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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5184_Библиотеки_им_академика_М_И_Перельмана.pdf
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is hoped that this compilation will facilitate ongoing progress in areas of TMJ
craniofacial pain and TMJ-related movement disorders. With the addition of
online videos, readers will be able to see signicant clinical demonstrations
of TMJ therapeutics and its impact upon patients aficted with movement
disorders.
Springeld, IL, USA BrendanC.Stack Jr.
Preface
Acknowledgments
Brendan C.Stack, Sr., DDS, MS (1937–2020) (Fig.1), was an orthodontist
whose ve decades of work helped clinicians better care for patients suffering from chronic craniofacial pain. Dr. Stack was expert at diagnosing the
causes of chronic face and head pain and used orthodontic techniques,
many of which he developed, to relieve pain, suffering, and associated
symptoms.
Dr. Stack was born in NewYork, NY, to Eugene Francis Stack, Sr. (an
attorney), and Catherine Loretta Curran (a high school teacher), secondgeneration Irish immigrants, and was raised in Great Neck (Long Island), NY
(Figs.2, 3 and 4). He graduated from St. Francis Xavier High School, a Jesuit
Military School, in Manhattan, NY (Fig.5). He continued his Jesuit education when he matriculated to Georgetown University in Washington, DC,
where he obtained his bachelors and doctor of dental surgery degrees in 1958
and 1962, respectively (Fig.6). While awaiting a place in an orthodontic resi-
dency, Dr. Stack served as a second lieutenant in the U.S.Public Health
Service as a hospital dentist at the U.S. Public Health Hospital of New
Orleans, LA.Upon completion of his intern year, he returned to Georgetown
where he completed his residency and master’s degree in orthodontics in
1965. He then set up several private practices in the Northern Virginia suburbs of Washington, DC.
Dr. Stack started to develop an interest in temporomandibular joint (TMJ)
dysfunction in the late 1960s, before dysfunction in the joint had been widely
recognized as a clinical entity, complication of previous orthodontic treatment, or a source for headaches, facial pain, imbalance, and gait disturbance
among many other symptoms. In my father’s own words from My journey
from orthodontics to craniofacial pain and TMJ to movement disorders, “by
1967, I had begun to treat temporomandibular joint (TMJ) patients. A young
man approximately 12 or 13 years old suffering with chronic headaches,
repeated absences from school, clicking and locking of his jaw joints, and a
myriad of typical TM joint symptoms came to my ofce. This was my rst
TMJ case and its successful treatment whetted my appetite for these types of
patients, which continues to the present day.” Dr. Stack explored his thoughts
and impressions with many contemporary colleagues and advanced his and
their knowledge. Such prominent pioneers in this eld with whom he collaborated included Drs. Harold Gelb (1925–2022), Lawrence A. Funt
(1925–2017), Bruce H. Kinnie (1932–2013), William Farrar (1927–1985),
Jack Martini, and Jack L.Haden (1922–2022) among many others.
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Fig. 1 Brendan C.Stack, Sr., pictured circa 1980s. (Courtesy of the Stack family trust)
Acknowledgments
Fig. 2 Brendan C.Stack, Sr., pictured circa 1939. (Courtesy of the Stack family trust)
As a result of these early observations, he was a co-developer of the F–S
(Funt–Stack) index and later the K–F–S (Kinnie–Funt–Stack) index of TMJ
symptoms, which became standard diagnostic instruments (Fig. 7). This,
combined with the care of thousands of patients, led Dr. Stack to lecture
widely about his approaches and techniques for TMD-focused therapy.
Consequently, he developed followings of like-minded colleagues in the
United States, Europe, and Japan. Patients came from throughout the United
States and abroad to be treated by Dr. Stack.
