Dr. Joseph Da Cruz has spent many years of research, refining and collaborating to develop an innovative Mandibular Growth Device that integrates Splint, Orthopaedic, and Myofunctional Appliance (SOMA) therapy into one phase of treatment. The SOMA uses a multifaceted approach to treating TMJ pain and dysfunction, growth and development, sleep, neck issues and much more.

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) into a stable comfortable position to also provide immediate relief of Temporo-Mandibular Dysfunction (TMD) in a lot of cases, but more difficult cases need time & follow up. A thorough investigation is needed in the beginning. There are primary, secondary and tertiary cases where primary are the easiest and
tertiary is the most difficult. Due consideration is always taken.

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 is a common problem found in standard fixed and removable dental appliances. The issue with standard appliances are that they 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 SOMA creates sufficient retention without jamming the cranial sutures. 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 is when cranial release occurs. 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 orthopaedic 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, orthopaedic 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. The occlusal balance is also a critical part of the SOMA methodology.

Dr. Joseph Da Cruz credits Dr. John Diamond (https://drjohndiamond.com) for his assistance in designing the SOMA appliance and sharing knowledge on kinesiology and osteopathy.

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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, orthopaedic, 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.
For a prefect cosmetic result, aligners can be use in the final phase of treatment.

The Soma Appliance supports forward positioning of the lower jaw by gently guiding it into a more optimal, forward-focused relationship with the airway. This slight advancement helps widen the upper airway, reducing obstruction and allowing air to move more freely during sleep. As the jaw shifts into a healthier position, patients often experience improved breathing, reduced snoring, and better overall airflow. The appliance is custom-fitted to each patient to ensure the forward positioning is both effective and comfortable, supporting better function without unnecessary strain.

The Soma Appliance helps decompress the palatal sutures by applying gentle, controlled forces that encourage natural widening and improved mobility of the palate. This decompression reduces structural tension, supports better nasal airflow, and creates more space for proper tongue posture. By relieving pressure in this area, the appliance can enhance overall craniofacial balance and contribute to improved breathing, comfort, and long-term oral function.

The Soma Appliance helps improve overall facial structure by gently guiding the jaws and palate into better alignment. As the jaw moves into a healthier position and the airway opens up, many patients notice a more balanced and natural facial profile. This improved alignment also makes orthodontic treatment easier and more effective, giving the teeth the room they need to move into place properly. The result is a healthier bite, a more comfortable smile, and a more supported facial appearance.

The Soma Appliance supports gentle cranial expansion by helping the jaw and palate move into a more natural, open position. As tension in these areas is reduced, the upper neck—specifically the atlas and axis—can settle into a healthier alignment. This can ease strain, improve posture, and support better overall comfort. The result is a more balanced foundation for breathing, movement, and long-term oral health.