Fisioterapeuta chileno, considerado o maior expert mundial na área da reabilitação de disfunções cérvico-crânio-mandibulares
É palestrante e formador assíduo em diversos eventos em todo o mundo, quer na área da Fisioterapia, quer da Medicina Dentária.
Doutorado em Terapia Manual Ortopédica pela University of St. Augustine (EUA).
Professor titular do Departamento de Ortodontia da Faculdade de Odontologia da Universidade do Chile.
Professor Adjunto da Universidade de St. Augustine (EUA) e Diretor da Faculdade de Ciências da Reabilitação da Universidade Andrés Bello (Chile).
Diretor do Programa de Doutoramento em Fisioterapia da Universidade de St. Augustine (EUA).
Professor colaborador na Faculdade de Ciências da Saúde da Universidade do Vale da Paraíba, Brasil.
Diretor do Departamento de Reabilitação Físico-Médica, Integramedica, Chile.
Diretor do CEDIME (Centro de Estúdio de las Disfuncciones Músculo-esqueléticas).
Membro honorário da American Academy of Orofacial Pain, American Academy of Craniofacial Pain, Asociación Argentina de Kinesiologia y Fisiatria, Asociación Colombiana de Fisioterapia, Sociedad de Ortodoncia de Chile, Academia Brasileira de Desordens Craneomandibulares, Craneofaciais e Dor Facial.
Membro Fundador e ex-presidente da Academia de Desordens Craniomandibulares do Chile e da Academia Ibero-Latino-Americana de Disfunção Crâneo-mandibular e Dor Facial.
Membro fundador da Academia Italiana de Dor Orofacial e Crânio-mandibular.
Autor de diversos livros, com edições em Português, Inglês e Espanhol, assim como de inúmeros artigos científicos.
Membro do Conselho Editorial da "Cranio: The Journal of Craniomandibular Practice" e da "Manual Therapy".
Sexta-feira, 18 Março - Auditório 1 - 9h00
Duração: 1h45 minutos
«Assimetrias faciais: uma abordagem músculo-esquelética»
For centuries headaches have troubled mankind. It is known that since 3000 B.C. drastic measures were adopted to alleviate a headache. They penetrated the bony skeleton to free the evildemons who were responsible to cause the “untreatable headache symptom”. Later in 400 B.C. Hippocrates described the combination of visual disturbances, headache and nausea. 200 years later Galenus named this combination of symptoms “HEMICRANIA”.
In 1934 Costen, ENT specialist, described a combination of signs and symptoms connected with the pathological Temporomandibular Joints. Later, the Costen Syndrome became the most important concept of dysfunction of the Masticatory system related to facial Pain.
Although Costen in 1934, mentioned headaches as the most prevalent symptoms in he ́s article. Many others as Berlin et al, were the first ones to mention the close relation between Craniomandibular disorders and Headaches. Later many studies confirmed this association. These studies demonstrated the incidence of Craniomandibular disorders in headache patients and showed an alleviation of headaches after treatment of the musculoskeletal system of the Temporomandibular joints,occlusion and related structures. Later in 1982 Lous and leson and Forssel in 1985 , were the first ones to consider the neurologic diagnosis of the headaches in studies on the prevalence of CMD., in general headache patients.
Back in 1984 - 1987 Rocabado showed that 65.1 % of the pediatric population being treated for Orthodontics purpose, were headache symptomatic conditions, and showed the most important finding a loss of the physiological curvature of the spine with a straight or an inverted spine. This might be the reason why such large percentage of young pediatric population between the ages of 8 to 12 years present loss of cervical lordosis and are symptomatic. The beginning of a multifactorial condition for common headache patients that is not a problem of age. Later Rocabado showed that degeneration of the spine in symptomatic patients was as high as 68 % in patients that had loss of the physiological curvature of the spine with abnormal craniocervical relation.
At present is well recognized the influence of abnormal musculoskeletal relation of the head neck and the shoulder girdle as common finding in Headache patients. 372 patients were diagnosed as having Tension Type Headaches (TTH), and compared with 225 control subjects. The lagest percentage showed a loss of the cervical lordosis with sustained flexor muscle contraction that interfered with the loss of the physiological curvature. Mainly the Longi Colli, Hyoid musculature, Anterior and medius scaleni and the SCM muscle. Low set shoulder with hyperactivity of the neck flexors, exert a posterior rotation of the craniocervical region with increased activity of the suboccpital musculature, the passive occipital loading is one of the mayor pathophysiologic causes of the suboocipital and hemicranial typeheadaches.
In a radiographic study of the craniocervical relation in patients between 8 and 12 years of age, under orthodontic treatment, has demonstrated that 65.1 % are already symptomatic. The joint and or muscular pathology is not a problem of age, degenerative process can be present at any age, without pain, usually undiagnosed. The major pathological findings are related to abnormal relation between Occiput, Atlas and Axis with loss of Craniovertebral Centric Relation. This biomechanical abnormal relation can induce an abnormal pattern of growth and development of the Occlusal plane and Facial Assymetry.
There is a neurological link between the upper cervical nerves and the sensory fibers of the trigeminal nerve which receives nociceptive information from the face and other pain sensitive structures in the head. as the upper three cervical nerves enter the dorsal columns, via the dorsal root ganglion, their fibers synapse with the descending fibers of the spinal trigeminal nucleus which descends within the spinal cord caudally to the level of C3.