Retreating orthodontic failures: Part II.

Part I of this series (June 1993 JGO) clearly documented the inadequacies of some orthodontic methods to obtain satisfactory stable results for patients. Forty-four patients were selected for this study, as their prior orthodontic treatments--all from orthodontic specialists or orthodontic postgraduate institutions--had failed for a variety of functional reasons. The treatment for the 44 patients would not have been necessary if the initial orthodontic treatment had been successful. Therefore, somewhere in the treatment, problems existed which were not corrected by the treatment methods, or problems arose because of the treatment methods. Part I of this series clearly and precisely showed that some orthodontic methods initiate TMJ problems. In a review of the literature presented in Part I, the following conclusions were reached: 1. The optimum functional relationship of the human temporomandibular joint exists when the force vectors within the joint are directed anteriorly and superiorly. 2. Some orthodontic treatments disrupt this optimum functional relationship by placing posterior or posterior/superior forces on the structures of the temporomandibular joint. 3. There is an increased incidence of joint signs and symptoms for some of the patients treated with those conventional methods which place pathologic forces on the temporomandibular joints. Present treatment methods are inadequate if they damage the patient's structures. The guidelines of treatment are wrong if problems exist because of the treatment methods and these guidelines then need to be corrected. What is offered in this article is a method of treatment that was and is successful in retreating those patients who were initially treated by orthodontic specialists, yet who developed TMJD problems during or after their treatment.(ABSTRACT TRUNCATED AT 250 WORDS)