An adult case of TMJ osteoarthrosis treated with splint therapy and the subsequent orthodontic occlusal reconstruction: Adaptive change of the condyle during the treatment

Tanaka, Eiji; Kikuchi, Kazuaki; Sasaki, Akira; Tanne, Kazuo

doi:10.1067/mod.2000.93966

Cited by 34 publications

(29 citation statements)

References 8 publications

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“…13,14 However, Tanaka et al 15 reported that splint therapy together with an orthodontic approach might be able to induce adaptive change of the condyle in an adult patient with severe osteoarthrosis of the TMJ accompanied by an anterior open bite. Although repositioning of the disc was not achieved, the reason for such adaptive responses of the eroded condyle was attributed to the achievement of a stable occlusion, reestablishment of uniform joint spaces (antero-superior), and elimination of excessive or unbalanced stress on the condyle that may have reduced TMJ loading because of an optimum condylar position.…”

Section: Discussionmentioning

confidence: 99%

The Temporomandibular Joint in a Rheumatoid Arthritis Patient after Orthodontic Treatment

Sasaguri

Ishizaki-Takeuchi

Kuramae

et al. 2009

The Angle Orthodontist

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A 32-year-old Japanese female patient consulted the authors' dental clinic with a 4.5-year history of rheumatoid arthritis (RA). She complained of pain during mouth opening and difficulty in eating due to masticatory dysfunction caused by an anterior open bite. Imaging showed severe erosion and flattening of both condyles. RA stabilized after pharmacological therapy and became inactive during the orthodontic therapy aimed at reconstructing an optimal occlusion capable of promoting functional repositioning of the mandible. At present, 4 years and 2 months postretention, the reconstructed occlusion remains stable, and both condyles continue to be remodeled. The distance from reference position to intercuspal position has gradually decreased throughout the 4-year posttreatment and postretention periods. Orthodontic therapy that comprehensively reconstructs occlusion and enhances the functioning of the mandible can induce remodeling of eroded condyles, even those with a history of rheumatoid arthritis.

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Section: Discussionmentioning

confidence: 99%

The Temporomandibular Joint in a Rheumatoid Arthritis Patient after Orthodontic Treatment

Sasaguri

Ishizaki-Takeuchi

Kuramae

et al. 2009

The Angle Orthodontist

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“…Although TMJ-OA often has an unpredictable course, optimal condylar position and stable occlusion can achieve biomechanical equilibrium in the TMJ, and this may inhibit progression of TMJ-OA, and occasionally lead to functional and adaptive remodeling of the condyles through resorption repair. 20 In the current case, there was no recurrence of TMJ symptoms during the orthodontic treatment. Al-http://dx.doi.org/10.4041/kjod.2012.42.2.144 though anterior disc displacement without reduction and condylar resorption and deformity persisted after treatment, all symptoms of TMJ disease disappeared, and long-term stability of both the occlusal and symptomatic states was obtained.…”

Section: Resultsmentioning

confidence: 76%

Management of acquired open bite associated with temporomandibular joint osteoarthritis using miniscrew anchorage

et al. 2012

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This article reports the orthodontic treatment of a patient with skeletal mandibular retrusion and an anterior open bite due to temporomandibular joint osteoarthritis (TMJ-OA) using miniscrew anchorage. A 46-year-old woman had a Class II malocclusion with a retropositioned mandible. Her overjet and overbite were 7.0 mm and -1.6 mm, respectively. She had limited mouth opening, TMJ sounds, and pain. Condylar resorption was observed in both TMJs. Her TMJ pain was reduced by splint therapy, and then orthodontic treatment was initiated. Titanium miniscrews were placed at the posterior maxilla to intrude the molars. After 2 years and 7 months of orthodontic treatment, an acceptable occlusion was achieved without any recurrence of TMJ symptoms. The retropositioned mandible was considerably improved, and the lips showed less tension upon lip closure. The maxillary molars were intruded by 1.5 mm, and the mandible was subsequently rotated counterclockwise. Magnetic resonance imaging of both condyles after treatment showed avascular necrosis-like structures. During a 2-year retention period, an acceptable occlusion was maintained without recurrence of the open bite. In conclusion, correction of open bite and clockwiserotated mandible through molar intrusion using titanium miniscrews is effective for the management of TMJ-OA with jaw deformity.

