Given our findings of a pain-reducing effect in young patients undergoing orthodontic separation during the early mixed-dentition stage, LLLT is an interesting alternative option of providing analgesia even in very young patients.
Apparently, MRI scans of the TMJ are necessary in almost all potential orthognathic surgery patients to achieve optimal surgical results. Female Class II patients recruited the largest patient group among the studied collective. It is this group that deserves the greatest caution before and after surgery (TMJ pathologies!). In patients with jaw discrepancies, a TMJ examination should be made prior to surgery in order to be able to include the condition of the TMJs in the planning of treatment. This examination best includes Magnetic Resonance Imaging (MRI) and Manual Functional Analysis (MFA).
The present case report documents the hitherto unusual application of camouflage orthodontics in one of our patients. Our female patient had previously been treated orthodontically alio loco and had also undergone bimaxillary orthognathic surgery. She presented with TMJ complaints, with associated pains. Despite a dental Class I and centrally seated condyles, her discs had prolapsed anteriorly without reduction and she had developed a massive degenerative-inflammatory TMJ disease. Skeletally, she was a Class II case despite previous orthognathic surgery. In addition, there was also an initial suspicion of rheumatic involvement that could not be confirmed. We distalized the entire lower dental arch without bicuspid extraction. Then we advanced the mandible with the Mandibular Anterior Repositioning Appliance (MARA).We discuss exactly how the modified camouflage therapy was structured and how the individual treatment steps took place.
Numerous studies have been devoted to the causes of craniomandibular dysfunction (CMD). This investigation addressed the effect of class III malocclusion and crossbite on CMD based on a sample of 115 prepubertal and adolescent patients of both sexes. Although class III malocclusion only accounted for 12.2% of the total sample, thus, being the smallest group, the percentage of crossbite (71.4%) among these patients was disproportionately higher than among the other classes. Of the total sample, the prevalence of crossbite was 30.4%. We compared these findings to a large-scale (n=4727) study by Thilander et al. (2002), who reported a strikingly high percentage of class I patients compared to our findings (72.7% versus 27.8%) and a lower percentage of crossbite cases (8.0% versus 30.4%). In accordance with the "orthodontic risk child" concept by Grabowski et al. (2007) and Stahl et al. (2007), we conclude that class III malocclusion and crossbite are keys in the pathogenesis of CMD.
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