The protocol suggested by A.G.O.

Diagnosis of cranio-cervical-mandibular disorders and symptoms connected

Medical exam of the patient:

  • general and specific anamnesis
  • pain and muscle tone of the cranio-cervical-mandibular district
  • ostural balance
  • Crom
  • tabilometric platform
  • scoliometer (or inclinometer)

Instrumental exams:

  • assembly of models on the articulator: evaluation of centric relation-maximum intercuspation ratio, with Mpi (Sam) and Cpm (Girrbach) measurement.
  • study of the jaw terminal hinge axis movement:
  • opening and closing
    • crosswise right and left
    • protrusing
    • in bruxism
    • when speaking
    • during free movements through a special test analyzing the rotation-translation component of the different movements
  • differential electromyography of the temporal-masseter-sternocleidomastoid muscles during isometric contractions of the percentage overlapping coefficient (POC)
  • latero-lateral and antero-posterior cephalometric layout

Diagnostic imaging:

  • OPT (Optical Projection Tomography)
  • telecranium in latero-lateral and anteroposterior poly tome
  • Transoral c0, c1, c2 analysis through a cephalostat
  • Transoral X-ray of the cervical column in anteroposterior and latero-lateral through a cephalostat
  • Echotomography of the TMJ through clinical dynamic tests with and without a bite
  • CT scan of the Temporomandibular Joint
  • MRI of the Temporomandibular Joint

Obviously, the clinical exam can define and limit the indiscriminate use of all these tests.

Therapy of cranio-cervical-mandibular disorders and connected symptoms.

Therapy for the restoration and stabilization of the disc-condyle joint relationship with dental occlusion in the resolution of postural-occlusive tensions.

Restoration of a valid chewing system through the multiple possible combinations (see clinical cases):

  • Pretherapy with bite and prosthetic
  • orthodontic finalization for dental and disc-condyle repositioning, also through a possible orthognatic-surgical intervention
  • physiokinetic therapy for the resolution of correlated occlusive-postural dystonia

Physical therapy accelerates the disappearance of pain symptoms, moving the temporomandibular joints, improving the proprioceptive perception of the patient with guided passive and voluntary actions and its motion control.

Physical therapy is associated to the repositioning of the jaw through instrumental and clinical evaluations able to detect every single problem of the patient, identify the position the jaw will have to take to reduce the dislocation and address occlusal forces, according to the occlusal plane, to make them non-deflective, reducing the muscle tone of facial muscles, more efficient and, therefore, painless, better oriented against the occlusal plane, and reducing, also, the consecutive charge and pain of the temporomandibular joints.

Pain disappears fast due to the synergy between instrumental (condilography and electromyography) disc-condyle repositioning and the reconditioning made by an expert physiotherapist.

The physiotherapist uses an evaluation chart to address the reconditioning therapy of the posture and muscle activity of the chewing muscles in complete synergy with the evaluations of the gnathologist.


MEAW arch

The MEAW orthodontic technique is used to modify the inclination of the occlusal plane and helps repositioning the jaw on the sagittal and transversal plane in the right position inside the joint sleeve.

Therefore, MEAW is a more specifically an orthognatic technique, rather than just an orthodontic one.

And this is possible, thanks to the MEAW arch, used associated with other means, such as:

  • “strategic” rising wedges
  • short intermaxillary elastics
  • exceptionally, programmed bite

When using the MEAW

MEAW is used for the treatment of patients affected by temporomandibular joint disorders and, in specific cases, to solve orthognatic problems associated with prosthetic and implant prosthetic rehab.

The patient is treated for “strong” pain symptoms: headache, temporomandibular joint paint by the ear, cervical column instability, swallowing problems, motor instability (light dizziness), Eagle and “small” postural syndrome: of the rachis or podalic pole.

The diagnosis, premise of the treatment, is based on the principles of the clinical functional analysis:

  • Gnathological visit (according to R. Slavicek);
  • Exam of the arches on the articulator in reference;
  • Electronic condylgraphy;
  • Cephalometry carried on according to the criteria suggested by Prof. Sadao Sato (JP).

The criteria used to carry on the therapy divide in two great codifications: high or law angle, in cases of first/second/third class, with or without crowding.

The MEAW technique has its foundation of the interpretation of the importance of the inclination of the occlusal plane and the posterior discrepancy for the genesis of dysgnathia that for “MEAW” is due to jaw rototranslation that the MEAW can correct. The flex-extension of the skull is at the basis of the interpretation of the inclination degree of the occlusal plane and the consequent jaw positioning during the facial growth.