A patient with deformity of the temporomandibular joint who received a second orthodontic treatment for open bite which appeared after the previous orthodontic treatment

Abstract

The long-term progress in the pathology of the temporomandibular joint (TMJ) was examined in a patient with malocclusion and deformity of TMJ. The patient was a 20-year 5-month-old female, with the complaint of open bite. The overjet and overbite were 7.0 mm and 0 mm, respectively. The molar relationship was Angle Class II, and ANB angle was 5.9°. She was diagnosed as open bite accompanied with deformity of bilateral TMJ. After 3-month observation of pathologic status of TMJ with a stabilization type splint, teeth alignment with multi-bracket appliances was initiated. After treatment for 2 years and 3 months, an acceptable occlusion was obtained, and retention was initiated. Although changes in the condition of the disk and condyle were observed, no temporomandibular disorder (TMD) symptoms appeared during the whole treatment period. After 5-year retention, stable occlusion was maintained without TMD symptoms. From this case report, it is suggested that long-term observation of the pathologic status of TMJ after orthodontic treatment is important for patients with malocclusion with deformity of TMJ as well as treatment planning based on a diagnosis of TMD before treatment.