A Cervo Peres Luppino Peres

Document Sample
A Cervo Peres Luppino Peres Powered By Docstoc
					                          Systemic Odontology and AK

                              Dr. Agné Cervo Peres
                            Dra. Roseli Luppino Peres

      The knowledge of AK is fundamental for an adequate practice of odontology
because we very frequently find patients with muscular hypotonia due to sensibility to
foods, heavy metal contamination, and 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 neuromuscular development of the
patient.

       The muscular hypotonia can cause alterations in the growth of the bones and,
consequently, important alterations in occlusions which can have postural, organic, and
emotional consequences. 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, especially in those related to mouth 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.

        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.

        The majority of the temporomandibular dysfunctions have as predisposing and
adjuvant 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 parafunctional habits.

        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.
         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.

        The technique most preferably used is the Functional Dynamic Rehabilitation 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.

      These appliances cause anteroposterior, lateral and posteroanterior movements.
They cause a three-dimensional stimulus of growth.

       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 we’ve got the postural balance
of the patient. In these cases, the appliances with AMP are also utilized for the
recuperation of the neuromuscular 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.

        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.
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 cranial-mandibular-cervical system.

       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 bipupillary plane . The recuperation of the
balance of the Stomatognathic System is very important in relation to the body posture
and the ocular convergence.

      The quality of visual perception is related to a factor of muscular tension.
According to some authors, a focus or a dental occlusion disorder can cause lack of
convergence through trigeminal afferents on the intervening formation of
oculomotricity.

       There is the possibility of backward adaptation of the eye both in the postural
balance as in the postural imbalance. The tonic postural system is an indivisible whole
and the eye is an integral part of this whole, so we can understand its possibilities of
adaptation.

       In Functional Orthopedics of the Maxillaries, we provoke the elimination of
pathological muscle memory, which can lead the facial musculature to a more
physiological position. With this, we can assume that there is a change in the
positioning of the skull bones, allowed by the non-compression of the muscles, which
can release the flexibility of the bones, favored by the non-welding esphenobasilar
synchondrosis and the presence of all the non-welded sutures. With appliances, we can
change cranial disorders caused by muscular alterations, such as extension dysfunction
where there is the opening of the sphenooccipital angle, the skull increases its
anteroposterior diameter, orbits decrease in size, and the palate is narrow and high,
favoring myopia. Likewise, when there is a flexion dysfunction, with the closing of the
esphenobasilar angle, the skull has its transverse diameter increased, there is an increase
in the diameter of the orbit, and the hard palate is flatter favoring hypermetropia.

        Dentistry, today, should look for the general well-being of the individual, his
level of development, his learning and his quality of life. It is also important to help in
the differential diagnosis of scoliosis, headaches, earaches, hyperactivity, dyslexia, and
depressions.

        The eye muscles may have variations in tonicity, through the trigeminal system,
including information that comes from the temporomandibular joint and by occlusion.
Breathing, especially through the mouth, makes the head and shoulders move forward,
thus damaging the whole system. The correction of these aspects can improve the
existing postural deficiency and symptoms of headache, muscle pain, imbalance,
vertigo, dyslexia, attention deficit and hyperactivity.

       According to some authors, different muscles do not work isolated, but they
form true synergic or antagonistic clusters.
It becomes clear in this work, that the professional responsible for the treatment of the
occlusion must know posturology perfectly well.

        Over acidity, very common today, can become a dangerous condition that
weakens all body systems. It gives rise to an internal environment conducive to disease,
as opposed to a pH-balanced environment which allows normal body function necessary
for            the            body               to            resist           disease.

       The concept of acid alkaline imbalance as the cause of disease is not new. In
1933 a New York doctor named William Howard Hay published a ground-breaking
book, A New Health Era in which he maintains that all disease is caused by
autointoxication (or "self-poisoning") due to acidosis in the body.

       Man produces about 1000 to 1500ml/day of saliva. The largest salivary glands
are the parotid, the submandibular, and the sublingual glands. The smaller glands, in
large numbers, are scattered throughout the buccal mucosa.

        Exocrine glands are located in the vestibule (buccal and labial) and in the oral
cavity (floor, tongue and palate), and consist of mucous and seromucous acini. The
salivary glands are stimulated by the autonomic nervous system and the vasopressin and
aldosterone hormones. The production of saliva is characterized by a continuous basal
secretion (or resting secretion), which moisten and protects the oral mucosa, and an
increased demand on salivary glands especially during mastication. These flow
variations involve not only the volume of saliva, as well as its organic and inorganic
constituents.
        The parotid are pure serous glands and contribute with 25% of salivary secretion
and its excretory duct is called Stenon or parotid, which leaves from near the 2nd upper
molar among the masseter and buccinator fibers.

