Cervical Revolution

An Integrated Approach to the Treatment of Patterned Cervical Pathomechanics

Choose

Course Format

Prior attendance of Postural Respiration is required. *Dentists may attend without prior attendance of Postural Respiration.

This advanced lecture and lab course places emphasis on the role the cervical spine plays in the management of cranial function and position. Intercervical, atlanto, occipital, and cranial assessment will help the clinician appreciate occiput, sphenoid and temporal orientation and thus how to proceed in determining what PRI manual or non-manual techniques should be considered. Airway alignment, diaphragmatic demand and arthrokinematic correlations will be discussed, as they relate to the left sidebending and right torsion physiologic cranial positions. Specific repatterning techniques will be offered for these two cranial positions of the Right Temporal Mandibular Cervical Chain (TMCC) pattern. Information will be provided on when and how to engage with a dentist regarding oral appliance intervention and fabrication. Participants will be able to immediately apply non-manual techniques to enhance normal functional cervical lordosis, active rotation and freedom for vestibular frontal plane integration.

Prior attendance of Postural Respiration is required. *Dentists may attend without prior attendance of Postural Respiration.

Educational Level: Advanced
Live Course Student Faculty Ratio 16:1

Instructional Methods: Lecture, demonstration &, clinical application, case discussion, and Q&A

Live Stream courses will take place from 8am-5pm CT each day, and certificates of completion/CE credit will be awarded the following week after completion of the course evaluation survey and short post-test. For more information on whether your state/organization is approved for CE approval, please click on the “Accreditation” tab below. Live Stream courses will be engaging, interactive and include demonstration of objective testing and/or non-manual techniques, in addition to course attendees being able to ask questions throughout the course. All that’s needed on your end is reliable internet access, a webcam, microphone and speaker (or a smart phone can be used if you do not have a computer or laptop with this capability). The course manual will be shipped directly to you 1-2 weeks before the course. *International registrants will receive access to a digital version of the course manual. In addition, participants will receive access to the recording of the live stream course for 14 days to review the material, and re-watch any material that may have been missed due to connection issues. Those who attend in-person during a live streamed course will also receive access to the recording for 14 days. Extensions beyond this 14 day review are not available. ***Please note: In order to receive access to the recording for review, you must participate in person on the Live Stream course with your camera on for at least half of the course (8 hours). If you sign up for the course and do not participate in at least 8 hours of the live stream, you will not receive the recording and you will not be refunded. Also, once course manuals have been shipped (or emailed to international attendees), there will be no refunds for cancellations.***

Recognize and evaluate contributing muscular impact on torsion and compression of cervicothoracic, craniocervical, and craniomandibular joints.
Distinguish when to refer to a dentist for an oral appliance to assist in maintaining cervical neutrality and neurologic stabilization of the cervical spine and cranium through the use of opposition muscle of the Right TMCC.
Establish an understanding of sphenoid occipital-basilar (SB) and basilar sphenoid (BS) biomechanical influence on temporal and cervical-thoracic function.
Identify the difference between a cranium that is in bilateral extension versus a cranium that is in a right temporal internal rotated position (R TMCC pattern) and design a treatment program using PRI techniques and dentistry if needed.

Day One

7:30am – 8:00am	Registration and Light Breakfast
8:00am – 9:30am	Overview of the Cervical-Cranial Complex and Related Evolutionary Concepts
9:30am – 10:00am	Neurovascular Implications of Cervical Restriction
10:00am – 10:15am	Break
10:15am – 10:45am	Normal Cervical Tri-Planar Passive Motion
10:45am – 11:15am	Normal Intracervical Spinal Coupling Considerations
11:15am – 12:00pm	Occipital Atlanto (Cranio-Cervical) Joint Function
12:00pm – 1:00pm	Lunch (on your own)
1:00 – 3:00pm	Cervical Examination Overview and Reasoning (Demonstration and Lab)
3:00 – 3:15pm	Break
3:15pm – 5:00pm	Occipital Influences on Temporal Position and the Temporal Mandibular Cervical Chain (TMCC)

Day Two

7:45am – 8:00am	Sign-In and Light Breakfast
8:00am – 10:00am	Cranial Left Sidebending (SB) Physiologic Position
10:00am – 10:15am	Break
10:15am – 11:00am	Left SB Non-Manual Technique Standing Cervical-Cranial Respositioning (Demonstration and Lab)
11:00am-12:00pm	Overview of Supportive Left SB Non-Manual Techniques
12:00pm – 1:00pm	Lunch (on your own)
1:00pm – 2:00pm	Cranial Right Torsion Physiologic Position
2:00pm – 3:00pm	Right Torsion Non-Manual Technique Standing Alternating Reciprocal Cranail Expansion (Demonstration and Lab)
3:00pm – 3:15pm	Break
3:15pm – 4:00pm	Occlusion as Related to Cervical Neutrality, Airway Alignment and Cranial Balance
4:00pm – 4:30pm	PRI Recommended Proprioceptive Occlusal Orthotics
4:30pm – 5:00pm	Overview of Supportive Right Torsion Non-Manual Techniques

Temporal Bone

Gehin A. Cranial osteopathic biomechanics, pathomechanics and diagnostics for practitioners. Chruchill Livingston Elsevier 2007, Paris.
Magoun HI. Osteopathy in the cranial field, 3^rd edition. Northwest printing, Inc. 1976, Boise.
Sills F. Craniosacral biodynamics. North Atlantic Books 2001, California.
Sutherland WG. The cranial bowl, 1^st edition reprinted 1994. Free Press Company, Mankato.
Upledger J. Craniosacral therapy II: beyond the dura. Eastland Press, Inc 1987, Washington.