Acknowledgments
xxix
Fig. 3 Brendan C.Stack, Sr. (second from the left), with his siblings and neighbors circa
1940. (Courtesy of the Stack family trust)
Fig. 4 The Eugene and “Loretta” Stack family children pictured circa 1940. The Stack
siblings, seated left to right, Lorene Ann, Brendan Sr., and Eugene Francis, Jr. (Courtesy of
the Stack family trust)
Over the years, Dr. Stack noticed that many facial pain patients had facial
tics such as eye blinking, eyelid tics, mouth tics, head nodding, shoulder
shrugging, and head tremors. Quoting my father, “I was asked to give a presentation on TMJ problems in children for a dental organization. This was at
a time in the development of TMJ thinking where it was thought that TMJ
was a middle-aged person’s disease and that there was no such thing as TMJ
dysfunction in children. Terms like pediatric headaches had not yet been
used. In evenings subsequent to the request to give this presentation, I was
viewing the slides of … patients whom I had treated, looking for children
with TMJ problems. While perusing approximately 400 cases, I noticed in
the records and photography that a high percentage of the patients had move-
xxx
Acknowledgments
Fig. 5 Brendan C. Stack, Sr., as a cadet at the St. Francis Xavier Jesuit High School,
NewYork, NY. (Courtesy of the Stack family trust)
ment disorders, either too much movement or too little movement … All I
knew then was the generic term, movement disorders, and that by the end of
my treatment most of these were totally gone … one young woman in particular stands out; she was a newly married 27-year-old who had just bought
her rst house. She had stated that she and her new husband made the mistake of buying a townhouse because she had to crawl up and down the stairs
on her hands and knees and wished that she had bought a one level house …
while I did not pay attention to it initially, I noticed … at the end of treatment
she could go up and down the stairs normally. This was in addition to having
eliminated her facial pain and her limited and deviated mouth opening.”
“As the years went by, I continued to treat craniofacial pain and TMJ
disorders with little thought to movement disorders. My underlying treatment philosophy evolved into the fact that many, but not all, movement disorder patients had an underlying internal derangement of the
temporomandibular joints … which had not yet resulted in (typical) internal
derangement of the TMJs but had resulted in an abnormal maxillomandibular relationship. It was this internal derangement or malrelationship that
caused the movement disorders. I continued to treat patients with this philosophy with great success.”
Acknowledgments
xxxi
Fig. 6 Brendan C.Stack, Sr., as a student at Georgetown University, Washington, DC,
1954–1962. (Courtesy of the Stack family trust)
“What I accomplish with my appliances is the repositioning of the mandible into a new and different maxillomandibular relationship, decompressing the auriculotemporal nerve, and eliminating noxious input through the
5th cranial nerve into the central nervous system. To accelerate the patient’s
response, I frequently combine the use of these appliances with a very deep
penetrating soft-tissue Lumix 2 (USA Laser Biotech, Inc., Richmond, VA).”
Dr. Stack considered tic patients as TMJ patients for their pain but also
noticed tics dissipating at the same time. When word started spreading
throughout the movement disorder patient community, Tourette’s patients
started coming to his practice. He was very successful in improving their
symptoms and quality of life, and these techniques were accepted by some of
his colleagues (Fig.8).
The positive reception of Dr. Stack’s presentations resulted in many continuing education lecture courses and the self-publication of many books and
video presentations (http://www.orthodontic.ca/education/cemeetings/vid-
eos/stackofknowledge.pdf). He also had over 30 peer-reviewed articles pub-
lished in the scientic literature, a signicant amount for a private practitioner.
Dr. Stack was responsible for mentoring, consulting, and training many TMJfocused practitioners across the country. According to my father, “In January
2010, I was invited to be the keynote speaker at the National Meeting of the
Parkinson’s Research Association in Palm Springs, California. As a result of
their referrals, I successfully treated a Parkinson’s patient who was previously unsuccessfully treated with an implanted brain stimulator. All the foregoing led to my treatment of cervical torticollis and other types of movement
disorders. My premise has always been the same: that the internal derangement and/or the resulting abnormal maxillomandibular relationship is the
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Acknowledgments
Fig. 7 The K–F–S temporomandibular joint visual index. See Appendix
Fig. 8 Anthony B. Sims, DDS, ABCFP, IMD, DHS, close friend and student of Dr. Stack,
pictured with him at a dental seminar event
Acknowledgments
xxxiii
underlying cause of the motor component of movement disorders. I do not
think the treatment I stumbled upon treats anything other than the motor component of movement disorders. I leave the evaluation of various changes to
the central nervous system (CNS) to others who are smarter than I.”
