Diagnostic and treatment protocol for a patient with temporomandibular disorder using a stabilization splint and temporary anchorage devices

Am J Orthod Dentofacial Orthop. 2021 May;159(5):666-681.e2. doi: 10.1016/j.ajodo.2020.05.015. Epub 2021 Feb 27.

Abstract

Treatment of orthodontic patients with temporomandibular disorder (TMD) is challenging for orthodontists because of the TMD signs and symptoms and unstable mandible position, which may lead to improper diagnosis and treatment design. This case report presents a 22-year-old woman with proclined maxillary incisors and TMD. First, stabilization splint therapy was implemented to eliminate temporomandibular joint pain and to obtain the stable adapted centric posture. Subsequently, orthodontic treatment was initiated on the basis of a definitive diagnosis made from the postsplint records. Temporary anchorage devices were used to intrude maxillary molars and distalize the maxillary dental arch. Favorable soft tissue, skeletal, and dental relationship were accomplished after 12 months of comprehensive orthodontic treatment. Functional occlusion was established with teeth as well as vacuum-formed retainers. Excellent posttreatment stability was maintained after a 20-month retention.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cephalometry
  • Clinical Protocols
  • Female
  • Humans
  • Mandible
  • Splints*
  • Temporomandibular Joint Disorders* / diagnosis
  • Temporomandibular Joint Disorders* / therapy
  • Young Adult