Sphenobasilar Articulation

Cook A. The mechanics of cranial motion – the sphenobasilar synchondrosis (SBS) revisited. Journal of Bodywork and Movement Therapies (2005) 9, 177-188.
Lee M, Elster A. Suture closure in the human chondrocranium: CT assessment. Radiology 1995; 196:747-756.
Magoun HI. Does the gross mechanical picture stop at the occipito-atlantal articulation? Academy of Applied Osteopathy Yearbook 1949, 145-6.
Melsen B. Time and mode of closure of the spheno-occipital synchondrosis determined on human autopsy material. Acta anat. 83:112-118 (1972). Dept. of Orthodontics and Oral Pathology, The Royal Dental College, Aarhus, Denmark.
Okamoto K, Ito J, Tokiguchi S, Furusawa T. High-resolution CT findings in the development of the sphenooccipital synchondrosis. Am Journal Neuroradiology (AJNR) 17:117-120, January 1996. Peer Reviewed Literature. Compendium of Sacro Occipital Technique. Eastland Press 2001, Washington.
Richter P, Hebgen E. Trigger points and muscle chains in osteopathy. Chapter 4. Thieme Publishing Group 2009, New York.
Sahni D et al. Time of fusion of the basisphenoid with the basilar part of the occipital bone in northwest Indian subjects. Forensic Science International, 98 (1998) 41-45.
Sills F. Craniosacral biodynamics. Volume Two. North Atlantic Books 2004, Berkley, California
Sumner G, Haines S. Cranial intelligence: A practical guide to biodynamic craniosacral therapy. Singing Dragon 2010, Philadelphia, PA.

TMD Related To Muscle, Myokinematics & Movement

Andreassen S, Rosenfalck A. Recording from a single motor unit during strong effort. IEEE Trans Biomed Eng 1978;25:501-508.
Andreassen S, Rosenfalck A. Regulation of the firing pattern of single motor units. J Neurol Neurosurg Psychiatry 1980;43:897-906.
Buchthal F, Guld C, Rosenfalck P. Action potential parameters in normal human muscle and their dependence on physical variables. Acta Physiol Scand 1954;32:200-218.
Carlson CR, Bertrand PM, Ehrlich AD, Maxwell AW, Burton RG. Physical Self-Regulation Training for the Management of Temporomandibular Disorders. J Orofac Pain 2001;15:47-55.
Carlson CR, Bertrand PM. Self-Regulation Training Manual. Lexington, KY, 1995.
Carlsoo S. An electromyographic study of the activity and an anatomic analysis of the mechanism of the lateral pterygoid muscle. Acta Anat (Basel) 1956;26:339-351.
GT. A diagnosis and treatment algorithm for common TM disorders. J Jpn Prosthodont Soc 1996;40:1029-1043.
Darlow LA, Pesco J, Greenberg MS. The relationship of posture to myofasacial pain dysfunction syndrome. J AmDent Assoc 1987;114:73-75.
Derfler B, Goldberg LJ. Spike train characteristics of single motor units in the human masseter muscle. Exp Neurol 1978;61:592-608.
Dubner R, Sessle BJ, Storey AT. The Neural Basis of Oral and Facial Function. New York: Plenum Press, 1978.
Dworkin SF, Turner JA, Wilson L, Massoth D, Whitney C, Huggins KH, et al. Brief group cognitive-behavioral intervention for temporomandibular disorders. Pain 1994;59:175-187.
Frymann V. The core link and the three diaphragms. AAO Yearbook, 68:13, 1968.
English AW. Limbs vs jaws: Can they be compared? Am Zool 1985;25:351-363.
Enoka RM. Morphological features and activation patterns of motor units. J Clin Neurophysiol 1995;12:538-559.
Eriksson P-O, Eriksson A, Ringqvist M, Thornell L-E. Special histochemical muscle-fibre characteristics of the human lateral pterygoid muscle. Arch Oral Biol 1981;26:495-507.
Feinmann C. The long-term outcome of facial pain treatment. J. Psychosom Res 1993;37:381-387.
Ferrario VF, Sforza C, Dellavia C & Tartaglia GM.Evidence of an influence of asymmetrical occlusal interferences on the activity of the sternocleidomastoid muscle.Journal of Oral Rehabilitation 2003; 30:34-40.
Gonzalez H, Manns A. Forward head posture: Its structural and functional influence on the stomatognathic system, a conceptual study.J of craniomandibular practice. Jan 1996, Vol 14(1):71-80.
Goodheart GJ. Kinesiology and dentistry. J Am Soc Prev Dent 1976;6:16-18.
Green JR, Moore CA, Higashikawa M, Steve RW. The physiologic development of speech motor control: Lip and jaw coordination. J Speech Lang Hear Res 2000;43:239-255.
Greene CS. Focus article: The etiology of temporomandibular disorders: Implications for treatment. J Orofac Pain 2001;15:93-105.
Greene CS. An evaluation of unconventional methods of diagnosing and treating temporomandibular disorders. Oral Maxillofac Surg Clin North Am 1995;7:167-173.
Greene CS. A critique of nonconventional treatment concepts and procedures for temporomandibular disorders.In: Laskin DM, et al (eds). President’s Conference on Examination, Diagnosis, and Management of Temporomandibular Disorders. Chicago: American Dental Assoc, 1983;177-181.
Grossi D, Chaves T. Physiotherapeutic treatment for temporomandibular disorders (TMD). Braz J Oral Sci. Jul/September 2004, Vol 3(10):492-497.
Hackney J, Bade D, Clawson A.Relationship between forward head posture and diagnosed internal derangement of the temporomandibular joint.J Orofac Pain 1993;7:386-390.
Hannam AG, McMillan AS. Internal organization in the human jaw muscles. Crit Rev Oral Biol Med 1994;5:55-89.
Haraguchi S, Iguchi Y, Takada K. Asymmetry of the face in orthodontic patients. Angle Orthodontist. 2008, Vol 78(3):421-426.
Harrison A et al. A proposed diagnostic classification of patients with temporomandibular disorders: Implications for physical therapists. JOSPT. March 2014; 44(3):182-197.
Hattori Y, Watanabe M, Sasaki K, Kikuchi M. Motor unit behaviour in three-dimensional in human masseter [abstract]. J Dent Res 1991;70:553.
Herring S. Critical commentary1. The role of the human lateral pterygoid muscle in the control of horizontal jaw movements. J Orofac Pain 2001;15:292-295.
Hiraba K, Hibino K, Hiranuma K, Negroro T. EMG activities of two heads of the human lateral pterygoid muscle in relation to mandibular condyle movement and biting force. J Neurophysiol 2000;83:2130-2137.
Hruska RJ. Management of pelvic-thoracic influences on temporomandibular dysfunction. Orthopedic Physical Therapy Clinics of North America. June 2002; 11 (2): 263-284.
Koolstra JH, van Eijden TMGJ. Dynamics of the human masticatory muscles during jaw open-close movement. J Biomech 1997;30:883-889.
Kraus S. TMJ disorders – Management of the craniomandibular complex. Chruchill Livingstone 1988.
Leeuw R. Orofacial pain: guidelines for assessment, diagnosis and management, 4^th edition. Quintessence Publishing Co, Inc 2008, Illinois.
Lewin GR, Rueff A, Mendell LM. Peripheral and central mechanisms of NGF-induced hyperalgesia. Eur J Neurosci 1994;6:1903-1912.
Lund P, Nishiyama T, Moller E. Postural activity in the muscles of mastication with the subject upright, inclined and supine. Scand J Dent Res 1970;78:414-424.
Mannheimer JS, Rosenthal RM. Acute and chronic postural abnormalities as related to craniofacial pain and temporomandibular disorders. Dent Clin North Am 1991; 35:185-208.
McMillan AS. Critical commentary 2: The role of the human lateral pterygoid muscle in the control of horizontal jaw movements. J Orofac Pain 2001;15:295-298.
McMillan AS. Task-related behaviour of motor units in the human temporalis muscle. Exp Brain Res 1993 ;94:336-342.
Mense S. Nociception from skeletal muscle in relation to clinical muscle pain. Pain 1993;54:241-289.
Miller AJ. Craniomandibular Muscles: Their Role in Function and Form. Boca Raton: CRC Press, 1991.
Moller E. Critical commentary 3: The role of the human lateral pterygoid muscle in the control of horizontal jaw movements. J Orofac Pain 2001;15:298-303.
Moller E. Human muscle patterns. In Sessle BJ. Hannam AG (eds). Mastication and Swallowing: Biological and Clinical Correlelates. Toronto: Toronto Unversity Press; 1976:138-144.
Moller E. The chewing apparatus. An electomyographic study of the action of the muscles of mastication and its correlation to facial morphology. Acta Physiol Scand 1966;69(suppl 280):1-229.
Murray GM, Phanachet I, Klineberg IJ. Electromyographic evidence for functional heterogeneity in the inferior head of the human lateral pterygoid muscle: A preliminary multi-unit study. Clin Neurophysiol 1999;110:944-950.
Murray GM et al. The human lateral pterygoid muscle: A review of some experimental aspects and possible clinical revelance. Aust Dent J. 2004 Mar; 49(1):2-8.
Murray GM, Phanachet I, Uchida S, Whittle T. Focus article: The role of the human lateral pterygoid muscle in the control of horizontal jaw movements. J Orofac Pain 2001;15:279-292.
Piekartz H, Bryden L. Craniofacial dysfunction and pain. Reed Educational and Professional Publishing, LTD 2001, Massachusetts.
Piekartz H. Craniofacial pain: neuromusculoskeletal assessment, treatment and management. Butterworth Heinemann Elsevier 2007.
Proschel P. An extensive classification of chewing patterns in the frontal plane. Cranio 1987;5:55-63.
Rocabado M, Tapia V. Radiographic study of the craniocervical relation in patients under orthodontic treatment and the incidence of related symptoms. Cranio1987;5:36-42.
Sakaguchi K, Mehta N, Abdallah E, Gorgione A, Hirayama H, Kawasaki T, Yokoyama A. Examination of the relationship between mandibular position and body posture. Journal of Craniomandibular practice; Oct 2007 Vol 25 (4) 237-249.
Sessle BJ. The neural basis of temporomandibular joint and masticatory muscle pain. J Orofac Pain 1999;13:238-245.
Sohrabi R, Miranda RC, Toran-Allerand CD. Estrogen differentially regulates estrogen and nerve growth factor receptors in RNA’s in adult sensory neurons. J Neurosci 1994;14:459-471.
Stohler CS. Muscle-related temporomandibular disorders. J Orofac Pain 1999;13:273-284.
Turk DC, Rudy TE, Kubinski JA, Zaki HS, Greco CM. Dysfunctional patients with temporomandibular disorders: Evaluating the efficacy of a tailored treatment protocol. J Consult Clin Psychol 1996;64:139-146.
Urbanowicz, M. Alteration of vertical dimension and its effect on head and neck posture. The Journal of Craniomandibular Practice 1991;9:174-179.
Valentino B & Melito F.Functional relationships between the muscles of mastication and the muscles of the leg.Sug Radiol Anat 1991.Vol 13: 33-37.
Weijs WA. Evolutionary approach of masticatory motor patterns in mammals. In: Bels VL, Chadron M, Vandewalle P (eds). Biomech of Feeding in Vertebrates. Berlin: Springer-Verlag, 1994: 281-320.
Widmalm SE, Lillie JH, Ash Jr MM. Anatomical and electromyographic studies of the lateral pterygoid muscle. J Oral Rehabil 1987;14:429-446.
Windhorst U, Hamm TM, Sturart DG. On the function of muscle and reflex partitioning. Behav Brain Sci 1989;12:629-681.
Wood WW, Takada K, Hannam AG. The electromyographic activity of the inferior part of the human lateral pterygoid muscle during clenching and chewing. Arch Oral Biol 1986;31:245-253.