“I have been on a journey. I had no idea where I would arrive when I
started practicing in 1967. I also had no idea that along with treating TMJ and
craniofacial pain patients, I would also treat patients with movement disorders. It’s been a long journey, but one lled with learning and the personal
satisfaction of having made a difference in the lives of my patients.”
Dr. Stack was a co-founder and inaugural president (1985–1990) of the
American Academy of Craniofacial Pain (www.aacfp.org), which was estab-
lished to educate and certify practitioners that treat craniofacial pain. Later,
the Jack L.Haden-Brendan C.Stack, Sr. (Haden-Stack), Award was established to recognize excellence among members of the AACP (Fig.9). At the
1994 meeting of the AACP, Dr. Stack, Sr., invited his son, Brendan C.Stack,
Jr., MD, to speak on mass lesions of the head and neck which could mimic
TMD symptoms (Fig.10). Dr. Stack was named “Clinician of the Year” in
1988 by the American Association of Functional Orthodontists (Fig.11). He
was the Tufts University’s (Boston) 2003 recipient of the “Lifetime
Achievement Award” for his years of contribution to the eld of craniofacial
pain. Dr. Stack’s last practice was in Vienna, VA, where he had been located
since 1980 (Fig.12).
Fig. 9 Drs. Haden (left) and Stack (right) at the awarding of the Haden-Stack award to Dr.
Allen J.Moses (center) at an annual AACP meeting
Fig. 10 Brendan C.Stack, Sr., pictured with his son Brendan C.Stack, Jr., (left) at the
1994 ACFP annual meeting, Arlington, VA. (Courtesy of the Stack family trust)
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Upon his passing (Figs. 13 and 14), Dr. Stack left behind his children
Brendan C. Stack, Jr., MD (Springeld, IL, and Roland, AR), Jennifer
L. Wheeler (Phoenix, AZ), Maureen K. Stack (Medford, OR), Valerie
A.Waite (North Salt Lake City, UT), Alexander J.Stack (Daly City, CA),
Matthew A.Stack (Pasadena, MD), and Diana L.Milani (Highlands Ranch,
CO) and 22 grandchildren.
Acknowledgments
Fig. 11 Cover of the Functional Orthodontist, January/February 1989 issue
Fig. 12 Brendan C.Stack, Sr., at work in his ofce, Vienna, VA. (Courtesy of the Stack
family trust)
Acknowledgments
xxxv
Fig. 13 Brendan C. Stack, Sr., on the occasion of his 80th birthday with his children,
February 1, 2017, Tyson’s Corners, VA.Pictured (L to R): Alexander J. “Alex” Stack, Matthew A.Stack, Maureen K.Stack, Diana L.Milani, Brendan C.Stack, Sr. (center), Jennifer
L.Wheeler, Cynthia L.Stack (daughter-in-law), Brendan C.Stack, Jr., and Valerie A.Waite.
(Courtesy of the Stack family trust)
Fig. 14 Grave marker of Brendan C. Stack, Sr., St. Jerome’s Cemetery, Holyoke, MA,
where he was interred with his father, mother, and elder brother. (Courtesy of the Stack
family trust)
References
Stack BC.Dr. Brendan C.Stack: an interview with the 1988 AAFO Man of
the Year. Interview by Craig Stoner. Funct Orthod. 1989;6(1):6–7, 9–19.
Stack BC.Journal of functional orthodontics interviews Dr. Brendan Stack
on TMJ. Interview by Dr. Jimi Mehta. Funct Orthod. 1990;7(5):20–1,
24–5.