Lançamento de Tratamento a Nível Mundial

O texto abaixo contem as pesquisas mais recentes de neurociência sendo usados pela técnica do RFA:

 

HUMAN BODY TOTAL CARE (HBTC) WITH AFR.

A treatment protocol

By Wilson Aragão

 

“The head is the region of the human body where a number of independent functions are performed: breath, smell, taste, chewing, vision, hearing, balance and neuronal integration.”(Melvin Moss)¹

 

and the balance of all these functions is directly related to the spatial position of the temporomandibular joints – TMJ.” (Wilson Aragão).²

 

The HBTC is a treatment protocol wich reaches all parts of the human body, from the head, integrating all encephalic nerves and their functions, like breathing, chewing, swallowing, smell, taste, hearing, balance and vision.

 

For human beings, breathing, both inhaling and exhaling, must be completely performed by nose.

 

When someone breathes through the nose, the air is filtered by the nasal cavities structures, which are surrounded by the turbines where the air has to make turns to reach the nasalpharynx due to the sinusoidal path.

 

Air is also filtered by the cilia, which retain dirt and also the nasal mucus, that traps dirt that crashed into the sinusoidal structure.

 

The diameter of the nasal cavities structure decreases so that the nasopharynx diameter reaches about ten percent of the diameter of the nasal cavity opening. This means air filtration is properly done.

 

Air temperature is equalized by nostrils, so that, no matter where, wether at a -10° C/ 14° F or a 40° C/ 104° F temperature, the human being lungs receives air at 36° C/ 96.8° F.

 

Temperature equalization is performed by the structure of the nasal fossae. This structure has a very intense blood supply controlled by the CNS and may present vasoconstriction or vasodilatation. It also has muscles that open or close the nasal fossae according to temperature.

 

Humidification of the air that goes into the lung is provided by the lacrimal fluid (tear film), which flows out the eyes, from the nasolacrimal duct to the height of the lower turbines, where air is aspirated into the lungs.

 

Humidification is very important, because the air exchange in the alveoli should take place at about 95% humidity.³

 

Concerning to moisture, it is important to emphasize that lacrimal fluid contains approximately 94 chemical elements, such as immunoglobulins (IgA, IgE, IgG, IgM), which are sucked in and then distributed throughout body by breathing and blood flow , what makes immune system function in a proper way. Another tear film element, the dipalmitoylphosphatidylcholine (DPPC), is very important for the formation of the surfactant liquid in the lung alveoli.2

 

Finally, the pressurized air goes to the lungs.

 

As nasal ducts become narrower and sinusoidal in shape, air flows faster, increasing pressure. So, when air reaches nasopharynx, its speed is faster than when it entered nostrils. That is how pressure is achieved by nasal breathing.

 

While chewing, the condyle in the balance side moves downwards, forwards and inwards, following the trajectory provided by the lower beam of the lateral pterygoid muscle, and this movement is detected by the proprioceptors of position and motion of the TMJ joint capsule and is transmitted to the brain for analysis, while the exteroceptors in the oral mucosa, cheeks and tongue inform the cerebral cortex where food is, and if it is placed by the tongue between teeth, to be properly chewed.

 

Meanwhile, the condyle on the chewing side (work side) is moved to the side and slightly backwards by the masseter and temporalis muscles, within the limits of elasticity of the TMJ joint capsule, which it is also informed to the brain by movement and position proprioceptors within the TMJ joint capsule.

 

Whenever one chews unilaterally on the right or left side, a hypertrophy of masseter, sternocleidomastoid and supra and infra hyoid muscles takes place on the same side.

 

Due to unilateral chewing and its consequent hyperthrophy of the masticatory muscles, the supra and infra hyoid muscles, and muscles of the shoulder girdle, the body gets out of its proper axis, what leads to serious results on all body joints and internal organs.

 

With the hypertrophy of these muscle groups, the collar bone is taken up by the hypertrophy of the muscular segment to the collar bone to mastoid bone. The shoulder blade comes forward and upward by hypertrophied omo hyoid muscle.

 

As a result of muscle actions, muscle fascia of the chewing side elevates all structures , such as pelvis, which is lifted and rotated forward, resulting in a transference of the body weight to the leg of the opposite side.

 

On the chewing side, the internal structures of the thorax and abdomen are pulled up. In humans, if unilateral chewing takes place on the left side, heart and kidneys are the affected organs.

 

In women, besides all already mentioned, its remarkable the stretching of the ovary in this side.2

 

Concerning to the chewing opposite side, body compression is quite noticeable. If someone chews left, the kidney on the right side is compressed, what will affect the ability of filtering the blood and possibly lead to the development of kidney stones after some years.

