Anterior open bite due to temporomandibular joint osteoarthrosis with muscle dysfunction treated with temporary anchorage devices.

Abstract

Skeletal Class II high-angle open bite is often accompanied by osteoarthrosis of the temporomandibular joint (TMJ-OA). This type of malocclusion is challenging to correct, and it has been reported that patients with TMJ-OA treated with orthognathic surgery often experience skeletal relapse and a poor prognosis. This case report describes the treatment of a 25-year-old woman with retrognathia and TMJ-OA, whose masseter and temporal muscle activities were weak. Temporary anchorage devices were placed in the maxilla and the mandible, and the first molars were intruded. We used improved superelastic nickel-titanium alloy wires with tip-back bends for both arches, and intermaxillary elastics were used to upright the molars. After treatment, intrusion of the maxillary and mandibular first molars, counterclockwise rotation of the mandible, and improvement of occlusion and profile had been achieved. The patient's condyles were repositioned into ideal positions, and masticatory muscle activity was augmented and balanced. After 2 years of retention, the mandibular and condylar positions were stable, and acceptable occlusion was maintained without recurrence of TMJ symptoms; harmonious activity of the masticatory muscles was retained. The findings of this case report suggest that molar intrusion using temporary anchorage devices for a patient with severe anterior open bite and TMJ-OA may be useful for improving stomatognathic function, occlusion, and facial esthetics.

• Authors: Chiho Kato, Takashi Ono
• Journal: American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics (Am J Orthod Dentofacial Orthop) Vol. 154 Issue 6 Pg. 848-859 (Dec 2018) ISSN: 1097-6752 [Electronic] United States
• PMID: 30477783 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2018 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Cephalometry
• Electromyography
• Female
• Humans
• Magnetic Resonance Imaging
• Malocclusion, Angle Class II (therapy)
• Masseter Muscle (physiopathology)
• Open Bite (etiology, physiopathology, therapy)
• Orthodontic Anchorage Procedures (instrumentation)
• Radiography, Panoramic
• Temporomandibular Joint Disorders (complications, physiopathology, therapy)