PDF: Protocols for orthodontic treatment of patients with temporomandibular joint disorders

Orthodontists often have trouble treating patients who have temporomandibular joint disorders because occlusion changes depend on the position of unstable condyles.

This characteristic means the patients do not have definite criteria with which to make an accurate orthodontic diagnosis, so clinicians are unable to establish a reliable treatment plan.

This article reports on the treatment of a patient with skeletal Class II relationship and condylar resorption. A stabilization splint was used before any active orthodontic tooth movement to stabilize her condylar position. 

Although the patient exhibited dramatically increased open bite and a retruded mandibular position after splint therapy, her occlusion and facial esthetics were resolved by orthodontic camouflage treatment with appropriate orthodontic mechanics after extraction of 4 premolars.

This article presents the successful orthodontic treatment of a female adolescent patient with TMD and suggests appropriate treatment protocols on the basis of an evaluation of her condylar stability. 

It also suggests other treatment objectives, such as achieving functional occlusion and good facial esthetics. 

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