This document outlines the agenda for the American Association of Orthopedic Medicine workshop on Pain Management and Healing in the 21st Century. The workshop will feature presentations on topics such as dental occlusion and health, how occlusion can impact stress levels, animal research on occlusion, clinical cases demonstrating the effects of occlusion, and the use of templates or mouthpieces in treating conditions like sleep apnea. Presenters will discuss how occlusion can mechanically and physiologically influence posture, physiology, and dynamic body functions. The template therapy aims to stabilize the brain and reduce overactivity of the masticatory muscles by providing low-level stimulation to key areas in the brainstem.

1. AMERICAN ASSOCIATION of
ORTHOPEDIC M EDICINE
December 7 & 8, 2007
WORKSHOP
Pain M anagem and Healing in the 21st Century
ent
Jointly Sponsored by Am erican Association of
Orthopedic M edicine AAO and the University
M
of California, San Diego School of Medicine

2. Contribution from dental to
medical
Template Therapy and Irregular Output of
the Trigeminal Nervous System
David L. Burns D.D.S.
December 7&8 2007
Fort Wayne, Indiana

3. Dental Occlusion and Health
Dr. David L. Burns
Academy of Physiological Dentistry
American Dental Association
Indiana Dental Association
American Academy of Functional Orthodontics
American Academy of Pain Management
International College of Craniomandibular
Orthopedics
American Academy of Craniofacial Pain

4. drdlburns@comcast.net
www.davidlburnsdds.com
260-432-8596

6. CONTENTS
HOW DO WE KNOW IF
OCCLUSION IS GOOD OR BAD?
HOW DO WE TREAT TMD?
ANIMAL RESEARCH
CLINICAL CASES
SPORTS DENTISTRY

7. HOW DO WE KNOW IF
OCCLUSION IS GOOD
OR BAD?

8. OCCLUSION
GOOD ----------------- EUSTRESS
BAD -------------------DISTRESS
FOR WHOLE BODY
POSTURE
PHYSIOLOGY
DYNAMIC FUNCTIONS

9. WHY DOES OCCLUSION
CAUSE EUSTRESS
OR
DISTRESS?
A. MECHANICAL FACTORS
B. PHYSIOLOGICAL FACTORS

10. MECHANICAL FACTORS PHYSIOLOGICAL FACTORS
MUSCLES
1. BITE 1.
2. GUZAY’S QUADRANT THEOREM 2. SENSORY- AFFERENT
FORCES MUSCLE SPINDLES
AXIS-- X&Y
GOLGI TENDONS
LEVERS
EXTEROCEPTORS
DISC
3.
3. CENTRAL NERVOUS SYSTEM
DISPLACED
CORTEX
RUPTURED
BRAINSTEM
4. COMPRESSION
PYRAMUS BONE 4. MOTOR- EFFERENT
CERVICAL VERTEBRAE ALPHA- GAMMA
AUTONOMIC N.S.
PSYCHOSOMATICS
5.

11. OCCLUSION
GOOD ----------------- EUSTRESS
BAD -------------------DISTRESS
FOR WHOLE BODY
POSTURE
PHYSIOLOGY
DYNAMIC FUNCTIONS

12. Quadrant
Theorem
Established by
Casey M.Guzay
1973:Chicago, USA
Kiyoshi Maehara
1985: Osaka, Japan
Center of jaw
movement is in
the Sub-Atlas .

14. In order to masticate or speak properly, the
cranium has to keep a stable position.
In case of deep bite or mal
occlusion, neuro motor
system is activated more than
before. This action causes the
posterior muscles to constrict
more. Cervical vertebrae then
receive the force to cause the
compression.
The posterior cervical muscles and the masticatory muscles
always co-work with each other. It is suggested that the length
of the posterior cervical muscles goes along with the length of
the masticatory muscles.

15. Ia and II are proprioception fibers and go into the
mesencephalic nucleus, locus cereleus and gray
matter of aqueduct of mid-brain. These places act
as first ganglia of the trigeminal nerve.
Ia
II

16. HOW DO WE TREAT TMD?

17. What is a Template & Therapy?
Kind of mouth piece
1.
Stretch of the Masticatory M.
2.
Stabilization of the Head Position
3.
Improve the diseases and non-specific
4.
complaints
Connect the medicine and dentistry
5.

18. How to use the stick in medical care?
Template or stick is not a drug
This work stabilizes the brain by cutting off the
output signals to the masticatory muscles .
1. During the hospitalization patients should bite stick
2. Never take the dentures out during the sleeping time
3. Ease to pain control when bite the Stick or TP.
4. While under anesthesia bite block is necessary in
order for the stabilization of blood pressure
5. In case of incurable diseases, stick or Tp help for
patients

19. ANIMAL RESEARCH
AND THINKING

20. Conclusion of Animal
Experiments
Vertical height loss led to
Whole body muscle tension changes
1.
Imbalance of Autonomic nervous
2.
system.
No changes of blood and urine tests
3.

