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To the editor.

Thank you for the opportunity to reply to Dr. Steve Broderson's letter in the last issue of the AAGO journal. We are happy that he found our articles informative. Dr. Broderson's points are well taken.

In comparing the hyperflexion and inferior vertical strains the distinction lies primarily in the anterior quadrants; one being externally rotated (hyperflexion) and the other internally rotated (I.V.S.). These distinctions predispose to recognizable characteristics in each group. We agree that variation can arise in any classification.

We acknowledge that postural factors play a role in our evaluation of patients. We rely on our colleagues in osteopathy and physical therapy for verification.

As regards the radiographic comment, we agree that superimposition of the articular eminences overlying the sphenoid is a reality. However, careful examination of the upper and lower borders of the occiput and sphenoid, especially in children where the S.B.S. is still visible, can show a change in curvature.

We acknowledge the work of Kernott which recognizes the effects of cranial strains in the mouth but on an empirical basis. Our application of the cranial concept extends beyond this viewpoint and offers a logical, inclusive and comprehensive basis for understanding the dental variations which Kernott identified.

Gavin James and Dennis Strokon
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Author:James, Gavin; Strokon, Dennis
Publication:American Academy of Gnathologic Orthopedics Journal
Date:Sep 1, 2006
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