Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.691
Peer-review started: July 3, 2021
First decision: September 28, 2021
Revised: October 9, 2021
Accepted: December 2, 2021
Article in press: December 2, 2021
Published online: January 14, 2022
Processing time: 192 Days and 17.8 Hours
The role of occlusal factors on the occurrence of temporomandibular joint disorders (TMDs) is still unclear and it is tricky for orthodontists to treat malocclusions in patients with TMDs. We report the case of the second orthodontic treatment of an adult female with Class II division 2 malocclusion associated with TMD. With the removal of anterior occlusal interference, TMD symptoms were alleviated and cone beam computed tomography (CBCT) images showed the bilateral condyles shifted forward.
This case report presented an orthodontic retreatment of an adult female with TMD and mandibular backward positioning based on CBCT examination and Joint Space Index (JSI) analysis. The left and right JSI values of -38.5 and -52.6 indicated that the position of bilateral condyles had posterior displacement. Ten years prior to this evaluation, she underwent orthodontic treatment resulting in the extraction of two upper premolars and one lower central incisor. The joint symptoms, including pain and sounds, were alleviated along with verified mandibular forward repositioning by extraction of another lower central incisor.
Mandibular backward positioning could be associated with TMD. JSI analysis based on CBCT is a convenient way to examine condylar positions quantitatively.
Core Tip: Class II division 2 malocclusion is considered to be a risk factor for temporomandibular joint disorders (TMDs). In this case of the second orthodontic treatment of an adult female with Class II division 2 malocclusion associated with TMD, we measured the joint space to assess the condylar position and found that the bilateral condyles were located in the posterior position. We suspected that this patient’s TMD was a manifestation of mandibular backward positioning. Temporomandibular joint symptoms were alleviated with the removal of anterior occlusal interference, and the posttreatment cone beam computed tomography images showed that bilateral condyles shifted forward after orthodontic treatment.