This case report describes orthodontic treatment, stomatognathic function and image evaluation of skeletal mandibular protrusion with temporomandibular joint disorders. At the initial examination the patient was a female aged 20 years 6 months. The right lateral incisors, and left central and lateral incisors were cross bite. An impacted tooth was found between the right lateral incisors and the canine teeth in the maxilla. The bite was closed to the left and back in function. Clicking on the bilateral TMJ, but which the patient was unaware of, was found. The impacted tooth, the maxillary second premolars, the mandibular first premolars and all third molars were extracted. A splint was used on the mandible and reconstructed to the bite plate type under the leveling in the maxilla. After treatment, the left condyle showed a double contour on the back side due to bone remodeling. After orthodontic treatment, malocclusion was corrected and stomatognathic function was improved.

View full abstract

Lumican and fibromodulin belong to the family of small leucine-rich repeat proteoglycans (SLRPs). They are reported to stabilize fibrils and regulate fibrillogenesis. We investigated the expression of lumican and fibromodulin in the articular disc of the temporomandibular joint of rats.
The specimens were examined immunohistochemically using antibody against lumican and fibromodulin.
The localization of lumican and fibromodulin showed significant differences: lumican was localized in the synovial membrane and posterior disk attachment, while fibromodulin was expressed in the articular disc.

View full abstract

This clinical report describes a therapeutic approach using two different functional splints for patient with prolonged anterior disc displacement without reduction of the temporomandibular joint, accompanying with open bite, unstable feeling in the lower jaw or masticatory disturbance. Although the articular discs on both sides still showed anterior displacement without reduction on MRI after splint therapies, the tenderness of the masticatory muscle, restricted mandibular movement, joint noise, mouth opening, and masticatory disturbance were all greatly improved compared with before the treatment.
The use of two kinds of functional splint appeared to yield a favorable outcome for patient who was suffering from temporomandibular joint disorders.

View full abstract