For patients who received functional orthopaedic treatment for skeletal Class II correction with a fixed functional appliance, reduction to a physiological condyle-fossa relationship occurred bilaterally in the region of the joints. Our study suggests that the improved dental occlusion was not achieved at the price of a change to an unphysiological position in the temporomandibular joints.
Orthodontic treatment with a rigid, fixed functional appliance to correct skeletal distoclusion results in the following side effects on the disc-condyle relationship in the TMJ: the treatment does not have adverse effects on initially physiological disc-condyle relationships; in TMJs with initial partial or total anterior disc displacement, improved disc position can be achieved.
Functional jaw orthopedics for correction of skeletal Class II with the rigid fixed FMA leads to side-effects reflected in the disc-condyle relationship in the temporomandibular joints: no adverse effects were observed in joints presenting an initial physiological disc-condyle relationship, whereas the disc position may improve in joints with initial partial or total anterior disc displacement. In comparison with the baseline findings, we observed no post-treatment restriction in the extent of maximum mouth opening, protrusion, and left and right laterotrusion. Maximum active retrusion increased due to the treatment. MR imaging and MSA only partly cover the same aspects of temporomandibular joint diagnostics.
The technique of forced eruption accompanied by fibrotomy enabled the roots to be elongated by ca. 4 mm without apposition of alveolar bone. This permitted restoration with physiologic gingival conditions, eliminating the need for surgical crown lengthening with marginal ostectomy or tooth extraction.
Dental esthetics are often impaired by a disharmonious contour of the gingival margin in the anterior region. However, the soft tissue contour can be improved by orthodontic eruption of the relevant teeth prior to prosthodontic treatment. The successful use of an orthodontic microscrew implant as anchorage for the eruption appliance is demonstrated in a case report.
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