Occlusion and Appliances

Amat P. Occlusion, orthodontics and posture: are there evidences? The example of scoliosis. J Stomat. Occ. Med. 2009; 2:2-10.
Carlson J. Physiologic occlusion. Midwest Access 2005, Minnesota.
Moeller D et al. Use of removable mandibular neuroprosthesis for reduction of posttraumatic stress discorder (PTSD) and mild traumatic brain injury-associated nightmares, headaches, and sleep disorders. J of Special Operations Medicine. 2014; Vol 14: 64-73.
Motta LJ, et al. Temporomandibular dysfunction and cervical posture and occlusion in adolescents. Braz J Oral Sci. 2012;11(3):401-405.
Okeson J. Orofacial pain: guidelines for assessment, diagnosis, and management. Quintessence Publishing Co, Inc 1996, Illinois.
Rothbart B. Malocclusions linked to abnormal foot motion. Positive Health. October 2008, Vol 151.
Rothbart, B. Malocclusion Driven by the Feet. Positive Health. September 2008; Vol 151.
Rothbart B. Prescriptive proprioception insoles and dental orthotics change the frontal plane position of the atlas (C1), mastoid, molar, temporal, and spenoid bones: A preliminary study. J of Craniomandibular and Sleep Practice. 2013; 31:1-9.