 

It may also cause an appendicitis crisis due to the decreased blood flow to the appendix, a poorly nourished blood organ, and may occur as a consequence of ischaemia and necrosis.2

 

In Women, polycystic ovaries may occur, by stretching on the chewing side and compression on the no-chewing side, because ovaries are extremely sensitive organs.

 

There are very obvious signs of unilateral chewing on the outer side of the body.

 

The shoulders are uneven. when the shoulder level on the chewing side is higher, the distance between shoulder and neck is smaller on the chewing side.2

 

Backwards, a cervical vertebrae scoliosis may evolve at the chewing side, due to trapezius muscle upwards and forwards movements.

 

With the shoulder, trapezius muscle raises and takes spine from C1 to C12 to the chewing side.

 

In a profile view, if one chews left, at the right profile view a kyphosis is seen due to the left shoulder is higher and forth.2

 

The front side of the body will stretch due to the fascia. At chewing side, chest gets higher than at the other side. This change in men is not very clear; however, in women it produces an unpleasant lifting effect, which is always on the chewing side.2

 

In front view and standing position, its remarkable that, at the chewing side, this persons hand stands higher than the other one. Fig. 13, 14, 15.

 

Due to the unilateral chewing, the pelvic girdle will get higher and rotated forward, making the body weight rest on the leg the other side.2 In a panoramic radiograph, this position of the pelvic girdle may lead to a ‘shorter leg’ diagnosis.

 

And this makes misdiagnosis very common, leading to prescriptions of insoles to compensate these ‘shorter legs’ and thereby perpetuating pathology. Also because unilateral chewing, it will be noticed joint problems in the leg opposite to chew. The most common are kneee problems.2

 

Tongue has 17 muscles, eight on each side and one in the middle. These muscles are inserted at various levels such as the palate, the hyoid bone and jaw, and on both sides of these structures.

 

Swallowing problems may also occur when a person chews unilaterally, since the tongue muscles only work this side of the masticatory, while the othermuscles are not triggered and track the movement by inertia, because they are together. Then tongue muscles of chewing side are hypertrophied, while the no-chewing side ones get baggy, with consequences such as the palate increase on chewing side, in comparison to the width measures of the median raphe. As already mentioned, there is an increase in the inserts ossification and also a change of structures spatial position, such as the soft palate, and also the hyoid bone and jaw.2

 

By swallowing with closed lips, tongue removes air from nasopharynx and oropharynx and sends pressure mostly to paranasal sinus. If patient chews unilaterally, swalling creates a much stronger pressure on the chewing side and therefore this pressure will be stronger in the paranasal sinus of the chewing side.2

 

Olfaction is carried to the brain by the encephalic nerve I, olfactory nerve, and has connections with the limbic system, hypothalamus and reticular formation.

 

During feeding proccess, the olfactory nerve is mainly responsible for the experience of flavor variations according to the different kinds of food, since tongue can only capture basic tastes.

 

Taste is perceived by special afferent encephalic nerves: V-Trigeminal, VII-Facial, IX-Glossopharyngeal, with a small role played by the X-Vagus.

 

Since this activity has already been described by other scientific papers, I will not go further than showing that unilateral chewing promotes the movement of the bolus only on chewing side of the tongue. Therefore, after long time not using nerve endings in taste buds on the no-chewing side, these buds gradually lose their taste efficiency until complete inactivity.

 

The hearing in human beings is connected to the cochlear nerve for transmission to the CNS. But it is much more related to the functional performance of the biological units related to the middle ear.

 

When humans speak, their own voice is heard through the Eustachian Tubes, which must be permeable and have its opening to nasopharynx working properly. Besides, the structures must be running the same on both sides, with harmonic and synchronous bilateral chewing, breathing, nasal and nasopharyngeal under sub atmospheric pressure to allow the proper function of the middle ear and correct mechanical transmission to the cochlea, sending the correct signals to the brain.

 

When lips are inadequate sealed., atmospheric pressure environment gradually invades the region of oro and nasopharynx, reaches Eustachian tube and middle ear and finally gets to the mastoids .When air pressure reaches all these regions, gravity law also acts on them, making middle ear bones percussion be interpreted as sound.

 

Stapedius, the muscle that moves ear bones, is one of the most sensitive in human body. For proper function, this muscle demands a sub atmospheric pressure in the middle ear region. But when atmospheric pressure invades middle ear, this muscle has to work against atmospheric pressure and therefore against Law of Gravity. Although Stapedius muscle works at any circumstance, when it does it against Gravity, its effort is interpreted by the brain as noise: the so-called tinitus.

