Stabilization splint combined with multiloop edgewise archwire for treatment of skeletal Class III open bite malocclusion with temporomandibular disorders: a case report with a 6-year follow-up

Abstract

Background: Orthodontists believe that temporomandibular disorders (TMDs), as a group of multifactorial diseases, should be carefully examined before treatment, closely monitored during the process, and maintained stably after treatment. Stabilization splint, as a traditional treatment method, owns the characteristics of low cost and risk compared to joint surgery. This treatment combines traditional stabilization splint and multiloop edgewise archwire (MEAW) techniques, aiming to treat complex clinical cases through non-surgical and non-invasive methods to achieve relatively stable orthodontic outcomes. Case Presentation: This case report illustrates the two-phase treatment of a 17-year-old male patient characterized by an anterior open bite, Class III malocclusion, mandibular deviation, and severe temporomandibular joint symptoms. In phase one, the patient was provided with a stabilization splint for a duration of 9 months. This initial phase aimed to alleviate symptoms and reposition the condyle by eliminating the locking relationship between the upper and lower teeth, while establishing a new muscular and articular balance. In phase two, the patient underwent multiloop edgewise archwire treatment, which involved the use of a reverse-curve archwire, short class III traction, and anterior vertical traction. After 26 months of treatment, a functional and esthetic occlusion, normal overjet and overbite and a relatively well-balanced facial profile was established. After a 6 years post-treatment follow-up, the results of this case have demonstrated long-term stability. Conclusion: The report provides substantial evidence supporting the effectiveness and long-term stability of the MEAW appliance in managing these complex clinical scenarios.