Cranial Therapy and Dentistry

Chaitow L.Cranial manipulation theory and practice, 2^nd edition. Elsevier Churchill Livingstone 2005.
Delz E. The ALF (advanced lightwire functional appliance) creating facial beauty and balance.International Journal of Orthodontics Summer 2009; Vol 20(2):23-28.
James G, Strokon D. Cranial strains and malocclusion. International Journal of Orthodontics 2006. Vol 17 (1-3). * To obtain copies of all updated articles written by James and Strokon printed in the International Journal of Orthodontics, contact (800) 447-8770.

Respiration and Airway

Agrawal A, Chaturvedi TP, et al. Oropharyngeal airway: The orthodontist perspective. International Journal or Orthodontics. Fall 2016;27(3):51-56.
Bartley J. Breathing and temporomandibular joint disease. Journal of Bodywork & Movement Therapies (2011) 15, 291-297.
Bordoni B et al. The influence of breathing on the central nervous system. Cureus. 2018;10(6): e2724. DOI 10.7759/cureus.2724
Chaves T, Grossi D, Oliveira A, Bertolli F, Holtz A, Costa D. Correlation between signs of temporomandibular (TMD) and cervical spine (CSD) disorders in asthmatic children. Journal of Clinical Pediatric Dentistry. 2005; Vol 29(4):287-292.
Correa E, Berzin F. Temporomandibular disorder and dysfunctional breathing. Braz J Oral Sci, Jul/September 2004; Vol 3(10):498-502.
Grossi D, Chaves T. Physiotherapeutic treatment for temporomandibular disorders (TMD). Braz J Oral Sci. July/September 2004; Vol 3(10):492-497.
Hruska RJ. Influences of dysfunctional respiratory mechanics on orofacial pain. Dent Clin N Am 41:211-27, 1997.
Puranik D, Bhat SR. Spatial changes in upper airway induced by change in head postures in horizontal, average and vertical growth pattern: A comparative lateral cephalometric study. Indian Journal of Orthodontics and Dentofacial Research. 2018;4(4):208-215.
Yeampattanaport O, Mekhora K et al. Immediate effects of breathing re-education on respiratory function and range of motion in chronic neck pain. J Med Assoc Thai. 2014 Jul; 97(7):S55-59.

Vision Relationships

Cuccia AM, Caradonna C. Binocular motility system and temporomandibular joint internal derangement: A study in adults. American Journal of Orthodontics and Dentofacial Orthopedics. May 2008;133(5):640e.15-640.e20
Marchili N, Ortu E. Dental occlusion and ophthalmology: A literature review. Open Dent J. 2016;10:460-468.
Milani RS, de Periere DD, Micallef JP. Relationship between dental, occlusion and visual focusing. J Craniomandib Pract. 1998;16:109-18.
Monaco A, Streni O, et al. Relationship between mandibular deviation and ocular convergence. J Clin Pediatr Dent. 2004;28(2):135-138.
Ohlendorf D, Desoi D, et al. An evaluation of horizontal jaw relations during standing and sitting with open or closed eyes. Journal of Craniomandibular Practice. July 2012;30(3):201-208.
Pradham NS, White GE, et al. Mandibular deviations in TMD and non-TMD groups related to eye dominance and head posture. J Clin Pediatr Dent. 2001;25(2):147-155.

TMD and Neuroreceptors

Yin C, Lee Y, Lee Y. Neurological influences of the temporomandibular joint. J of Bodywork and Movement Therapies.Vol 11: 285-294.
Cuccia A, Caradonna C. The relationship between the stomatognathic system and body posture.Clinics 2009:64(1):61-6.
Harrison A, Thorp J et al. A proposed diagnostic classification of patients with temporomandibular disorders: Implications for physical therapists. JOSPT. 2014; 44(3):182-197.
Gomez FM, Giralt MT, et al. A possible attenuation of stress induced increase in striatal dopamine metabolism by the expression of non-functional masticatory activity in the rat. Eur. J. Oral Sci. 1999; 107(6): 461-467.

Cervical Spinal Posture & Cervical Pain

Baiao da Neiva M, et al. Posture alterations related to temporomandibular joint dysfunction. Journal of Dentistry and Oral Hygiene. 2012;4(1):1-5.
Daffin L, et al. The effect of cervical spine subtypes on center of pressure parameters in a large asymptomatic young adult population. Gait & Posture. 2019;6:112-116.
Dareh-deh HR, et al. Therapeutic routine with respiratory exercises improved posture, muscle activity, and respiratory pattern of patients with neck pain: a randomized controlled trial. Nature Scientific Reports. 2022;12:4149.
Farmer PK, et al. An investigation of cervical spinal posture in cervicogenic headache. Physical Therapy. 2015; 95(2): 212-222.
Khayatzadeh S, Kalmanson OA, et al. Cervical spine muscle-tendon unit length differences between neutral and forward head postures: Biomechanical study using human cadaveric specimens. Physical Therapy. July 2017; 97(7):756-766.
Kranenburg HA, Tyer R, et al. Effects of head and neck positions on blood flow in the vertebral, internal carotid, and intracranial arteries: A systematic review. JOSPT. October 2019; 49(10):688-697.
Lippa L et al. Loss of cervical lordosis: What is the prognosis? J Craniovertebr Junction Spine. 2017; 8(1):9‐14.
McAviney J, et al. Determining the relationship between cervical lordosis and neck complaints. Journal of Manipulative and Physiological Therapeutics. 2005; 28:187-93.
Neumann D. Kinesiology of the musculoskeletal system, Foundation for rehabilitation. 2^nd Ed. Mosby Elsevier, 2010.
Ozbek MM, Koklu A. Natural cervical inclination and craniofacial structure. American Journal of Orthodontics and Dentofacial Orthopedics. December 1993; 104(6):584-591.
Pandamsee M. Incidence of cervical disorders in a TMD population. J Dent Res IADR; Abstract No. 680, 1994.
Ries LGK, Berzin F. Analysis of the postural stability in individuals with or without signs and symptoms of temporomandibular disorder. Braz Oral Res. 2008; 22(4):378-83.
Testa M, Geri T, et al. Alternations in masticatory muscle activation in people with persistent neck pain despite the absence of orofacial pain or temporomandibular disorders. Journal of Oral & Facial Pain and Headache. 2015; 29(4):340-48.
Upledger J. Craniosacral therapy. Volume Two. Eastland Press, 1987.