 

The cochlear nerve is responsible for balance and hearing in human body, so that these two senses are intrinsically linked. As consequence, absolute absence of sound and sound above audible decibel limits lead to loss of balance.

 

Balance is tied to spatial position of the eyeballs and it is co-rulled by impulses of the nerves that control eye movements, the encephalic nerves III, IV and IV.

 

All these functions are carried to the thalamus and cortex by the trigeminal nuclei.

 

Vision is part of head activities. It is carried to the brain by encephalic nerve II, the ‘optical nerve’.

 

To achieve an adequate view, eyes must present movements which are controlled by three encephalic nerves, the II, IV and VI pairs respectively, and the VIII encephalic nerve too. These couples make all the movement needed to see in almost all directions.

 

But if someone chews unilaterally and/ or is a ‘mouth breather’, eyeballs position is altered due to the replacement of the muscles responsible for the eyeballs movement. This occurs because there is a fascia surrounding facial muscles, from neck to the occiput. In unilateral chewing, the activity of these fasciae is altered , and as result a change of the spatial position of the eyeballs takes place.

Figure 1,2

Fig 1- Before AFR treatment.

 

Fig 2 – After 02 months AFR treatment.

 

After some years of unilateral chewing, with the bi pupillary changes, the information transmitted through the encephalic nerve that make eyeballs move gets changed, which changes the information that comes from the eighth encephalic nerve to the brain, causing imbalance episodes, interpreted as labyrinthitis.

 

The integration of all these neuronal activities described above is carried to the thalamus and then to the brain by encephalic nerves, but the direct activity of all encephalic nerves, except the I and II (Olfactory and Optical nerves), is driven to Thalamus by encephalic nerve V (Trigeminal nerve). So, taking this into account, all the functional activities described earlier end up being conducted by the Trigeminal – for good or evil.

 

The treatment system I call ‘Human Body Total Care (HBTC)’ comprises three intraoral devices called AFR (Aragao’s Function Regulator) + breathing exercises + chewing exercises. It can treat systemic diseases, and may be or not associated with other medical, dental, physiotherapy professional procedures.

 

The AFR devices promote the proper position of the temporomandibular joints (TMJ) within the Glenoid cavity, without compression of the bilaminar zone, where nerves and vessels (arterioles, veins) are located.

 

Due to the compression of the bilaminar zone, the unilateral chewing initially causes edema, with all the characteristic table of inflammation. If compression remains, changes will occur either in other areas, such as glenoid cavity wall or in the jaws condyle, caused by ischemia.

 

This compression also exists on the Auriculo-temporal nerve, a branch of the Trigeminal, which innervates this region.

 

The treatment promoved by the HBTC method is done by the AFR (Aragao’s Functions Regulator), and is effective because when the AFR is placed in the buccal vestibule of the patient, and his/her lips close, the following occurs:

 

The structures of the TMJ on both sides are moved into a good position, both TMJ space on the same level (no stretching or compression of the joint capsule or the bilaminar zone, no projection of the mandibule).

 

Accordingly to the lips sealing, swalling occurs, and resulting from swallowing, the oronasofaryngeal space is submitted to sub atmospheric pressure, the ideal working condition for these structures, particularly neuronal receptors V, VII, IX and X encephalic nerves, respectively Trigeminal, Facial, Glossopharyngeal and Vagus nerves.

 

Under such condictions, all nociceptive signaling of TMJ to the Trigeminal nucleus turns to a non- nociceptive signal, in order that neural signaling of all encephalic nerves V, VII, IX and X which come from oronasofaryngeal space gradually become normal.

 

Due to the use of the AFR under the conditions above, the reticular formation, the hypothalamus and limbic system, now receive and send signals to the trigeminal sensory nuclei, gradually modulating the functions of these areas.

 

All motor functions, particularly motor neurons, improve significantly their function through the use of AFR.

 

It is described bellow how AFR works on the treatment of systemic diseases, according to the disease groups as follows:

 

Chronic pain.

 

Headaches, migraines, fibromyalgia.

 

Muscle aches, backache, joint pain and spine pain.

 

Primary headache disorders include migraine, tension-type headache, cluster headache and other trigeminal autonomic cephalalgias. These disorders are neurovascular in origin, whereby a neurologic mechanism triggers a vascular response.

 

The characteristics of headaches vary. Migraine, for instance, is described as a disabling throbbing, pulsating, or beating pain, whereas tension-type headache is characterized as a non-disabling dull, steady, aching pain.

 

Dental profession has become increasingly active in managing some of these pain disorders; however, the major burden of managing most of these disorders still lies with the medical community.