21. Reference of Animal
Experiments
Rats : Dr. Tatsuya Ueda Dr. Kiyoshi Maehara
1.
2. Guinea Pigs: Dr. Yukio Azuma, Dr. Hitoshi Taga,
Dr. Masaharu Hashimoto Dr. Kiyoshi Maehara
3. Beagle Dogs: Dr. Masaharu Hashimoto, Dr. Kiyoshi
Maehara, Dr. Teruaki Sumioka
4. Rhesus Monkeys: Dr. David Burns, Dr. Masaharu
Hashimoto, Dr. Keiichi Tamaki, Dr. Kiyoshi Maehara
1-2 Asahi University School of Dentistry Department of Pharmacology
3-4 Fujisawa Pharmaceutical Company Limited

22. CLINICAL CASES

23. Clinical Findings 1
Posture: Malposture,Humpback and
1.．
1.．
Scoliosis etc.
2. Stabilization of cervical vertebra:
Cervical spondylosis deformans, Headache,
Shoulder/Neck stiffness, Glaucoma and Numbness
of finger/arms
3. Analgesic action : All kind of pain caused
from inflammation or neuralgia below the pons which
is a trigeminal pathway.

24. Clinical findings 2
of blood flow to brain
4.．Improvement
from vertebral arteries :
Consequence of the cerebral infarction,
Parkinson’
Epilepsy, Parkinson’s disease and Dementia
5.．Stabilization of autonomic nervous
system:
Hyper・
Hyper・Hypotension, Diarrhea, Fatigue,
Diabetes and Anxiety neurosis
6.．Stabilization of immune system:
Asthma、
Asthma、Atopic dermatitis, Collagen disease
and Myasthenia gravis

25. Clinical findings 3
Improvement of motor function and
7.
skills: protect from sports injury,
acceleration of motor reflexes:
Strength of the muscles and light and motor
reflex
8. Improvement of TMJ disorder:
Clicking, can’t open mouth due to lock jaw,
arthritis of TMJ and so on
Leads to proper occlusion
9.

26. An actress suffered from whiplash by traffic
accident and could not remember her script. She
was cured within a week by the template wearing.

27. Effect of the template therapy with sleep
apnea syndrome patients.
Hitoshi TAGA1) , Teruaki TOMARU1)
Satoshi NAITOH2) , Kiyoshi MAEHARA3)
1)Showa Univ. Med. Fujigaoka Hosp.
Dept. of Anesthesiology
2)Showa Univ. Med. Fujigaoka Hosp.
Dept. of Otolaryngology
3)Hamamatsu Med. Univ. Dept. of Oral Surgery

28. 30
20
%
10
0
UPPP Template Nose Septo Reduce Tonsillect
drops plasty weight omy
Choice of treatment for the SAS patients.

29. 97
＊＊
96.5
96
Effect of template
＊
95.5
on mean SpO2.
95
%
94.5
AI<20:n=17,
before
after
94
≦
20≦AI<40:n=5,
93.5
≦
40≦AI:n=4. *p<0.05,
93
AI<20 20≦AI<40 40≦AI
**p<0.01.
90
＊
85
80
Effect of template 75
on lowest SpO2. % 70
65
AI<20:n=17,
≦ ≦ 60
20≦AI<40:n=5, 40≦AI:
55
n=4.
50
*p<0.05. AI<20 20≦AI<40 40≦AI

30. 13%
stationary
13%
effective
marked improvement
27%
74%
39%
Effect of template
34%
Effect of UPPP

31. SPORTS DENTISTRY

32. Clinical findings 3
Improvement of motor function and
7.
skills: protect from sports injury,
acceleration of motor reflexes:
Strength of the muscles and light and motor
reflex
8. Improvement of TMJ disorder:
Clicking, can’t open mouth due to lock jaw,
arthritis of TMJ and so on
Leads to proper occlusion
9.

33. Reasons for the Effectiveness of
Template Therapy
From the viewpoint of the physics:
1.
Guzay’s Quadrant Theorem
2. From the viewpoint of the physiology:
Masticatory muscles are stretched and
controlled by the trigeminal nervous
system
(Controlled by brainstem directly)

34. We Are Looking For The
Neuro-Dentistry
Dental treatment is same as brainstem treatment:
1. Reduce pain from oral area: stabilization of spinal
tract of trigeminal
2. Improve the malocclusion: stabilization of the
basal ganglia
3. Increase vertical of bite: stimulate to the
mesencephalic nucleus, locus cereleus and gray
matter of cerebral aqueduct of mid-brain
(Reduce the pain which is closely related to neuro
system)

35. Conclusion
WHEN WE BITE SOMETHING
Mechanism of action is stabilization of the brain:
The muscles are no longer overactive from bite
1.
overclosure only stimulation to the trigeminal
mesencephalon and gray matter of the mid aqueduct
where pain is reduced
2. The teeth are important for chewing but also
support ones head position and posture.
3.．When teeth are missing and/or not replaced, the
brain is going to overwork resulting in brain fatigue/
tiredness