Abstract
The treatment of patients with temporomandibular joint (TMJ) symptoms and mandibular lateral deviation due to premature tooth contact includes the relief and elimination of temporomandibular joint symptoms, determination of therapeutic mandibular position after removing premature contact, and occlusal reconstruction to establish a stable centric stop. In this study, for a case of crowding with mandibular lateral deviation and TMJ symptoms, we identified functional lateral eccentric occlusion due to premature contact using the functional wax bite method, and determined the therapeutic mandibular position using a stabilization type splint before initiating orthodontic treatment. The left anteriorly displaced disc was repositioned while wearing the splint. During the period of orthodontic treatment, the therapeutic mandibular position was maintained as much as possible using a bite block. Although TMJ symptoms, such as temporary restriction of mouth opening and uncomfortable feeling in the preauricular area, occasionally occurred during the period of orthodontic treatment, stable occlusion in the therapeutic mandibular position was established after 4 years and 11 months of dynamic orthodontic treatment. Although temporary disturbance of mouth opening occurred during the retention period, stable occlusion was maintained 2 years after retention. This case report suggests the usefulness of orthodontic treatment by which stable occlusion in the therapeutic mandibular position can be established, although long-term careful observation is necessary to avoid the recurrence of TMJ symptoms.