 

Besides the convergence of the peripheral input, the trigeminal nuclei also receive extensive neuronal and interneuronal connections from sites throughout the CNS, including the motor cortex, which also sends afferents to other cranial nerve nuclei and reticular formation structures, the limbic system, and the hypothalamus. The nuclei are also rich in receptors for the spectrum of neurotransmitters through which sensory input and motor behaviors are modulated.

 

In addition, second-order nociceptive neurons from subnucleus caudalis arborize throughout the reticular formation and limbic structures and connect to the subnucleus interpolaris, subnucleus oralis and main sensory nucleus. These nuclei also receive descending motor input from cortex and circuits which are related to pain interpretation. These ascending second-order neuronal and descending corticospinal connections show that nociception, before and after it is interpreted as pain, affects ongoing behavior.

 

It is remarkable that all the CNS input is also carried by second-order neurons from the dorsal horn of the spinal cord. Therefore, potential pain input from regions outside trigeminal receptive fields may excite CNS structures that intensively communicate with trigeminal nuclei and modulate their functions.

 

Due to unilateral chewing, muscular shortening results in muscle fasciae stretching and consequent elevation of all viscerae on chewing side. Symptons such as “atypical thoracic pains” are triggered as mediastinum area gets smaller and compressed.

 

Chronic pains are treated by AFR (Aragao’s Functions Regulator), since its placement into buccal vestibule causes lips sealing , with the following results:

 

Sleep disorders.

 

Systemic diseases such as sleep apnea, snoring, insomnia, bruxism, panic disorder (night terrors) and mouth breather syndrome most often have mouth breathing and/or unilateral chewing as common denominator.

 

The main cause of mouth breathing is the lack of register on the Central Nervous System (CNS) of the breathing through the nose on the first year of extra uterine life, that is, the new born starts breathing through the mouth early on the first year of life.²

 

But the picture above described is unusual, because children as a rule breathe through nose when breastfed, what is correct and must be done for one year, at least.

 

While nose breathing, the air that goes during inhaling to lungs through nasal cavities is added to the lachrymal fluid (tear film), which flows into the nasolachrymal duct at the height of the middle turbines.

 

Lachrymal fluid contains more than 94 chemical elements, and plays a great role on several inner lung metabolic exchanges, from inner alveolar pressure to auto-immunizing elements production, providing the individual with higher tolerance to allergenic elements².

 

Mouth breathers cannot chew bilaterally, alternating dental arch sides, because by moving the bolus from one side to another, it can be inhaled through the trachea, causing shock and cough to expel the food. So, to be able of breathing through mouth, one must perform unilateral chewing.

 

Brain oxygenation becomes inefficient as result of mouth breathing, and therefore it may get harmed as a whole.

 

Quality and quantity of neurotransmitters become inadequate, as those which form the sleep inductor melatonin, causing insomnia.

 

In relation to cognition and behavior, mouth breathing children are unquiet and have to be in constant agitation in search for more oxygen.

 

Although dispersive and agitated, when these children are forced to stand still, they get sleepy and cannot pay attention to classes at school, and as result they are often diagnosed with Attention Deficit Disorder (ADD) and unnecessarily medicated. Fig. 3,4.

Fig .3 – Before AFR Treatment.

 

 

Fig. 4 – After 01 year AFR treatment

 

Mouth breathing for many years causes cerebral hypoxia. Particularly in early childhood, it can induce hypoxia in the limbic system region, thus causing daytime panic attacks and sleep episodes of night terrors.²

 

In the treatment with the AFR, the first relationship is observed basal patient’s bone and determining the type indicated for AFR.

 

Then, the patient shall be told to exercise slow and deep breathing with sealed lips, for 10 minutes per hour, awake. ²

 

By this means, breath will be adjusted according to the buffering capacity of blood, and it will also regulate heart activity, blood stream pressure, the amounts of oxygen-hemoglobin and erythrocytes, the hemoglobin-oxygen affinity, hematopoiesis, the excretory functions of the kidneys, intestinal tract and transpiration.

 

The variations of the values of these constants are picked up by internal or direct by interceptors the respiratory center by the action of the blood.The perception of decreased rate of oxygen is due to hemorreceptors located in the carotid and aortic bodies. These receptors have the innervation of the Vagus and Glossopharyngeal nerves.The periodic nature of inhalation and exhalation is controlled by neurons located in the bridge and the medullae. They are named respiratory centers. Today recognize three main groups of neurons.4

 

My hypothesis concerning to sleep apnea is that when someone sleeps and breathes through mouth in supine position, the tongue, while free from the action of sub atmospheric pressure provided by lip seal, contacts the oropharynx region, which is innervated by the Glossopharyngeal and Vagus nerves, and this contact activates the pneumotaxic center on the brain, then causing inhaling stop. This contact is the usual signal for swallowing, but not in this circunstance, because the phenomenon here described means sleep apnea, causing saturation of CO2 ,heart’s activity increase and lung stop.

