The effects of two methods of Class III malocclusion treatment on temporomandibular disorders

Abstract

The aim of this research was to evaluate, within a controlled clinical study, the effects of a Delaire-type facemask or a modified Jasper Jumper (JJ) used in the treatment of children with Class III malocclusions due to maxillary retrognathia on temporomandibular disorders (TMDs). Forty-six patients with Class III malocclusions referred for orthodontic treatment were divided into two groups, a test and a control. The test group comprised 33 randomly chosen patients (15 females, 18 males) aged 8-11 years. The control group included 13 patients (eight females, five males) with similar features. TMD assessment was performed before and after treatment using a two-axis questionnaire, the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMDs). Qualitative data were evaluated using chi-square and McNemar tests. No statistically significant differences related to the presence of TMD were observed pre- or post-treatment (P > 0.05). The most commonly encountered diagnosis was arthralgia in the JJ group both before and after treatment. Evaluation of joint and muscle regions showed decreased symptoms, apart from the diagnosed discomforts, in the JJ group (P < 0.05). Reduced symptoms were observed in the Delaire group; however, this reduction was not statistically significant. An increase, not considered to be statistically significant, was observed in the control group. The Delaire-type facemask and modified JJ used in the early phase of Class III malocclusion treatment did not result in TMD.

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 .…”

Effects of facemasks versus intraoral appliances in treating maxillary deficiency in growing patients: A systematic review and meta-analysis

“…The particulars of the selected studies are presented in Table 2. 8 whereas the studies by Husson et al, 14 Showkat bakhsh et al (2012) 24 and Kurt et al 22 were judged as un clear on allocation concealment.…”

“…Sequence generation was adequate for all studies, with the exception of that by Kurt et al 22 Husson et al 14…”

“…Finally, 5 studies were included in the systematic review. 8,9,14,22,24 Excluding Kurt et al, 22 the 4 remaining studies were used for the metaanalysis after quality as sessment ( Fig. 1).…”

“…These factors can compromise the patient compliance, definitely affecting the therapeutic results. 9,14,19 On the other hand, a large number of intraoral de vices have been introduced to treat class III malocclu sion, including Fränkel's functional regulator, 20,21 the reverse twin block, 15 the modified Jasper Jumper de vice, 22 the modified tandem traction bow appliance, 13,14 and fixed tongue appliances and plates. 8,9 They do not have bulky external appearance or the potential for soft tissue irritation, which are associated with a facemask.…”