Preventing adverse effects on the temporomandibular joint through orthodontic treatment.

The temporomandibular joint is one of the most complicated working assemblies in the human body. We are just now beginning to understand it and give it the respect and careful treatment it deserves as an integral functioning part of the dental anatomy. No orthodontic procedure can be performed in isolation without considering its possible effect on the temporomandibular joint. Therefore, the following recommendations are made for diagnosis and treatment planning. Etiologic factors that might cause upward and backward pressures on the mandible should be reduced as much as possible. Mechanotherapy that may cause upward and backward pressures on the condyles is not recommended. Final detailed correction of dental abnormalities should always consider optimal temporomandibular health and function. Retention procedures should be planned to provide a proper path of closure to minimize or prevent possible retrogressive posttreatment changes. It is the author's hope that the hypotheses and suggestions in on TMJ problems and on the preventive role of orthodontics in the patient's treatment.