Cranial Strain Pattern Prevalence

Hafezi F, Javdani A et al. Laterality and left-sidedness in the nose, face and body: A new finding. Plast Reconstr Surg Glob Open 2017;5:e1590.
Monaco A, Sgolastra F, et al. Prevalence of myopia in a population with malocclusions. European Journal of Paediatric Dentistry. 2012; 13(3):256-258.
Piancino MG, Dalmasso P et al. Thoracic-lumbar-sacral spine sagittal alignment and cranio-mandibular morphology in adolescents. Journal of Electromyography and Kinesiology. 2019;48:169-175.
Timoshkin E, Sandhouse M. Retrospective study of cranial strain pattern prevalence in a health population. JAOA. 2008; 108(11): 652-656.

Occlusion and Posture

Carlson JE. Physiologic Occlusion. Midwest Presses, 2005. Alexandria, Minnesota.
Cuccia AM, Caradonna C. The relationship between the stomatognathic system and body posture. Clinics. 2009 Jan;64(1):61-66.
Fonder A. The dental physician. University Publications, 1977. Blacksburg, Virginia.
Glastier J. Temperomandibular dysfunction and systemic distress. International dentistry – African Edition. Vol 2, No. 1.
Grondin F, Hall T, et al. Does altered mandibular position and dental occlusion influence upper cervical movement: A cross-sectional study in asymptomatic people. Musculoskeletal Science and Practice. 2017; 27:85-90.
Ionita C, et al. Methods of postural analysis in connection with the stomatognathic system. A systematic review. Journal of Medicine and Life. April 2023;16(4):507-514.
Julia-Sanchez S, et al. Dental occlusion influences the standing balance on an unstable platform. Motor Control. 2015;19(4):341.
Julia-Sanchez S, et al. The influence of dental occlusion on the body balance in unstable platform increases after high intensity exercise. Neuroscience Letters. 2016;617.
Karasawa K, Takeda T, et al. Effects of experimental horizontal mandibular deviation on stepping test of equilibrium function. J Nov Physiother. 2014; 4(1):192.
Kibana Y, Ishijima T, et al. Occlusal support and head posture. J Oral Rehabil. 2002 Jan;29(1)58-63.
Michelotti A, Buonocore G, et al. Dental occlusion and posture: An overview. Prog Orthod. 2011;12(1):53-58.
Pruneda JFM. Dental malocclusion and its relationship with body posture: A new research challenge in stomatology. Bol Med Hosp Infant Mex 2013;70(5):341-343.
Yoshino G, Higashi K, et al. Changes in weight distribution at the feet due to occlusal supporting zone loss during clenching. Cranio. 2003 Oct;21(4):271-278.

Gnathologic Orthopedics and Facial Orthotropics

Bronson JM, Bronson JA. Early treatment with the ALF functional appliance. IJO. 2014;25(1):11-14.
Bronson JM, Bronson JA, et al. Introducing the advanced light force (ALF) appliance. Oral Health. Mar 2015:10-17.
Hang WM. Case Report: Unconventional treatment for patient with serious pain pattern. The Journal of Gnathologic Orthopedics and Facial Orthotropics. Mar 2017:5-11.
Hoefs M. Case Report: Facial asymmetry associated with a tempormandibular disorder. The Journal of Gnathologic Orthopedics and Facial Orthotropics. Dec 2015:5-11.
Jefferson Y. Skeletal types: Key to unraveling the mystery of facial beauty and its biologic significance – update 2017. International Journal of Orthodontics. Summer 2017; 28(2):19-35.
Paison TA. Case Report: Preventative dental facial orthopedics in 5 year olds. The Journal of Gnathologic Orthopedics and Facial Orthotropics. Mar 2017:15-20.

Occlusion and Mastication

Azuma K, Zhou Q et al. Association between mastication, the hippocampus, and the HPA axis: A comprehensive review. Int. J. Mol. Sci. 2017; 18:1687.
Gomez FM, Giralt MT, et al. A possible attenuation of stress-induced increases in striatal dopamine metabolism by the expression of non-functional masticatory activity in the rat. European Journal of Oral Sciences. Dec 1999; 107(6):461-467.
Gomez FM, Ortega JE et al. Relationship between non-functional masticatory activity and central dopamine in stressed rats. Journal of Oral Rehabilitation. Nov 2010; 37(11):827-833.
Kubo K, Ichihashi Y et al. Masticatory function and cognitive function. Okajimas Folias Anat. Jpn. Nov 2010; 87(3):135-140.
Kubo K, Iinuma M et al. Mastication as a stress-coping behavior. Hindawi Publishing Corporation BioMed Research International. Volume 2015, Article ID 876409, 11 pages.
Ohkubo C, Morokuma M et al. Interactions between occlusion and human brain function activities. Journal of Oral Rehabilitation. 2013; 40:119-129.
Ono Y, Yamamoto T et al. Occlusion and brain function: Mastication as a prevention of cognitive dysfunction. Journal of Oral Rehabilitation. 2010; 37:624-640.
Turp JC, Greene CS et al. Dental occlusion: A critical reflection on past, present, and future concepts. Journal of Oral Rehabilitation. 2008; 35:446-453.

Anterior Interior Chain (AIC)
Muscles: Diaphragm, Psoas, Iliacus, TFL, Vastus Lateralis, Biceps Femoris
Opposition Muscles: Hamstrings, Gluteals, Internal Obliques
There are two anterior interior polyarticular muscular chains in the body that have a significant influence on respiration, rotation of the trunk, ribcage, spine and lower extremities. They are composed of muscles that attach to the costal cartilage and bone of rib 7 through twelve to the lateral patella, head of the fibula and lateral condyle of the tibia. These two tracts of muscles, one on the left side of the interior thoraco-abdominal-pelvic cavity and one on the right, are composed of the diaphragm and the psoas muscle. With the iliacus, tensor fasciae latae, biceps femoris and vastus lateralis muscles this chain provides the support and anchor for abdominal counter force, trunk rotation and flexion movement.

