BACK TO BASICS

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BACK TO BASICS
APPLIED KINESIOLOGY
P.A.K. INTERNATIONAL ANNUAL MEETING 2008
ANTWERP

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ROSELI LUPPINO PERES
ODONTOLOGY AND AK
The knowledge of AK is fundamental for an
adequate (practice of )odontology because we very
frequently find patients with muscular hypotony
due to sensibility to foods, heavy metal
contamination, presence of candida in the system,
among other reasons. These factors usually cause
the patient to have muscular problems as well as
mouth breathing. This problem causes lack of
adequate development of all facial and cranial
sinuses and can lead to a lack of proper
neuro-muscular development of the patient.
This hypotony can cause alterations in the growth
of the bones and, consequently, important
alterations in occlusions which can have
postural, organic, and emotional consequences.
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For an efficient diagnosis, we do not find
anything better than the muscular tests that are
part of our work routine. A perfect odontological
treatment with state of the art techniques will
be of no use if we do not have a good diagnosis
of the origin of odontological problems, because
if we do not eliminate the causes, there will be
recurrence, and this frequently happens in
treatments, specially in those related to buccal
(oral) postures because one only sees the buccal
problem, and not, the systemic problem that has
caused it. AK opens a fantastic number of
possibilities for efficient odontological
diagnoses and treatments with minimal recurrences.
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The interconnection of the Trigeminal System with
the musculature and the three first cervical
segments explains the fact that we cannot observe
cervical alteration without occlusion problems
and vice-versa. Occlusion problems can generate
decrease of the oral hollow and problems in the
stomatognathic system and in the organic
functioning. To change this, we use Functional
Orthopedics, when the patient can use appliances.
We can use all that Odontology offers in order to
recover the balance of the mouth and the general
balance of the patient as a consequence.
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The majority of the temporomandibular
dysfunctions have as predisposing and
coadjuvating factors alterations at occlusion
level, which have been pointed as responsible for
the compromising of the muscular system. The rest
position of the mandible has been considered the
base position from which one can obtain the
Vertical Dimension of the Occlusion, which can
suffer alterations, due to occlusion pathologies
and para-functional habits.
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To keep the correct dimension of the mouth during
the treatment, we use one tool called
Aero-muscular Possibilitator. The AMP has been
used as auxiliary in the diagnosis and it is also
a way of treatment that aims at muscular
relaxation. The AMP, whether anterior or
posterior, is tested through muscular tests
before and when put in the patient's mouth in
order to confirm its efficiency.
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We also do a postural analysis before installing
the appliances and immediately after it, which
shows us, on the descendent cases, immediate
alteration on the posture.
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The technique most preferably used is the
Functional Dynamic Reabilitation of the
Maxillaries developed by a Brazilian dental
surgeon called Dr. Maurício Vaz de Lima. They are
encapsulating appliances, which stimulate growth
by utilizing resistance of the majority of the
teeth against the minority of them.
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These appliances cause anteroposterior, lateral
and posteroanterior movements. They cause a
three-dimensional stimulus of growth.
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For those patients who will have their balance
recuperated through prosthesis, we use splints
with AMP, first the splint with anterior AMP,
afterwards with posterior AMP, which will
determine what the vertical dimension which
re-establishes the balance is. For this, the
muscular test will show us when weve got the
postural balance of the patient. In these cases,
the appliances with AMP are also utilized for the
recuperation of the neuro muscular balance of the
stomatognathic system so that it is possible,
afterwards, to do a re-habilitation with
prosthesis, whether they are fixed, implants,
removable, or total, which has the function of
maintaining the acquired balance.
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Another factor that must be observed is the
focuses we can have on the stomatognathic system,
which can also be diagnosed through muscle tests.
There is a predominance of focuses in areas
where extractions have been made, especially of
third molars. With the use of appliances, we can
stimulate the eruption of those teeth, avoiding
extractions.
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AGNÉ CERVO PERES
TMJ EXERCISES In the present work, it has been
demonstrated that when the mandible is out of the
physiological position, there can be alteration
in the position of the skull and consequently,
there can be alteration in the relationship
between the skull and the cervical column and the
vertebral column.
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SCHEME OF THE FUNCTION ACCORDING TO BRODIE,
MODIFIED BY CASTILHO MORALES
CRANIO
MANDIBLE