 

Chemoreceptors are the elements that bring inhaling back. They are the central and peripheral chemoreceptors (carotid and aortic bodies), the most important being the carotid bodies, which are primarily responsible for all the increased ventilation in response to arterial hypoxemia.

 

In addition to these components, other parts of the brain influence the alteration of respiratory pattern: the limbic system and hypothalamus in emotional states such as fear or anger.

 

Since fear is a stimulator of the limbic system, and it is reported that the lack of O2 and increase of CO2 level brought by sleep apnea are lethal, the limbic system manages to recover inhaling, the carotid body excites the inspiratory center, re-inflate lungs and so heart activity returns to normal.

 

But for obese people, in addition to a long term mouth-breathing, lack of physical activity extends from day to day, and each apnea episode is followed by a violent tachycardia, leading to a respiratory rate of chocking and prolonged wheezing, until heart cannot stand any more, thus causing an infarction

 

In my treatment protocol, patient is instructed to use the AFR, make the exercise of lip closure in slow, deep breathing. The patient is also referred to a cardiologist to check heart condition, to a speech therapist for training the oropharynx and larynx muscles, and to a nutritionist for proper diet recommendation, besides getting the advice for at least a 40 minutes daily walk at accelerated speed, but no running.

 

Snoring treatment demands the same recommended exercises for sleep apnea therapy. After two months of using AFR and exercises, snoring will disappear. After using the AFR for 6 (six) months, the signs and symptoms of insomnia, mouth breathing and even burnout syndrome get better, as well as panic disorder, if the patient is accompanied by psychoanalyst treatment.

 

Bruxism

 

The treatment for bruxism requires the previous knowledge of its causes.

 

Bruxism has its origin in the malfunction of the TMJ. As you know, every joint should move freely, particularly the TMJ, because they move in all spatial directions to perform all stomatognatic system functions, such as talking, chewing, swallowing, yawning, sucking, kissing, spitting etc.

 

When a joint is traumatized or its movement is restricted, it gradually loses its condition of motion. If a joint stands immobilized for more than 40 days, ankylosis may occur. Although this may not take place, the lack of movement causes a serious problem in the muscles that are engaged in joint function. It is widely known that muscles lose many sarcomeres because of inactivity, and may become fibrous, even in a short time. 9,10

 

Suction is a pre-recorded function in a new-born infant brain, which jaw is projected for breastfeeding.

 

This action demands several encephalic nerves (V, VII, IX, X, XII) that communicate to each other and to the cerebral cortex through the Trigeminal nerve, to perform the functions of sucking, swallowing and breathing, with no competition among them.5

 

While the child is fed, the function of the lateral pterygoid muscles and the jaw elevator (mainly Masseter muscle) are intensively exercised, and this allows their function to mature and gives shape to the cavity of the mandibular bone on the Temporal bone and also the jaw. 11

 

The shape and depth of the mandibular cavity are formed by the Masseter muscle and the TMJ ligaments in the zygomatic arch, because the action of its periosteal matrices increases that area along the years, thus forming the articular eminence of the temporal bone as a secondary response to the translational vertical growth.

 

When the child is not breastfed, no maturation of the stomatognatic system or proper training of the TMJ takes place, as well as the proper maturation of the CNS (Central Nervous system).12

 

Caused by the absence of breastfeeding, the child remains with a basal distorrelation, leading to jaw retraction.

 

Under such circunstances, this child will very probably develop unilateral chewing, as a result of the lack of use of the lateral pterygoid muscles, and it is very unlikely that they will serve to bilateral chewing.

 

When someone is a mouth breather, chewing occurs in only one side, and this causes inadequate TMJ nerve signaling, interfering with the signal to reticular formation. And the reticular formation is also very sensitive to brain hypoxia, associated to unilateral chewing.

During sleeping, the autonomic nervous system (ANS) searchs the ideal jaw position in order to remove the mandibular condyle from the bilaminar zone, and, as result, the person may pass all night rubbing teeth,not finding the TMJ ideal position, because the occlusal plane is already wrong.

 

With the unilateral chewing, the jaw bone relationship will keep in distorrelation, because any time a swalling takes place, teeth contact occurs on distal parts of the molars.

 

When a child has an anterior rotation of the head, this position will cause the jaw to be retracted at each swallow.