Brachial Chain (BC)
Muscles: Anterior-Lateral Intercostals, Deltoid-Pectoral, Sibson’s Fascia, Triangularis Sterni, Sternocleidomastoid, Scaleni, Diaphragm
Opposition Muscles: Triceps, Lower Trapezius, Abdominal Obliques
There are two brachial polyarticular muscular chains lying over the anterior pleural and cervical area. These chains influence cervical rotation, shoulder dynamics and apical inspirational expansion. They are composed of muscle that attaches to the costal cartilages and bone of ribs 4 through 7 and xiphoid to the posterior, inferior occipital bone, anterior, inferior mandible and coracoid process of scapula. These two tracks of muscles, one on the left side of the sternum and one on the right, are anterior to the medial and upper mediastinum and upper thoracic cavity and are composed of the triangular sterni, sternocleidomastoid, scalene, pectoralis minor, intercostals and muscles of the pharynx and anterior neck. They provide the support and anchor for cervical-cranial orientation and rotation and rib position. The right brachial chain muscle is opposed by the right posterior back muscles (PEC), lower trap, serratus anterior, and external rib rotators, in addition to the left internal abdominal obliques. The brachial chain muscle on the left is opposed by the left posterior back muscles (PEC), lower trap, serratus anterior, external rib rotators, and right internal abdominal obliques.

Temporomandibular Cervical Chain (TMCC)
Muscles: Temporalis (ant. fiber), Masseter, Medial Pterygoid, Rectus Capitis Posterior Major, Obliquus Capitis, Rectus Capitis Anterior, Longus Capitis, Longus Colli
Opposition Muscles: Levator Scapula, Lower Trapezius, Anterior Cranial Cervical Muscle (Rectus Capitis Anterior, Rectus Capitis Lateralis, Logus Capitis, Stylohyoid, Styloglossus, Stylopharyngeus), Mandibular Cervical Muscle (Glossus, Digastrics), Lateral Pterygoids

Posterior Exterior Chain (PEC)
Muscles: Latissimus Dorsum, Quadratus Lumborum, Posterior Intercostals, Serratus Posterior, Iliocostalis Lumborum
Opposition Muscles: Abdominal Obliques

Licensed Physical Therapists and PT Assistants

Licensed Occupational Therapists and OT Assistants

Licensed Chiropractors

Certified Athletic Trainers

Dentists and Dental Assistants

Certified Strength & Conditioning Coaches

Certified Personal Trainers

Licensed Massage Therapists

Other Healthcare and Fitness Professionals
PRI welcomes any licensed healthcare or certified fitness professional to attend our courses. You may be asked to submit your license to practice as a healthcare professional or qualified fitness or strength coach certification (though an organization that is recognized in the United States) to attend PRI courses. Students studying to become a healthcare or fitness professional at an accredited university are encouraged to enroll, and may be asked to provide enrollment status and program/degree information. If you have questions about whether you are eligible to complete PRI courses, please contact us. Attendees are responsible for following their state statutes regulating their professional practice. A certificate will be awarded to attendees upon completion of this course or any of the other PRI courses.

International Attendees

Due to known copyright infringement and illegal pirating and distribution of PRI course material in locations across Asia, we are no longer allowing course attendance for PRI home study and live stream courses from several countries in Asia.

Accessible Learning Environments
All participants in Postural Restoration Institute™ (PRI) continuing education courses are entitled to an accessible, accommodating, and supportive teaching and learning environment. Participants have the right to request accommodations and the responsibility to provide disability documentation that supports those requests. PRI has the right to establish eligibility guidelines in accordance with both law and policy regarding disability and provide those accommodations that appropriately provide equal access to the programs and activities it sponsors.

A Certificate of Completion for 15 contact hours is awarded to attendees upon the successful completion of this course. Before attending a course, please verify CEU acceptance with your profession’s regulating body.

Physical Therapists and PT Assistants

In the states where PRI is sponsoring courses and where approval through state American Physical Therapy Association (APTA) or licensing agencies is required, PRI will apply for approval for CEUs for Physical Therapists and Physical Therapist Assistants.

The following states accept other state approval and thus would honor this course as an approved course: Alabama, Arizona, Colorado, Connecticut, Washington DC, Delaware, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Maine, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington, Wyoming.
Approved by the New York State Education Department, Office of the Professions. Approval valid February 18, 2022 – February 17, 2025.
Approved by the Texas Board of Physical Therapy Examiners for 15.00 CCUs for PTs and PTAs. Approval valid February 24, 2023 – February 24, 2025. Approval #76903TX.
Approved by the California Physical Therapy Association for 1.5 CEUs. Approval valid February 23, 2024 – February 23, 2025. CPTA #23-626.*Approval valid only for courses offered in the state of California & Live Streams. If you attend this course outside the state of California, you will need to submit an individual CEU approval application with the CPTA.
Approved by the Illinois Physical Therapy Association for 15 CE Hours.Course Approval #205-9094. Approval valid January 1, 2024 – January 1, 2025.

Chiropractors

In the states where PRI is sponsoring courses and where approval through state licensing agencies is required, PRI will look into applying for CEUs for Chiropractors (upon request). Requests must be made at least 90 days prior to the course date.

Approved by the Minnesota Board of Chiropractic Examiners for 15 regular units of instruction for 2024 course dates.
Approved by the New York State Education Department, Office of the Professions. Approval valid February 18, 2022 – February 17, 2025.

Athletic Trainers

Postural Restoration Institute (BOC AP# P2376) is approved by the Board of Certification, Inc. to provide continuing education to Certified Athletic Trainers. This program is eligible for a maximum of 15 Category A hours/CEUs. ATs should claim only those hours actually spent in the educational program.

Strength and Conditioning Coaches

Since continuing education courses are not required to have pre-approval through the National Strength and Conditioning Association (NSCA), this course is not currently approved through the NSCA. NSCA certificants interested in completing this course may contact the NSCA to inquire about CEU eligibility.

Massage Therapists

PRI is approved by the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) as a continuing education Approved Provider. Provider number 451877-12. *Approval applies to select live courses only. This live course is approved. **Approval not valid for New York licensed massage therapists.

