Effect of chin-cup treatment on the temporomandibular joint: a systematic review

Abstract

Based on the available evidence, chin-cup therapy for Class III orthodontic anomaly seems to induce craniofacial adaptations. Nevertheless, there are insufficient or low-quality data in the orthodontic literature to allow the formulation of clear statements regarding the influence of chin-cup treatment on the temporomandibular joint.

Relationship between orthodontics and temporomandibular disorders

“…Moreover, the impacts of a Delairetype facemask or a modified Jasper Jumper (JJ) used in the treatment of children with Class III malocclusions, on the TMJ were investigated in a recent clinical research, but without the evidence of correlation 35 . In a recent literature review carried out by Zurfluh et al, assessing the effect of the use of the chin cup, does not cause nor prevent the occurrence of TMDs, although it appears to cause significant changes in craniofacial complex 36 . Also, Hakan El et al, comparing the use of the Delairetype facemask and the Grummons-type in the treating patients with Class III malocclusions, demonstrated an improvement between the position of the mandible in centric relation and maximum intercuspation, but these authors accentuate that the patients should be evaluated equally in both cases for the display of TMJ symptoms 37 .…”

The Effect of Chin-cup Therapy in Class III Malocclusion: A Systematic Review

“…The prevalence of Class III malocclusion presents a wide variety among and within populations [5, 6], as declared by a high 23% rate in Asian populations contrasted to a smaller 5% rate in Caucasians [1, 7]. Treatment of Class III malocclusion has been a challenge for orthodontists [1].…”

“…Among various treatment modalities, the chin-cup is considered a traditional appliance for the early orthopedic management of prognathic growing patients [2, 8-11]. Its clinical effectiveness has been investigated over the years with many studies confirming a general improvement of Class III malocclusion through backward and downward mandibular rotation, retardation of mandibular growth, remodeling of the mandible and the temporomandibular joint (TMJ), retroclination of mandibular incisors and closing of the gonial angle [1, 2, 7, 10, 11]. …”

“…Owing to the absence of a standard protocol concerning the chin-cup’s appropriate use and the contradicting results of the reported outcomes and outcomes measures, a clear interpretation of data is not possible [1, 2, 7,12]. Although a great number of studies focus on the skeletal and dento-alveolar changes [2, 7, 10-12], the effects of chin-cup therapy on facial soft tissues remain uninvestigated.…”

“…Owing to the absence of a standard protocol concerning the chin-cup’s appropriate use and the contradicting results of the reported outcomes and outcomes measures, a clear interpretation of data is not possible [1, 2, 7,12]. Although a great number of studies focus on the skeletal and dento-alveolar changes [2, 7, 10-12], the effects of chin-cup therapy on facial soft tissues remain uninvestigated. Furthermore, the vast majority of studies report outcomes of the chin-cup use obtained over a short-term period [2, 7, 10, 12], while there is a lack of studies examining the long-term effectiveness of chin-cup therapy.…”