Orthodontic Treatment of TMD Patients with Posterior Intrusion Using TADs

Lee, Gye-Hyeong; Lee, Sang Mi; Yoo, Sun Kyong; Park, Jae Hyun

doi:10.1002/9781119513636.ch41

Cited by 3 publications

(6 citation statements)

References 11 publications

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“…It can be considered a strategic insertion site for palatal posterior miniscrew application. Some authors used this insertion site to obtain several orthopedic and orthodontic treatment effects such as skeletal palatal expansion [ 13 , 15 , 20 ], intrusion of maxillary posterior dental elements [ 18 , 19 , 21 , 22 ], and upper molar distalization [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it is located in the posterior part of the palate, and this aspect makes it suitable for the application of more effective posterior expansion forces [ 13 , 15 , 20 ], distalization forces [ 23 ], and intrusion forces for posterior maxillary dentition [ 18 , 19 , 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Literature showed that different authors published case reports using PPSAIS at different antero-posterior levels. Specifically, some authors placed TADs between the second premolar and the first molar [ 13 , 15 ]; others opted for placing TADs between the second molar and the first molar [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of bone depth, cortical bone, and mucosa thickness of palatal posterior supra-alveolar insertion site for miniscrew placement

et al. 2022

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Background The use of palatal miniscrew offers the possibility to improve the effectiveness of orthodontic expansion devices. Palatal expanders supported by miniscrew can be applied with different clinical protocols. Some authors proposed the use of four palatal miniscrews during miniscrew-supported palatal expansion to maximize skeletal effects in young adults’ treatment. However, bone availability decreases in the posterior paramedian palatal regions, making the positioning of the two-posterior paramedian palatal miniscrews challenging, when it is performed avoiding nasal cavities invasion. Some authors proposed miniscrews insertion in a specific region located laterally to the palatal process of the maxillary bone, and apically relatively to the dento-alveolar process. The aim of this study was to evaluate the bone thickness, cortical bone thickness, and mucosae depth of this anatomical site that, in this study, was defined as palatal posterior supra-alveolar insertion site. Results The evaluation of bone availability of palatal posterior supra-alveolar insertion site at different antero-posterior levels showed that the maximum amount of total bone thickness was found between the second premolar and the first molar. At this level total bone, thickness is significantly (p < .05) greater compared to the other sagittal sites and it offers on average around 2 mm of extra bone depth for miniscrew placement. Cortical bone thickness is adequate for primary miniscrew stability. Overall, cortical bone thickness considered at different insertion sites showed significant statistically (p < .05) differences. The findings of this study showed that palatal mucosa is particularly thick with average values ranging from 4 to 7 mm, and its extension ultimately affects miniscrew length selection. Palatal mucosa thickness showed no clinically significant differences comparing different sagittal and vertical insertion sites. Data also showed that palatal mucosal thickness slightly significantly increases (p < .05) with the inclination of the insertion axis relative to the occlusal plane. Finally, study findings showed that vertical growth pattern can significantly affect considered outcomes (p < .05). Conclusions Palatal posterior supra-alveolar insertion site is an appropriate site for posterior insertion of palatal miniscrews. Considering high anatomical variation preliminary CBCT evaluation is important to achieve optimal miniscrew placement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evaluation of bone depth, cortical bone, and mucosa thickness of palatal posterior supra-alveolar insertion site for miniscrew placement

et al. 2022

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“…Since stabilization splints are custom-fabricated to replicate functional occlusion patterns, they can effectively eliminate detrimental protective co-contractions during splint therapy, achieving a musculoskeletally stable TMJ condyle position. 11,[14][15][16][17] F I G U R E 1 0 Anteroposterior retractor with a nonparalleling force system was used in this case.…”

Section: Discussionmentioning

confidence: 99%

Digital application of three‐dimensional diagnosis and treatment with a virtual articulator

Lee,

Park,

Kim

et al. 2023

J Esthet Restor Dent

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ObjectiveThe purpose of this article was to introduce a method for the digital application of three‐dimensional (3D) diagnosis and treatment with a virtual articulator and 3D data.Clinical ConsiderationWith the use of cone‐beam computed tomography (CBCT) and intraoral and facial scans, we can create a virtual articulator and evaluate the mandibular position in maximum intercuspation and centric‐related occlusion for the patient with an unstable occlusion and temporomandibular disorders (TMD). Based on this, we treated a case using a digital mandibular position indicator (MPI) and fabricated a stabilization splint using a 3D printer. This approach eliminates the traditional impression or model mounting process and the analog face bow transfer. Furthermore, the design of the stabilization splint is accomplished using software.ConclusionsThe approach outlined in this article offers the potential for a digital diagnosis and treatment process by seamlessly integrating CBCT, intraoral scans, and facial scans with a high degree of accuracy. This may enhance precision in diagnosis and treatment planning, especially for patients with complicated TMD, in addition to facilitating effective communication with orthodontic patients who require thorough attention.Clinical SignificanceUtilizing a virtual articulator and digital MPI for the occlusal evaluation of patients with TMD and unstable occlusion makes it possible to diagnose and analyze the occlusal condition accurately. This approach also allows for precision and efficiency in treatment.

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“…Because stabilization splints are fabricated to reproduce the scheme of functional occlusion, harmful protective co-contraction can be eliminated during the splint therapy, and a musculoskeletally stable position of the TMJ condyles can be achieved. [21][22][23][24] A displaced disc cannot be recaptured or repositioned into the normal position, even with splint therapy. Because articular discs consist of dense fibrous connective tissue rather than hyaline cartilage, the retrodiscal tissue undergoes adaptive and reparative changes under inadaptable pressure and becomes fibrotic and avascular.…”

Section: Discussionmentioning

confidence: 99%

Protocols for orthodontic treatment of patients with temporomandibular joint disorders

Lee¹,

Park²,

Moon³

et al. 2021

American Journal of Orthodontics and Dentofacial Orthopedics

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Orthodontic Treatment of TMD Patients with Posterior Intrusion Using TADs

Cited by 3 publications

References 11 publications

Evaluation of bone depth, cortical bone, and mucosa thickness of palatal posterior supra-alveolar insertion site for miniscrew placement

Evaluation of bone depth, cortical bone, and mucosa thickness of palatal posterior supra-alveolar insertion site for miniscrew placement

Digital application of three‐dimensional diagnosis and treatment with a virtual articulator

Protocols for orthodontic treatment of patients with temporomandibular joint disorders

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