Other Healthcare and Fitness Professionals
PRI welcomes any licensed healthcare or certified fitness professional to attend our courses. You may be asked to submit your license to practice as a healthcare professional or qualified fitness or strength coach certification (though an organization that is recognized in the United States) to attend PRI courses. Students studying to become a healthcare or fitness professional at an accredited universtity are encouraged to enroll, and may be asked to provide enrollment status and program/degree information. If you have questions about whether you are eligible to complete PRI courses, please contact us. Attendees are responsible for following their state statutes regulating their professional practice. A certificate will be awarded to attendees upon completion of this course or any of the other PRI courses.

PRI reserves the right to cancel and refund a course attendee’s registration if any concerns arise regarding the course attendee’s qualifications as a healthcare or fitness professional, copyright infringement, or any other illegal activity involving PRI copyrighted materials. International attendees may be required to review and sign a Copyright and Intellectual Property Recognition and Disclosure Contract prior to receiving access to course materials.

Physical Therapists and PT Assistants

The following states accept other state approval and thus would honor this course as an approved course: Alabama, Arizona, Colorado, Connecticut, Washington DC, Delaware, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Maine, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington, Wyoming.
Approved by the New York State Education Department, Office of the Professions. Approval valid February 18, 2022 – February 17, 2025.
Approved by the Texas Board of Physical Therapy Examiners for 15.00 CCUs for PTs and PTAs. Approval valid February 24, 2023 – February 24, 2025. Approval #76903TX.
Approved by the California Physical Therapy Association for 1.5 CEUs. Approval valid February 23, 2024 – February 23, 2025. CPTA #23-626.*Approval valid only for courses offered in the state of California & Live Streams. If you attend this course outside the state of California, you will need to submit an individual CEU approval application with the CPTA.
Approved by the Illinois Physical Therapy Association for 15 CE Hours.Course Approval #205-9094. Approval valid January 1, 2024 – January 1, 2025.
Approved by the Minnesota Board of Physical Therapy for 15 hours. Course Approval #9651. Approval valid January 1, 2024 – December 31, 2024. *Approved for live stream courses only.

Chiropractors

Approved by the Minnesota Board of Chiropractic Examiners for 15 regular units of instruction for 2024 course dates.
Approved by the New York State Education Department, Office of the Professions. Approval valid February 18, 2022 – February 17, 2025.

Athletic Trainers

Postural Restoration Institute (BOC AP# P2376) is approved by the Board of Certification, Inc. to provide continuing education to Certified Athletic Trainers. This program is eligible for a maximum of 15 Category A hours/CEUs. ATs should claim only those hours actually spent in the educational program.

Strength and Conditioning Coaches

Since continuing education courses are not required to have pre-approval through the National Strength and Conditioning Association (NSCA), this course is not currently approved through the NSCA. NSCA certificants interested in completing this course may contact the NSCA to inquire about CEU eligibility.

Massage Therapists

PRI is approved by the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) as a continuing education Approved Provider. Provider number 451877-12. *Approval applies to select live courses only. This live course is approved. **Approval not valid for New York licensed massage therapists.

Other Healthcare and Fitness Professionals
PRI welcomes any licensed healthcare or certified fitness professional to attend our courses. You may be asked to submit your license to practice as a healthcare professional or qualified fitness or strength coach certification (though an organization that is recognized in the United States) to attend PRI courses. Students studying to become a healthcare or fitness professional at an accredited universtity are encouraged to enroll, and may be asked to provide enrollment status and program/degree information. If you have questions about whether you are eligible to complete PRI courses, please contact us. Attendees are responsible for following their state statutes regulating their professional practice. A certificate will be awarded to attendees upon completion of this course or any of the other PRI courses.

