Splint Orthodontic Myofunctional Appliance

At the Wholistic Dental Surgery, Dr. Joseph Da Cruz has spent many years of research, refining and collaborating to develop an innovative Mandibular Advancement Device (MAD) that integrates Splint, Orthodontic, and Myofunctional Appliance (SOMA) therapy into one phase of treatment. The SOMA, which is currently patent pending, uses a multifaceted approach to treating TMJ pain and dysfunction.

The SOMA treatment involves gentle expansion of bony structures in the upper palate without creating pain. This produces major improvements in facial patterns and straightens teeth, while pacifying the nervous system by dampening down the sympathetic overdrive. Through its design, the SOMA avoids fight-back of facial muscles produced by regular appliances, which in turn aids orthodontic correction with great efficiency. By reducing muscle fight-back, the SOMA can effectively decompress the Temporo-Mandibular Joint (TMJ) in a stable comfortable position to also provide immediate relief of Temporo-Mandibular Dysfunction (TMD). The benefits produced by the SOMA are far more than just orthodontic and facial. The SOMA has helped relieve different types of chronic pain, respiratory problems, TMD, neck/spine problems and immune system conditions. There is a hypothetical possibility that the pituitary gland and pituitary thyroid adrenal axis functions improve when the cranium is widened. In addition, the SOMA improves airway space, thus improving swallowing, speech, eating, breathing, and sleeping.

There are two common problems found in standard fixed and removable dental appliances. The first problem is that standard appliances lock the maxillary sutures and teeth. If the cranial sutures are jammed, they inhibit the Cranial Respiratory Impulse (CRI). The CRI is the continuous pulsation in the cranium whose strength is essential for optimum health. The second problem many standard appliances encounter is the use of metal across the mid-line of the palate. This is another major source of stress which affects the CRI.

The SOMA is able to avoid both of these problems due to its unique design. The SOMA creates sufficient retention without jamming the cranial sutures, while the metal, circular design does not stress the wearer. The SOMA prevents strain on the CRI and relaxes the muscles of mastication. When the muscles of mastication are relaxed, muscle fight-back does not occur around the bones of the face and jaw. This enables teeth to be orthodontically moved faster without relapsing. While of course it takes time to bring about bony changes, one of the most interesting aspects of the SOMA is that as soon as the brain perceives the correct realigning pressure, there is an immediate reduction in stress, sympathetic nervous system overactivity, an enhancement and balancing of the cranial respiratory impulse, opening of the nasal passages and relief of many muscle tensions.

The SOMA was initially developed for treating TMD, however, the TMD would not resolve satisfactory without also treating the malocclusion. An orthodontic approach was incorporated into the treatment process as a second component. Unfortunately this was not sufficient, a third component needed to be addressed, this was tongue positioning. Thus successful treatment could not be achieved unless proper stable jaw positioning was established with a sound cranial base. When these three components of treatment were addressed, that is TMD, orthodontics and a stable Jaw position (tongue position), the results were highly satisfactory in a short period of time. The SOMA address all three components of treatment to provide rapid, effective and stable TMD treatment. Consequently this approach produced beneficial side effects of reduced headaches, migraines, posture pain and sleep disordered breathing. This highly effective treatment is simple, intuitive and a stable treatment option for any dentist with a background knowledge in TMD.

Dr. Joseph Da Cruz credits Dr. John Diamond for his assistance in designing the SOMA appliance and sharing knowledge on kinesiology and osteopathy. Collaborative work between Dr. Joseph Da Cruz and Dr. John Diamond revealed that realignment of the cranial bones and forward positioning of the lower jaw are key factors that need to be addressed when dealing with the alignment of teeth. If the cranial structure and architecture are not corrected, then the superficial realignment will collapse.

By integrating splint therapy, orthodontics, and myofunctional treatment, the SOMA can help in the realignment process of the cranial base thus establishing a sound dental architecture from which teeth can be aligned and remain stable.

The SOMA is currently available through southern cross laboratories (www.scdlab.com) with agents in the following countries Australia, New Zealand, England, Hong Kong and the USA.


SOMA in Action

Let me give you an example of what the SOMA can accomplish. A case study ‘S’ revealed a patient who wore braces as a teenager to improve her smile unfortunately relapsed and the malocclusion (crooked teeth) reestablished itself after the braces were removed. The patient’s relapse occurred because her braces did not address the underlying problems of her Jaw position, breathing patterns, and orthopedic structure. This was accompanied by patterns of stress-related clenching and squeezing of facial muscles along with severe migraines, neck and back pain. Using SOMA treatment, the patient’s underlying problems were treated while her teeth were being orthodontically corrected. This method provided the patient with a stable, aligned smile and relief of her accompanied stressed-related symptoms. The following results were achieved in 1 1/2 years.





Within three months of wearing the SOMA, her lower jaw had moved forward and she was able to comfortably close her mouth and breathe through her nose (Jaw position can influence cases of sleep disordered breathing). As a result her palate widened, her teeth straightened (see photos), and her pain has totally disappeared. I sometimes describe this as unfolding of the face.

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"After 1 and a half years of treatment Mrs. S. now has been completely relieved of her migraines and TMJ problem and has a very beautiful smile."