HYOID
SPINAL COLUMN
MEMBRI SUPERIORIS CINGULUM
MEMBRI INFERIORIS CINGULUM
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Temporo Mandibular disorders can have their
origin on inflamatory processes, internal
alteration of the articular disk, articular
hypomobility or hypermobility, muscular
dysfunction or limitation of the amplitude of the
articular moviment. In muscular disorders, the
typical clinical diagnosis is the muscular spasm,
which, by compression of the blood vessels, will
produce ischemia generating a vicious cycle of
spasm-pain-spasm in this disorder there is a
decrease of the level of mandible movement due to
pain. The hyperactivity leads to fatigue and
spasm, and it can cause dysfunction in all the
musculature of the head and the body. The therapy
of the TMJ dysfunction focus on the oral
rehabilitation (occlusion) and the neuromuscular
re-education, to re-establish the normal
physiological rest position of the mandible,
through the strengthening and the balance of the
pterygoideus lateralis muscles and consequently,
the menisco-condylar coordination.
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Postural alterations can be related to the
shortening of the posterior chain specially the
suboccipital muscles that are associated to the
shortening of the Sternocleidomastoid and
Escaleno muscles, and these to the
cervico-thoracic-abdominopelvic fascia
muscles. On the anteriorization of the head there
is a shortening of the posterior muscles of the
neck and head, specially the suboccipital and
trapezium, which act as antagonists to gravity,
and can suffer a chronic functional overcharge,
generating micro lesions and as a
consequence muscular pain.
Etiology comprises of various functional,
anatomic and psychosocial
elements the treatment
also deals with multi-factorial aspects.
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One of the exercises used is done with a gadget
developed in Brazil and called Hyperboloid. There
are 5 different sizes available, which are used
for various types of therapies such as muscular
exercises to recover the correct muscular
functions, chewing exercises with various
different functions, but our main focus are TMJ
exercises.
M
PP
P
G
GG
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These exercises aim to recover the articular
disk the first exercise is done to recover the
articular disk that has had anterior dislocation,
then the exercise aims to recover the disk that
has had lateral, medial, and distal dislocation.
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Film
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FILM
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The second exercise comes from the Global
Postural Reprogramming, it first stretches the
elevating muscles of the mandible, and then it
stretches the lowering muscles.
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The neuromuscular system is closely connected to
the maintenance of the posture therefore any
factor whatsoever will influence the skull
cervical relationship causing compensatory
mechanisms, for example, whenever there is a
change in the posture of the head, compensatory
mechanisms will be activated throughout the body,
looking for the maintenance of the horizontal
bipupilar plane . The recuperation of the balance
of the Stomatognathic System is very important in
relation to the body posture and the ocular
convergence.
FILM
FILM
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In some studies, it is possible to see the
articulated connection of the mandible with the
skull base and the skull muscle and ligament
connections to the cervical region, which
together form a functional system called
cranio-mandibular-cervical system. According to
some authors, different muscles do not work
isolated, but they form true synergic or
antagonic clusters. It becomes clear in this
work, that the professional responsible for the
treatment of the occlusion must know posturology
perfectly well.
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Another point is the somatotopy between the
palatine suture and the vertebral column, based
on the principle that the bones in the skull are
flexible and accept a certain deformation and
they articulate themselves due to the sutures.  
The Dura-mater, adherent to the bones, runs
through the foramen in the base of the skull,
accompanying the cranial nerves and the
extra-cranial aponeuroses. There is a continuity
of aponeuroses from the extremities to the
interior of the cranium.  One can consider the
dura-mater as a group of cables whose role is
to unify the occipital to the sacrum if there is
a sacral torsion, the skull will adapt itself by
an induced torsion by the membranous system.  The
Occipital, sphenoid, and ethmoid bones function
like dented wheels and are mobilized by the
inter-cranial membranes. It is necessary to add
the temporals to this system.  In the anamnesis,
the examination (touch) informs about the shape
of the skull, the position of each of its bones,
allowing the comparison between one side and the
other.
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THANK YOU