Assessment of temporomandibular disorder and occlusion in treated class III malocclusion patients (original) (raw)
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Cranio : the journal of craniomandibular practice, 2017
The aim of this study was to identify clinical factors predisposing to the development or worsening of temporomandibular disorders (TMDs) following orthodontic surgical treatment for Class III malocclusion. A retrospective cohort study was performed on 88 patients with Class III malocclusion having undergone a combined orthodontic and orthognathic surgical treatment. Temporomandibular joint and masticatory muscle examinations were available prior to treatment and one year post-operatively. Multivariate logistic regression was used to predict the development of post-operative TMDs, and linear regression was used to predict the worsening of TMDs using Helkimo indices. Patients with Class III malocclusion presenting with pre-treatment anamnestic TMJ clicking (OR = 5.8; p = 0.03) and undergoing bimaxillary osteotomy procedures (OR = 18.6; p = 0.04) were more at risk for the development of TMDs. TMDs must be evaluated, monitored, and managed with caution in patients with Class III malocc...
Malocclusion and the need for orthodontic treatment in patients with temporomandibular dysfunction
PubMed, 2007
Objective: The aim of the study was to investigate the signs and symptoms of temporomandibular disorders (TMD) as well as the relationships between TMD, malocclusion and the need for orthodontic treatment. Material and methods: Forty consecutive patients (36 F, 4 M) with a median age of 35 (IQR 18) years. Eighteen patients had Class I, 22 patients Class II malocclusion. A rating scale for the influence of TMJ pain/discomfort on the activities of daily living (ADL) was used simultaneously with clinical examination. Helkimo's Dysfunction Index (D(i)) and the Index of Orthodontic Treatment Need (IOTN) were determined for each participant. Results: Pain/discomfort in the TMJ area was positively correlated with interferences in laterotrusion (p=0.021), pain on palpation over the posterior aspects of TMJ (p=0.012) and pain in the masticatory muscles (p=0.023). The impact of TMJ pain/discomfort was greatest on the performance of a yawn and on opening the mouth wide. There was no statistically significant correlation between malocclusion, D(i)and IOTN. A comparison of Class I malocclusion patients to those with Class II malocclusion revealed no statistically relevant differences in Di and ADL. Conclusion: In patients with malocclusion, pain from TMJ has a significant negative impact on activities of daily living. No significant differences were observed between Angle Class I and Class II groups of patients with respect to TMD. Orthodontic treatment was required for both groups.
Temporomandibular disorders and occlusion effect on orthodontic treatment
International Journal Of Community Medicine And Public Health
Evidence in the literature indicates the significant association between temporomandibular joint disorders and orthodontic treatment. As a result of the epidemiological investigations that indicated the high prevalence of temporomandibular disorders among patients with malocclusions, it has been suggested that there might be a cause-and-effect correlation between both of these conditions. Evidence in the literature is inconsistent regarding the association between temporomandibular joint disorders and malocclusion, and orthodontic treatment. In the present literature review, we have discussed the different aspects of temporomandibular disorders and malocclusion and their relation to orthodontic treatment approaches. Among the different studies in the literature, solid evidence indicates a significant association between temporomandibular joint disorders and malocclusion, and accordingly, research aimed to study the impact of orthodontic treatment on curing and preventing the develop...
Relationship Between Orthodontics and Temporomandibular Disorders: A Prospective Study
Journal of oral & facial pain and headache, 2016
To investigate the possible relationship between the orthodontic treatment of Class II malocclusion and the development of temporomandibular disorders (TMD). A total of 40 patients was evaluated at four time points: the day before the start of treatment employing bilateral Class II elastics (baseline), as well as at 24 hours, 1 week, and 1 month after the start of treatment. The development of TMD pain complaints in the orofacial region and changes in the range of mouth opening were assessed at these times. Shapiro-Wilk, McNemar, and Friedman tests with 5% significance level were used to analyze the data. The treatment produced pain of a transitory, moderate intensity, but there was no significant change from baseline after 1 month. There were no restrictions in the range of jaw motion or any evidence of limitations in mouth opening. Orthodontic treatment with bilateral Class II elastics does not cause significant orofacial pain or undesirable changes in the range of mouth opening. ...
Relationship between Orthodontics and Temporomandibular Disorders
Since the end of the 20 th century, the problems of the temporomandibular disorders (TMDs) have aroused interest to the orthodontists. The aim of this literature review is to present the contemporary evidence concerning the association between the presence of malocclusions and the occurrence of signs and symptoms of the TMJ. In addition, additional variables, which may affect the TMJs of a patient during the orthodontic treatment are pointed out. It is evident that there is an increased number of patients who are seeking for orthodontic treatment, not only in order to enhance their facial aesthetics and the function of mastication system, but also to relieve the symptoms of the temporomandibular joint (TMJ). There are multiple etiological factors that have been associated with the TMDs and they may be manifested by pain and/or sounds of TMJ. In addition, during the clinical examination it can be detected a deviation from the normal function of the mandible.
