Korean J Orthod.  2015 May;45(3):136-145. 10.4041/kjod.2015.45.3.136.

Management of open bite that developed during treatment for internal derangement and osteoarthritis of the temporomandibular joint

• Arai C
• Choi JW
• Nakaoka K
• Hamada Y
• Nakamura Y

• KMID: 1974805
• DOI: http://doi.org/10.4041/kjod.2015.45.3.136

Abstract

This case report describes the orthodontic treatment performed for open bite caused by internal derangement (ID) and osteoarthritis (OA) of the temporomandibular joint (TMJ). A Japanese woman, aged 31 years and 11 months, referred to our department by an oral surgeon had an open bite with clockwise rotation of the mandible and degeneration of the condyle. The overbite was corrected through intrusion of the maxillary and mandibular molars using mini-screw implants to induce counterclockwise rotation of the mandible. Then, the mandibular second premolars were extracted and comprehensive orthodontic treatment was performed to establish a Class I molar relationship with distalization of the maxillary arch and to eliminate anterior crowding. Following treatment, her facial profile improved and a functional and stable occlusion was achieved without recurrence of the TMJ symptoms. These results suggest that orthodontic intrusion of the molars is one of the safer and less stressful alternatives for the management of open bite due to degeneration of the condyles caused by ID and OA of TMJ.

Keyword

Temporomandibular joint; Internal derangement; Osteoarthritis; Mini-screw implant

MeSH Terms

Asian Continental Ancestry Group
Bicuspid
Crowding
Female
Humans
Mandible
Molar
Open Bite*
Osteoarthritis*
Overbite
Recurrence
Temporomandibular Joint*

Figure

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  Figure 1 Computed tomography images. A, Before condylar degeneration at the age of 28 years and 9 months. B, After condylar degeneration at the age of 31 years and 10 months.

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  Figure 2 Computed tomography images of the left condyle. The white arrow illustrates osteophytes.

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  Figure 3 Pretreatment facial and intraoral photographs.

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  Figure 4 Pretreatment dental casts.

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  Figure 5 Pretreatment radiographic examination. A, Pretreatment panoramic radiograph. B, Pretreatment lateral cephalogram.

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  Figure 6 Intraoral photographs obtained after molar intrusion.

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  Figure 7 Intraoral photographs at distalization of the maxillary arch.

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  Figure 8 Post-treatment facial and intraoral photographs.

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  Figure 9 Post-treatment dental casts.

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  Figure 10 Post-treatment radiographic examination. A, Post-treatment panoramic radiograph. B, Post-treatment lateral cephalogram.

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  Figure 11 Superimposition of pre- (solid lines) and post-treatment (dashed lines) lateral cephalometric tracings.

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  Figure 12 Facial and intraoral photographs obtained 2 years after treatment.

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