Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 14, 2022; 10(2): 691-702
Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.691
Orthodontic retreatment of an adult woman with mandibular backward positioning and temporomandibular joint disorder: A case report
Li-Yuan Yu, Kai Xia, Wen-Tian Sun, Xin-Qi Huang, Jing-Yu Chi, Ling-Jie Wang, Zhi-He Zhao, Jun Liu
Li-Yuan Yu, Kai Xia, Wen-Tian Sun, Xin-Qi Huang, Zhi-He Zhao, Jun Liu, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
Jing-Yu Chi, Department of Stomatology, Strategic Support Force Medical Center of PLA, Beijing 10010, China
Ling-Jie Wang, Department of Stomatology, Qingyang People's Hospital, Qingyang 745000, Gansu Province, China
Author contributions: Xia K, Sun WT and Huang XQ performed reviewing and editing; Yu LY wrote original draft; Chi JY and Wang LJ contributed to software, measurement and data curation; Liu J and Zhao ZH conceptualization; all authors have read and approved the manuscript.
Informed consent statement: Written informed consent for publication of clinical details and clinical images were obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Liu, DDS, PhD, Professor, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu 610041, Sichuan Province, China. junliu@scu.edu.cn
Received: July 3, 2021
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
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

Mandibular backward positioning could be associated with TMD. JSI analysis based on CBCT is a convenient way to examine condylar positions quantitatively.

Keywords: Cone beam computerized tomography; Joint Space Index; Temporomandibular joint disorder; Case report

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.