        Submandibular glands are serous and mucous glands; they contribute with 70%
of salivary secretion and their excretory ducts are called Wharton. This gland is partially
covered by the lower jaw; just ahead of the angle it bends in the posterior edge of the
mylohyoid muscle, being part below and part above of the muscle, i.e. of the floor of
the mouth. Its duct, above the muscle, runs anterior and medially to the sublingual fold
of the floor of the mouth, opening up along the lingual frenum.

       The sublingual glands and other smaller glands in the buccal mucosa are also
serous and mucous and they contribute with 5% of salivary secretion. The excretory
duct of the sublingual is called a Bartholin. The sublingual gland is located in the floor
of the mouth, covered by mucosa. It has several small ducts that open up on the
sublingual fold.

     Besides containing air, which gives the spumous aspect, the saliva has as the main
chemical components: water (99.5%), ptyalin (0.1%), nitrogen, sulfur, potassium,
sodium, chlorine, calcium, magnesium, uric acid and uric citric acid. It contains
structural proteins (mucins, staterine, agglutinin, lactoferrin, gustin, and sialine),
enzymatic (amylase, acid phosphatase, esterase, lysozyme, peroxidase, carbonic
anhydrase and kallikrein) and immunological (immunoglobulins, IgA salivary, or
immunoglobulin-secreting: IgSC).

      Unquestionably, the protection mechanisms of gastric and esophageal mucosa play
a decisive role in the ability these organs have to endure the mechanical and chemical
aggressions they are submitted to daily, and many of these mechanisms are mediated by
saliva. Saliva contains many inorganic and organic substances that contribute to the
protection against physical and chemical aggression and the maintenance of mucosal
integrity, not only of the oral cavity but the digestive tract as well. Saliva, with its
organic and inorganic content, is one of the main responsible for the homeostasis of the
mouth and digestive tract. Changes both in pH as well as in salivary volume have been
correlated with symptoms and suggestive signs of gastroesophageal reflux disease and
alterations in the laryngopharyngeal segment.



        It has been observed that patients with mouth atresia, showed a higher than
normal incidence of cervical decalcification and frequent lesions in mucosa in addition
to high incidence of tooth decay. It is known that the lack of bone development is often
linked to compression and lack of muscle function of the bone structure. This has led us
to suspect of possible changes in salivary juice by muscle compression in salivary ducts
and glands. Since the largest glands and their ducts are in the midst of the muscles, the
contraction of these muscles could cause the excretion of saliva with alteration in
salivary juice. It has been requested, then, the saliva pH test of a group of patients who
did not have digestive problems, mouth breathing, reflux, that is, for those whose acidic
pH was considered idiopathic. These selected patients showed mouth atresia and pH
below 6.9 and 7.0 which indicated salivary acidity. To be able to prove that the muscles
could be causing this type of salivary changes, new tests were made with the mouth
device called Aero Muscular Possibilitators, which takes the musculature to its resting
position. This position is considered to be the most physiological for the musculature
because it only exerts force against gravity to keep the jaw at rest.

        Applied Kinesiology tests have been used as a way of diagnosing muscle
balance in the mouth with the device. The muscle testing, palpation of masticatory
muscles, as well as the functionality of the system, have showed us that the device kept
the balance of all related structures.

        The second test of saliva pH resulted in mild alkalinity in some cases and in
others the pH became neutral.

       So that the material of the device (acrylic resin) did not interfere in the
examination, the first test was done with a piece of this material in the mouth. We
concluded that the change in contraction of elevating and descending muscles of the jaw
can lead to decreased pH of saliva, because the neural stimulus that excite the
functioning of the glands also cause the expansion of their atresic ducts due to the
hypofunction of the salivary glands opposed to the hyperfunction of the elevating and
descending muscles of the jaw.

        The function of the salivary glands is closely related to the muscle function. This
can be seen in patients who are intubated (orotracheal tube) that have dry mouth, tongue
coating, and lack of muscle function such as contraction, strength, relaxation, stretching,
i.e. poor oral motor skills. With respect to the masticatory stimulation in the case of
unilateral chewing, glands on the side mostly used respond with more secretion than
those on the less used side.

       Salivary studies on these individuals have shown new perspectives in
understanding the physiopathology of mouth atresia suggesting there are quantitative
and qualitative deficiencies in saliva

       Results of the present study suggest that the re-balance of facial musculature
allow a decrease in acidity of saliva, or better, an alkalinization closer to the
physiological.

        Despite the small number of subjects in this study (which is still in progress), we
believe that there is a global salivary deficiency, possibly primary, in individuals with
atresia of the mouth.

        The study of the salivary pH offers a less invasive way to assess the existence of
local acidity and it is fast and inexpensive.
You may also want to test the pH of your saliva. The results of saliva testing indicate
the activity of digestive enzymes in your body, especially the activity of the liver and
stomach. This reveals the flow of enzymes running through your body and shows their
effect on all the body systems.

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:11
posted:10/7/2011
language:Swedish
pages:5