I just finished treating a patient with a cranial expansion technique that I learned from Louise in the Cervical Revolution live stream last month. My patient could not believe that the pain in the right top of her head (when she bends over) has gone away. I was so pleased with this result! Louise did a great job explaining the cranium and relationships of bones to each other. I am so very grateful for the 2 weeks review period when participating on live streams. It is super helpful. I also was rather surprised about so many connections with my patient caseload, and the topics that were covered in the class. Several patients have talked about teeth, dizziness and even ear pain. I noticed some ear asymmetries and different heights in eyes. I now know better what to do with those patients! It opened up a new world for me, with noticing all of the connections that I did not know prior to the Cervical Revolution class. | Live Stream, February 2024
Skip’s manner and style is very easy to follow, making complex topics more digestible and accessible. He knew it was the first time attending Cervical Revolution for a few of us and so did a great job ensuring that we came away with a good understanding of the fundamentals of the subject matter. | New York, NY, October 2023
Skip was great, he really explains in depth and encourages conversation throughout a smaller course. I loved how he taught this class. | New York, NY, October 2023
First time taking a course from Louise and I loved it! She is very clear and organized. | Live Stream, September 2023
Louise Kelley DPT, PRC has a wonderful presentation style. She covers all the information by speaking not too fast and not too slow. She is excellent at repetition. She is humble and inquisitive and patient. She is a teacher who knows what the participants needs to learn. She is focused and keeps to the task at hand. | Live Stream, September 2023
Louise Kelley was absolutely fantastic. Very knowledgeable about the material, teaches the material in a very non-judgmental and able way, and was very effective at teaching the theoretical components as well as the techniques taught in the class. She’s a great asset to the PRI faculty. | Virginia Beach, VA, May 2023
Louise was an amazing instructor, she did an excellent job with the material and helped me understand things I didn’t not understand my first time taking the course. | Virginia Beach, VA, May 2023
Louise provides excellent instruction that is clear and easy to follow. |Live Stream, February 2023
So thankful for Louise’s input – she broke things down a bit more for me to understand. She came back to basics and repeated basic concepts in different ways which helped me understand. |Live Stream, February 2023
Skip is a very enthusiastic speaker and engages with the participants very well. |Live Stream, February 2023
Fantastic course, Skip is an excellent instructor. | Wellesley, MA, October 2022
Skip did a great job making complex material easy to understand. I really liked Louise’s contributions as well. She is a very detailed, methodical thinker and presents her ideas clearly. | Live Stream, September 2022
The course really outlined the importance of a neck and cranium for the whole system of the human body, especially when the patient can’t achieve neutrality. | Munich, Germany, July 2022
Thank you! Always great to continue learning and love how all PRI courses intertwine in some way just like the human body! | Live Stream, January 2022
Skip did an amazing job with helping me understand the material and keeping it a little more simple to understand the main purpose of everything happening.| Live Stream, September 2021
I so appreciate Skip’s willingness to take on this challenging material that is still more challenging to make understandable to clinicians. I think he did a wonderful job presenting the R TMCC very clearly with associated L SB & R torsion lesions. I feel much more comfortable with head and neck mechanics. Thank you! | Chapel Hill, NC January 2020
Skip was excellent. He is very smart and relayed his knowledge very well. He encouraged questions, comments, & dialogue. The attendees had great questions and comments. He presented like he was our peer (as a mentor). Skip is excellent with helping us understand the subject. | Chapel Hill, NC January 2020
I like that you pause to let us think. You are so humble & approachable while still being the expert. That is tough to balance-nicely done. I also genuinely felt like you cared about what I had to say-Thank you! Also, thanks for facilitating the awesome discussion with experienced PRC’s-but making sure we didn’t get too far off track. | Chapel Hill, NC January 2020
We/I did miss Ron but appreciated Skip’s Presentation-was helpful for me. Interactive, engaging, encouraging questions, interactions, thoughtful & careful with considering intent of questions & trying to give the most helpful answer. | Chapel Hill, NC January 2020
I’ve been waiting for this course for 2 years. PRI is what I wish PT school was. Finding this discipline feels like the continuation for craniosacral therapy I learned 25 years ago. | Chapel Hill, NC January 2020
It was a special weekend getting the opportunity to witness Skip George teach this course for the first time in a manner of confidence and preparedness like he had taught this complex subject matter for years. Well done, Skip! | Seattle, WA October 2019
Skip is an awesome instructor. I’d really like to take more classes with him. | Seattle, WA October 2019
Skip has been the best instructor I have had and has made the material much more digestible. | Seattle, WA October 2019
My expectations were met, as always. These classes always answer questions that arise that I observe in clients. | Seattle, WA October 2019
As always, blows my mind. I love these courses! | New York, NY
The new photos of all of the patients were an awesome addition! | Anchorage, AK
Excellent. Missing piece of pulling it together. | Lincoln, NE
The cervical revolution course will radically change your view regarding the traditional static skull and static mandible concept that persists and dictates diagnosis and treatment planning in dentistry and orthodontics even to this date. Numerous clinical and scientific statements along with live exercises will let you feel through your skin that occlusion has far reaching influence in our body and that our body has equal degree of influence in our occlusion. Hands down I highly recommend this course to any new or seasoned dentist especially those interested in occlusion cranio-mandibular dysfunction and integrative occlusal medicine! | Coppell, TX September 2017
I enjoyed the course very much! I plan to integrate it with my manual work for TMJ, O/A and A/A and C-Spine and in the future with a dentist. | Coppell, TX September 2017
This course gives me a better rationale to the interrelationship of teeth to TMJ to muscles of the face and neck. I am leaving this course a better dentist than when I initially came here. I have a better perspective of the relationship of cervical physical therapy to occlusion as it relates to joint pathology and dysfunction of muscles. | Boston, MA July 2016
I wanted to understand more of the meat and potatoes of exercises I get from Torin – conjugate hemi-gait. For those who have taken the previous TMCC course, the updated course of Cervical Revolution is a MUST! I personally cannot treat certain patients without integrating PRI concepts and dentistry. | Lincoln, NE May 2016
I am so grateful I got to take this course from Ron. It was a privilege. | Lincoln, NE May 2016
Perhaps most influential PRI course since my first course ten years ago. | Lincoln, NE May 2016
Excellent course and instructor. | New York, NY September 2015
Thank you for making this course more discernible for clinical application to identify what we need to look for in the clinic to see what we can treat, how to treat it and when to refer to a dentist. | New York, NY September 2015
This course helped me clarify some points I was not sure of especially regarding some of the non-manual techniques. | New York, NY September 2015
Thank you for providing such comprehensive material, references, etc. I look forward to studying it all more. | Chapel Hill, NC March 2015
I had taken the previous course (Cervical-Cranial-Mandibular Restoration) 3 times. I feel this new Cervical Revolution course is a giant leap forward. This course put things together for me in a way that rivals, if not surpasses the Advanced Integration course! | Chapel Hill, NC March 2015
Loved the evolution of Cervical Revolution! | Chapel Hill, NC March 2015

Course

Schedule

Date	Location	Faculty	Register
Sep 13-14, 2024 (Fri-Sat)	Live Stream US	Robert "Skip" George	Tickets The numbers below include tickets for this event already in your cart. Clicking "Get Tickets" will allow you to edit any existing attendee information as well as change ticket quantities. Early Registration $ 605.00 97 available Quantity Quantity: 0 Total: $ 0.00

Course Registration

Registration is limited to ensure a low faculty to student ratio. Please register early. Courses will be canceled or rescheduled if fewer than 15 participants have registered by the early registration deadline of four weeks prior to the scheduled course date.

Special Needs Requests

If you have a disability and require accommodation in order to fully participate in this course, please contact us at least two weeks prior to the course date or prior to purchasing any online home study course so that arrangements can be made.

Course Completion

The course must be attended in full, and an online course evaluation summary and short post-test (with a passing score of 70% or higher) must be completed in order to receive a certificate of completion. Certificates of completion will be emailed after the online course evaluation summary and post-test have been completed If you arrive late, or leave early, your certificate of completion will be adjusted for the number of CE hours you were in attendance. *For live stream courses, if you have your camera turned off (or you are not visible on camera) at any time for greater than 15 minutes, this time will be deducted from your total hours on your certificate of completion.

Cancellation and Refund Policy

Tuition is refundable less $50 if cancelled 14 days before the course date. Tuition is not refundable for registrations or cancellations within 14 days of the course. However, you may have someone attend in your place or attend on another date. If you choose to attend on another date, a $50 fee applies to transfer your registration. If you are a no show and we have no communication with you before the course you will forfeit your course tuition. PRI reserves the right to cancel a course and will refund the tuition fee only. *Please note: For Live Stream Courses, once course manuals have been shipped (or emailed to international attendees), there will be no refunds for cancellations.