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“…Orthodontic treatment is another approach for managing such cases. Tanaka et al (23) reported that splint therapy together with an orthodontic treatment might be able to induce adaptive change of the condyle in an adult patient with severe osteoarthrosis of the TMJ accompanied by an anterior open bite. Sato et al (11) also demonstrated that occlusal reconstruction using a prosthetic approach might be of considerable value for inducing the desirable remodeling of the condylar heads.…”

Section: Discussionmentioning

confidence: 99%

PROSTHODONTIC TREATMENT OF A PATIENT WITH RHEUMATOID ARTHRITIS WITH SEVERE CONDYLAR RESORPTION: 4-YEAR FOLLOW-UP-Aşırı Kondiler Rezorpsiyonu Olan Romatoid Artritli Bir Hastanın Protetik Tedavisi: 4 Yıllık Takip

Balık¹,

Ocak-Çimendur²,

Karataş³

et al. 2014

J Istanbul Univ Fac Dent

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In this study, dental management and 4 years follow up of a 45 years old patient with a 6 years medical history of rheumatoid arthritis with limited mouth opening and masticatory muscles tenderness was evaluated. The clinical examination revealed an anterior open bite thought to be a result of condylar resorption due to TMJ involved rheumatoid arthritis. In this case prosthodontic management was planned to be the treatment choice rather than advanced TMJ surgical rehabilitation. Prosthodontic management was decided according to clinical, radiographic examinations and patient's demands were considered. The prosthodontic management optimized the inter-occlusal relationship to maintain both functional and esthetic integrity. As a result the traumatic effect to the TMJ was reduced and 4 years follow up reveals that condylar resorption remained stable and no open bite occurred. Keywords: TMJ, rheumatoid arthritis, condylar resorption ÖZBu yazıda 6 yıllık romatoid artrit tedavisi sonrası ağız açıklığında kısıtlılık, çiğneme kaslarında ağrı, yemek yeme ve çiğneme problemleri ile kliniğimize gelen 45 yaşındaki bir hastanın dental tedavileri ve 4 yıllık takibi sunulmuştur. Klinik muayenede, romatoid artritin TME tutulumu nedeniyle oluşan kondiler rezorpsiyona bağlı ön açık kapanış gözlenmiştir. Bu vakada ileri TME cerrahisi yerine alternative olarak protetik tedavi planlandı. Yapılan klinik, radyolojik incelemeler ile hastanın istek ve beklentileri değerlendirilerek protetik tedavi planlanmıştır. Protetik tedavi ile uygun çeneler arası kapanış sağlanarak hastanın çiğneme fonksiyonu ve estetik görünümü düzeltilmiştir. Sonuç olarak TME'e gelen travmatik etki azaltılmış ve hastanın 4 yıllık takibinde ön açık kapanışın tekrar oluşmadığı ve kondiler rezorpsiyonun durduğu gözlenmiştir.

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An adult case of TMJ osteoarthrosis treated with splint therapy and the subsequent orthodontic occlusal reconstruction: Adaptive change of the condyle during the treatment

Cited by 34 publications

References 8 publications

The Temporomandibular Joint in a Rheumatoid Arthritis Patient after Orthodontic Treatment

The Temporomandibular Joint in a Rheumatoid Arthritis Patient after Orthodontic Treatment

Management of acquired open bite associated with temporomandibular joint osteoarthritis using miniscrew anchorage

PROSTHODONTIC TREATMENT OF A PATIENT WITH RHEUMATOID ARTHRITIS WITH SEVERE CONDYLAR RESORPTION: 4-YEAR FOLLOW-UP-Aşırı Kondiler Rezorpsiyonu Olan Romatoid Artritli Bir Hastanın Protetik Tedavisi: 4 Yıllık Takip

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