects than the previous by the self assessment of the patient’s symptoms. In case a new splint produces stress or pain to the patient, we have a previous well adapted splint to fall back to.

    We would use the same splints that we used for TMJ stabization in this phase. At no additional cost.

    The splint would be used to sleep, to do sports and rehab and whenever the patient feels he needs it. Not 24/7.

     

    NEUROLOGICAL REHAB

    Neurological Rehabilitation is one of the most important parts of the protocol that we have developed.

    Eyes give your brain information about the level of the horizon. If they are not tracking well, the result is faulty propioception, uneven shoulders and  scoliosis.

    Here below we will describe a basic Eye Tracking Exercise that helps balance and rehabilitate the nervous system in case of Dystonia, scoliosis and postural collapse. For further information, you can read our post on Neurological Rehab for Dystonia.

    Convergence Test

    The following test can show the extent of the imbalance. It is done by placing a pen vertically with the tip at the level of the eyes and the body of the pen touching the nose. When the eyes focus on the tip of the pen, the result might be like like picture 1 or picture 2.

    eyetracking

    Picture 1: Poor eye tracking with one eye turned in, while the other is not able to do so. This pattern is tipical of scoliosis and postural collapse.

    eyetracking2

    Picture 2: Good eye tracking with both eyes turned in equally. This result can be achieved with training.

    To improve your eyes, you can perform eye exercises as shown in the video below. The effects on posture, skeletal alignment and propioception are nothing short than amazing.

     

     

     

    SECONDARY TREATMENT AND PROCEDURES

    The treatment using the upper-maxillary ALF and lower-mandibular Rectifier has to be carried out along with some secondarytreatmets which include:

    – Postural Rehab

    – Manual cranio sacral and atlas therapy to help mobilize the skull and the upper cervical vertebrae from the outside and help facilitate the lever effects of the splints.

    – Exercises to increase lung capacity and rib cage volume

    – Myofuntional therapy (toungue).

     

    DURATION OF PHASE 2

    This phase would last one year. Splints would have high vertical dimension at the beginning and gradually work towards the lowest possible vertical dimension that maintains thr patient symptom and pain free.

    Cost: no extra cost for the splint. Cost of ALF would depend on the dental lab that manufactures it. But in the end it is just a bent wire with less than 1 hour of work to produce from start to finish.

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    PHASE 3 – FINISHING PROSTHETICS

    After one year, if the patient is stable and symptoms free with one splint he has been using for a few months, he has two options:

    1) Prosthetic work to build onlays that reproduce on lower molars and premolars the pits of the last Gelb – Rectifier splint

    2) Using a splint to sleep and do sports for the rest of then patient’s life and concentrating in physical therapy that increases he capacity of the body to adapt and stay for up to 24 hours without a splint and still be symptom free.

     

     

     

     

    Navigate Through this Blog

    To further understand our reasearch, approach and method, please read:

    A Bio-Mechanical Approach to Dystonia
    An introduction to the theory and analysis that support the pilot research project to use an adaptive intraoral appliance to treat and possibly cure Secondary Idiopatic Cervical Dystonia.

    Principles of Splint Therapy
    A description of the principles on which we base our protocol for the treatment of Cervical Dystonia and other occlusion realated movement disorders with varying degrees of neurological symptoms (from Tourette’s, to postural collapse, Parkinson’s and Generalized Dystonia).

    Protocol for the Treatment of Cervical Dystonia

    A step by step description of the 3 phases of the DIY protocol that we have developed for the treatment of Cervical Dystonia.

    The Molar Lever

    Our analysis of the bio-machinics of the Molar Lever and how dental occlusion is related to posture and skeletal allignment.>

    Phases of Lateral Postural Colapse

    Our analysis of the descending skeletal and postural effects of a collapsing and twisting skull that does not find adequate support in the dental arches.

    The Rectifier

    A description of the adaptive intra-oral aplliance -dental splint – that we use to treat Cervical Dystonia and the orthopedic forces that it produces by progressively pushing the mandible in retrusion, maxila in extrusion and elevating the skull by stretching and aligning the cervical vertebrae.

    Resources

    Bibliography and links to scientific research on the treatment of Dystonia and other neurological movement disorders with a bio-mechanical approach.

    Postural Colapse and Dental Arches

    A set of animations that present grafically the type of skeletal and postural effects that we intend to produce over a few months by modifying occlusion and the direction of forces between the skull and the mandible.