 

This situation on a daily basis will provoke the decrease of TMJ movement, which will be pressed against the retrodiscal area (bilaminar zone) and cause discomfort, pain , imbalance and headache.

 

When the childs sleeps, the ANS takes control of muscle movement and tries to position the jaw in order to decrease pressure in theTMJ bilaminar zone caused by jaw distorrelationship.

 

In search of a better position, the jaw meets the upper teeth in awkward positions caused by unilateral chewing, where it finds the occlusal plane differently on each side of the dental arches and accenteuade curve of Spee on the side of chewing.

 

All these events make the occlusal vertical dimension (OVD) to be amended, consistently to the spatial position of the TMJ and in addition to the lose of muscle sarcomeres and the increase of the connective tissue. 10

 

So, while sleeping, the ANS causes the jaw to look for an ideal vertical dimension of the patient. With this, teeth make harmful unontrollable movements against their opponent, what is frequent to happen during the REM (rapid eye movement) phase.

 

In adults, the bruxism etiology is often caused by the OVD (occlusal vertical dimension) changes related to various circumstances, such as unilateral chewing, tooth extractions, inadequate dentures etc.

 

It is the same in adults and children CNS. During sleeping, the CNS captures the changes in size and muscle functions, the joint hypo mobility, and makes the proper adjustments.

 

Emotional disturbances (stress) intensify the uncontrolled muscle movements, and psychological factor makes it more intense, but these are not the main causes of bruxism.

 

AFR treatments are indicated according to the patient’s basal bone more breathing execises to enhance the CNS activity, especially the reticular formation.

 

Upper airway diseases.

 

Sinusitis, rhinitis, mastoiditis.

 

Tonsilitis, enlarged adenoids.

 

Mouth breathing and its consequent lack of nasal expiration cause rhinitis, otitis, mastoiditis, due to the accumulated secretion in the paranasal sinus which are not cleansed. It often causes bacteria entrance in warm environment with secretion, ideal conditions for the settling of an infection.

 

The cleaning of the sinus cavities is made by nasal exhalation, the pressurized air coming out from lungs and passing through the ostium, which connects the nasopharynx with the paranasal sinus, and thus aspirating the contents of these cavities. At the same time, this process promotes sterilization of the area, due to the exhalated CO2.

 

Since the air breathed by the mouth is not humidified, it is neither filtered, nor has its temperature equalized, and so the bronchia and bronchioles get irritated, swollen, causing the beginning of bronchitis and bronchial asthma.

 

Since lungs do not inflate totally on mouth breathing, pneumonia finds the perfect conditions to occur. This is caused by the advanced position of the head, which prevents ribs from lifting, so that lungs are not fulfilled.

 

In the treatment with AFR, it is prescribed a series of breathing exercises.2 After 03 months exercise, patients are cured from rhinitis, sinusitis, mastoiditis, oititis, enlarged adenoids, tonsillitis and other upper airway diseases.

 

Facial Aesthetics.

 

Wrinkles, Chinese mustache, neck baggy, dark circles.

 

Asymmetrical face often results from mouth breathing and/or unilateral chewing.

 

The height of structures such as eyes, eyebrows, nose, lips corn and chin assume different spatial positions.2 Fig. 5, 6

 

Fig 5 – Before AFR treatment.

(headache, right arm ache)

 

 

Fig 6 – After 08 months AFR treatment.

(without any pain)

 

When the patient puts the AFR into the mouth, the vestibular and lip shields promote an immediate stretch of all facial and neck muscles. The shields work both side muscles equally.

 

And all those patients will gradually adopt the bilateral chewing with the same force and intensity.

 

Then the fasciae that surround these muscles also changes position, causing the same effect on the muscles of the orbicularis eye, orbicularis of the mouth and nose on both sides, and so the person will gradually get a symmetrical face.

 

When someone places the AFR into the mouth, the device provides an increase of the Moss oronasopharinx capsule and of the sub atmospheric pressure when swallowing occurs.

 

During speech, the unit promotes exercise, physical therapy, and lymphatic drainage of all soft tissue of the face and neck. Even the skin of the patient’s face gets a younger appearance as result of the blood circulations increase, which promotes a more effective renewal of skin and pores. After 03 months, the person will present no more Chinese mustache, neck baggy and dark circles.2 Fig. 7,8,9,10

 

Fig. 7 – Before AFR treatment.

(TMJ pain, headache. Look at the position of the eyes and nostrils)

 

 

Fig. 8 – After 01 month AFR treatment.     

(without any pain)

 

Fig. 9 and 10 – Before and 05 months later AFR treatment.

