Mitsui Silvia Naomi, Yasue Akihiro, Kuroda Shingo, Tanaka Eiji
Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Oral Sciences, Tokushima, Japan.
Department of Orthodontics and Dentofacial Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
J Orthod Sci. 2016 Jul-Sep;5(3):104-8. doi: 10.4103/2278-0203.186168.
This article reports the orthodontic treatment of a 20-year-old patient with dental crowding and temporomandibular joint disorders (TMDs). The patient presented moderate anterior crowding with a Class I molar relationship and masticatory disturbance in the mandibular position induced by previous splint therapy. Orthodontic treatment with multi-bracket appliance was initiated to correct the anterior crowding in both dental arches, after the extraction of first premolars and third molars, and also to maintain the splint-induced position of the condyles. After 26 months of treatment, an acceptable occlusion was achieved without any TMD symptoms. After 18-month retention, flattening on the right condyle was observed, possibly as an adaptative remodeling. After 16-year retention period, the occlusion was maintained without recurrence of any TMD symptoms, indicating a long-term stability of occlusion and temporomandibular joint (TMJ) components. Our results suggest the possibility of compromised treatment in patients with TMD to achieve a long-term stability in occlusion and TMJ function.
本文报道了一名20岁患有牙列拥挤和颞下颌关节紊乱(TMD)患者的正畸治疗情况。该患者表现为中度前牙拥挤,磨牙关系为I类,且因先前的夹板治疗导致下颌位置咀嚼功能紊乱。在拔除第一前磨牙和第三磨牙后,开始使用多托槽矫治器进行正畸治疗,以纠正上下牙弓的前牙拥挤,并维持夹板诱导的髁突位置。经过26个月的治疗,获得了可接受的咬合关系,且无任何TMD症状。在保持18个月后,观察到右侧髁突出现扁平,可能是适应性重塑。在保持16年后,咬合关系得以维持,未出现任何TMD症状复发,表明咬合和颞下颌关节(TMJ)组件具有长期稳定性。我们的结果提示,TMD患者在治疗中可能会面临挑战,以实现咬合和TMJ功能的长期稳定性。