Common Cervical-Cranio-Mandibular Restoration Dilemmas
Today brings an end to the discussion of System Integrational Dilemmas. If you have been tuning in the last few days, we have been presenting common issues that arise with PRI programs and some things to think about when attempting to overcome these dilemmas. Today we will feature common dilemmas that arise with a Cervial Cranio-Mandibular Restoration program:
1. Can’t open mouth past 45mm - no click
- More than likely will need an appliance or see an orthopedic gnathologist oriented dentist.
2. Can’t open mouth without a click
- Treat TMCC issues, free up cervical axial limitations, restore C3-C5 lordosis and if PRI stabilization effort maintains cervical neutrality a splint or TMD treatment may not be necessary, especially if there is no associated joint pain. If joint pain, then refer to a dentist for an appropriate splint.
3. Can’t passively rotate cervical spine to the left – axially with neutral brachial chains
- Treat left SCM, scalenes, upper trap, anterior and posterior capitus muscles to achieve right sidebending at OA and AA.
- Restore cranial flexion on the right manually.
- Re-check after placing tongue depressor between left molars; if cervical spine resumes neutrality – refer for intra-oral appliance.
- If all the above fail, consider neuro-optometric treatment.
4. Can’t protrude without lateral trusion
- Treat left SCM, scalenes, upper trap, anterior and posterior capitus muscles to achieve right sidebending at OA and AA.
- Restore cranial flexion on the right manually.
- Re-check after placing tongue depressor between left molars; if cervical spine resumes neutrality – refer for intra-oral appliance.
- If all the above fail, consider neuro-optometric treatment.
5. Can’t decrease a cant (bipupilar plane, otic plane, transverse occlusal plane)
- Will more than likely require palate expansion for system unlocking and possibly orthodontistry to ‘stabilize’ neutral cranium with proper occlusion.
Posted November 5, 2008 at 2:40pm by Bobbie Ninneman.