(above – fibromyalgia / bellow – without fibromyalgia).

 

Stomach and intestinal problems.

 

Burning, heartburn, gastroesophageal reflux disorder, gastritis, hiatal hernia, duodenal ulcer, irritable bowel syndrome, multiple chemical sensitivity.

 

The oro and nasopharynx are areas which should always be under sub atmospheric pressure, but instead, when someone is open mouthed, these areas suffer the action of the Gravity Law and environmental atmospheric pressure. These areas are innerved by the encephalic nerves IX Glossopharyngeal and X-Vagus.

 

The Vagus nerve is responsible for heart rate, respiratory frequency and by the gastric and aesophageal peristalsis.

 

Mouth breathing and the atmospheric pressure environment attack the glossopharyngeal and vagus nerves, causing their malfunctioning, So, the Vagus alters gastric and esophageal peristalsis, in order that the brain misinterprets the signal as food coming to the stomach, and thus it results in production of digestive acids.

 

As food does not come, these acids attack the gastric mucosae, decomposing it in several levels, starting by gases which return to the esophagus. With time, these events eventually cause all the diseases above.2 Fig. 11, 12

 

Fig. 11 – Before AFR treatment.

 

Fig. 12 – After 01 year AFR treatment.

 

The Vagus also innervates 2/3 of the intestines, in co-participation with the autonomic nervous system (ANS). When the vagus area is attacked in the oropharynx, it also changes the overall picture of the intestine through the diseases above referred.

 

Human body posture.

 

Several changes in corporal posture are due to unilateral chewing. The muscles of the chewing side become hypertrophied and shortened, thus the shoulder on the same side lifts.

The muscles that do this work more and are the Esternocleidomastoide, the Trapezius and the muscles of the neck and shoulder girdle.

 

Then the shoulder raises and with this moves up the shoulder blade. The Trapezius muscle is inserted from the occipital bone until the 12th. vertebrae and also fits into the upper lateral part of the shoulder blade. This up and forward movement of the shoulder blade makes a cervical spine scoliosis on the same side.2

 

After some years of the forward movement of the head caused by the mouth breathing, the patient will get a kyphosis.2 Fig. 13, 14 , 15.

 

Fig. 13 – Scheme posture.

 

 

Fig. 14 – Before and after 03 months AFR treatment.

(before-mouth breathing, ADD, / after- without the problems)

 

 

Fig. 15 – Before and after 03 months AFR treatment.

 

Occlusal vertical dimension balance.

 

When someone loses the vertical dimension of occlusion caused by tooth loss, excessive wear (bruxism), poorly fitted dentures, unilateral chewing, or other problems, AFR treatment is ideal to restore the spatial position of the TMJ and then to determine the position space of the teeth on both dental arches.

 

ARAGAO’S FUNCTION REGULATOR (AFR) ACTION.

 

The AFR is based on the teachings of the Moss Functional Matrix, Planas laws of growth and development, and “Trajectories of Functional Muscle”, of Dal Pont.2

 

Taking these principles, AFR devices have in common the vestibular and labial shields, made of acrylic and stainless steel wires that stimulate the stomatognathic system with appropriate exteroceptions and proprioception, while providing gymnastic, a physcal therapy of all tissue components of this system and the correct positioning of the temporomandibular joint (TMJ) of the patients.2

 

The vestibular apparatus AFR has shields small enough to change the trajectories of functional muscles of the stomatognathic system and steel wires that are not inserted between the upper teeth. It has no constructive bite with mandibular advancement.2

Aragao’s Function Regulator II (AFR II)² Fig. 16

Indication:

 

Orthopedic Functional:

Deep bite

Anterior open bite with basal bone in distal relationship.

Angle’s Cl I and Cl II.

 

Dysfuncional:

 

TMJ disorders

Chronic pain

Sleep disorders

Upper airway diseases

Stomach and Intestinal problems

Facial aesthetics

Human body posture

Occlusal vertical dimension balance

 

ARAGAO’S FUNCTION REGULATOR III ( AFR III )2 Fig. 17

 

Fig. 17                                        AFR III

 

Indication:

 

Orthopedic functional:

 

Angle Cl III

Patients with mesial basal bone relatioship.

Patients with cross bite involving the upper canine.

Ptients with anterior open bite with mesial bone relationship.

 

Dysfunctional:

 

TMJ disorders.

Chronic pain.

Sleep disorders.

Upper airway diseases.

Stomach and intestinal problems.

Facial aesthetics.

Human body posture.

Occlusal vertical dimension balance.

ARAGAO’S FUNCTION REGULATOR IV (AFR IV)2 Fig. 18

Fig. 18

Indication:

 

Orthopedic functional:

 

Hypo premaxilla development.