Journal of Oral Rehabilitation, 2000
occlusal contacts were not different between surgi-SUMMARY This study aimed to assess mandibular mobility and the prevalence of functional occlusal cal and non-surgical groups. Non-working side contacts occurred in 30% of subjects, posterior contacts contacts in subjects treated to a Class 1 incisor relationship by fixed orthodontic appliance ther-on protrusion in 20% and RCP-ICP prematurities in 18% of subjects. Non-working side contacts were apy. Two hundred and thirty subjects participated (mean age =18 years) of whom 42 underwent or-significantly more frequent in postgraduate cases compared to staff cases (PB 0•05). An overbite less thognathic surgery. All subjects were in retention than the mean of 2•4 mm resulted in a reduced with a mean time of 7 months between debond and examination. Maximal mandibular opening, lateral likelihood of canine guidance on the working side (PB 0•001) and an increased frequency of non-work-and protrusive excursions were all significantly reing side contacts and posterior contacts on protru-duced in the surgical cases compared to the nonsurgical group. Centric and eccentric non-ideal sion (PB 0•001).
The role of orthodontics in temporomandibular disorders
Journal of Oral Rehabilitation, 2010
Temporomandibular Disorder (TMD) is the main cause of pain of non-dental origin in the oro-facial region including head, face and related structures. The aetiology and the pathophysiology of TMD is poorly understood. It is generally accepted that the aetiology is multifactorial, involving a large number of direct and indirect causal factors. Among such factors, occlusion is frequently cited as one of the major aetiological factors causing TMD. It is well known from epidemiologic studies that TMD-related signs and symptoms, particularly temporomandibular joint (TMJ) sounds, are frequently found in children and adolescents and show increased prevalence among subjects between 15 and 45 years old. Aesthetic awareness, the development of new aesthetic orthodontic techniques and the possibility of improving prosthetic rehabilitation has increased the number of adults seeking orthodontic treatment. The shift in patient age also has increased the likelihood of patients presenting with signs and symptoms of TMD. Because orthodontic treatment lasts around 2 years, orthodontic patients may complain about TMD during or after treatment and orthodontists may be blamed for causing TMD by unsatisfied patients. This hypothesis of causality has led to legal problems for dentists and orthodontists. For these reasons, the interest in the relationship between occlusal factors, orthodontic treatment and TMD has grown and many studies have been conducted. Indeed, claims that orthodontic treatment may cause or cure TMD should be supported by good evidence. Hence, the aim of this article is to critically review evidence for a possible association between malocclusion, orthodontic treatment and TMD.
International journal of oral and maxillofacial surgery, 2007
The aim of this longitudinal study was to determine the effects of orthognathic surgery on signs and symptoms of temporomandibular disorders (TMD) and on pressure pain thresholds (PPTs) of the jaw muscles. Fourteen consecutive class III patients undergoing pre-surgical orthodontic treatment were treated by combined Le Fort I osteotomy and bilateral sagittal ramus osteotomy. The clinical examination included the assessment of signs and symptoms of TMD and the assessment of PPTs of the masseter and temporalis muscles. Anamnestic, clinical and algometric data were collected during five sessions over a 1-year period. Seven out of 14 patients presented with disc displacement with reduction at baseline, whereas four patients (two of them were new cases) did so at the end of follow up (p>0.05). None of the patients were diagnosed with myofascial pain of the jaw muscles at the beginning or end of follow up. PPTs of the masseter and temporalis muscles did not change significantly from bas...
Effect of Orthodontic Treatment on Temporomandibular Joint. A Review
2020
Introduction: The morphology of temporomandibular joint varies among individuals and the most important factor that could affect its shape is functional load impacted on it. This depends on the closed association between the morphology and function which demonstrates that presumed differences in condyle-fossa position and morphology among subjects vary with different types of malocclusion. The objective of this literature review is to determine the temporomandibular joint characteristics in response to orthodontic treatment. Materials and Methods: A web-based search was carried out using electronic databases such as PubMed, Science Direct and Google scholar between the year 2007 to 2017 with a focus on longitudinal studies, Prospective, Casecontrol, Retrospective and Randomized Controlled Trials. Results: 60 studies were searched in which 21 articles have been selected based on inclusion criteria. Among these studies, 2 were randomized controlled trials, 15 were prospective longitud...
Examination of temporomandibular disorders in the orthodontic patient: a clinical guide
Journal of Applied Oral Science, 2007
The possible association between orthodontic treatment and temporomandibular disorders (TMD) is a topic of great interest in the current literature. The true role of orthodontic therapy on the etiology of TMD, however, is still uncertain. From the clinical prospective, a thorough examination of the stomatognathic system is always necessary in order to detect possible TMD signs and symptoms prior to the beginning of the orthodontic therapy. Caution should be exercised when planning, performing and finalizing orthodontics, especially in patients who with history of signs and symptoms of TMD. The clinician must always eliminate patient's pain and dysfunction before initiating any type of orthodontic mechanics. Muscle incoordination, unstable disc-condyle relationship and bone alterations are usual TMD conditions that can interfere with the presenting occlusal relationship. This article reviews these aspects and presents a detailed clinical guide for the examination of the orthodontic patient, considering aspects related to facial pain and dysfunction.