After use AFR III in Angle’s Cl III patients.

Normo relationship basal bone ( Angle Cl I ) with mandibular projection.

 

Dysfunctional:

 

TMJ disorders.

Chronic pain.

Sleep disorders.

Upper airways diseases.

Stomach and intestinal problems.

Facial aesthetics.

Human body posture.

Occlusal vertical dimension balance.

 

The AFR is built from a functional bite that is made in the patient’s mouth. This bite is made with the repositioning of the temporomandibular joint (TMJ) of the patient into a correct position. It is made from the principles of AK (Applied Kinesiology).13

 

When the AFR is inserted into the patient’s mouth, both TMJ are repositioned in the patient’s bite position.

 

All nervous signaling is carried to the primary sensory nucleous of the Trigeminal nerve. This signal is conducted in its entirety to the thalamus and the brain. Simultaneously, all somestetic information (proprioception, chronic pain, touch) is modulated by the TMJ spatial position before being driven to the thalamus and the brain.

 

The AFR vestibular shields change the trajectories of functional major muscle groups of the stomatognathic system (pterygoid, masseter, buccinator, mimic, supra-hyoid, infra-hyoid, tongue) and these changes are recorded in the cerebral cortex.

 

Its noteworthy that, according to the positioning of the AFR into the mouth and the changes related to this action, both the effectiveness of TMJ work and the tonus of all the muscles of the stomatognathic system improve about 30%.

 

The same improvement rate is noticeable, concerning to the diaphragma tonus and breathing and cerebral oxygenation.

 

In addition to the local and general action of the AFR all over the patient’s body, the mouth breather patient is instructed to do breathing exercises some minutes each hour of his/her waking time. 2,7

 

Treatment

 

Phase 1

Prevention techniques of breathing, posture, and chewing exercises.

These instructions are to the parents. Until to 03 years old child.

 

Phase 2

Treatment with AFR devices

(Aragao’s Function Regulator + exercises).

 

Fig. 19 – Before and after 01 year AFR III treatment.

(Before-mouth breathing, sleep apnea, snoring, headache, rhinitis, and sinusitis/ After- without related diseases)

 

 

Fig. 20 – Before and after 11 months AFR II treatment.

(before-headache, ADD, sleep apnea, snoring, rhinitis, and sinusitis/ after – without the related diseases)

 

Phase 3

Com AFR treatment devices + Oral Rehabilitation

 

 

Fig. 21 – Before AFR treatment

(headache, bruxism, back pain)

 

 

Fig. 22 – During AFR treatment + Oral rehabilitation.

 

Fig. 23 – After 06 months AFR treatment + Oral rehabilitation.

(without any diseases and a very good new look.)

 

REFERENCES

 

1 – Moss ML – The primacy of functional matrices in orofacial growth. Dent. Pratic Tit.Vol.19, n. 2, p.65-73, 1968.

2 – Aragão W. Regulador de Función Aragão – Tratamiento de las enfermedades sistémicas a partir del sistema estomatognático. Editorial Ripano, Madrid, 2008.

3 – Guyton AC – Neurociência básica – Anatomia e Fisiologia. Rio de Janeiro: Guanabara Koogan, 1993.

4 – Lent R – Cem bilhões de neurônios. Rio de Janeiro, Ed Atheneu, 2001.

5 – Wilson-Pawels L, Akeson EJ, Stewart PA – Nervios cranianos- Anatomia y Clinica, Buenos Aires :Ed Panamericana, 1991.

6 – Haines DE – Neuroanatomy – An atlas of structures, cut and systems, Lippincott,Williams & Wilkins, 1991.

7 – de Leew R – Orofacial pain – Guidelines for assestment,diagnosis and management – Fourth Edition, Quintessence publications Co,Inc, 2008.

8 – West JB – Fisiologia respiratória – São Paulo- Ed Manole 2002.

9 – Williamns PE, Goldspink G – The effect of immobilization on the longitudinal growth of striated muscle fibers. J. Anat; 116: 45-55, 1973.

10 – Williams PE, Catanese T, Lucey EG, Goldspink G – The importance of stretch and contractive tissue accumulation in muscle. J. Anat.; 158:109-114,1988.

11 – Aragão W – Ortopedia dos maxilares. São Paulo, Pancast editorial,1992.

12 – Bueno APF – Introdução as bases cibernéticas da ortopedia dentofacial. Rio de Janeiro, Ed Europa, 1991.

13 – Walther DS – Applied Kinesiology. Sinopsis.2. Ed. Systems DC, 2000.

 


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