scholarly journals Occlusal Splint Therapy Followed by Orthodontic Molar Intrusion as an Effective Treatment Method to Treat Patients with Temporomandibular Disorder: A Retrospective Study

2021 ◽  
Vol 11 (16) ◽  
pp. 7249
Author(s):  
Bálint Nemes ◽  
Dorottya Frank ◽  
Andreu Puigdollers ◽  
Domingo Martín
Keyword(s):  
Morphological Changes ◽  
Temporomandibular Disorder ◽  
Treatment Method ◽  
Open Bite ◽  
Occlusal Splint ◽  
Anterior Open Bite ◽  
Splint Therapy ◽  
Molar Intrusion ◽  
Facial Height ◽  
Lateral Cephalograms

Our goal is to show that temporomandibular disorder (TMD) patients with orthopaedic instability can be effectively treated by the combination of occlusal splint therapy and molar intrusion. Diagnostic records of 18 patients reporting previous TMD and treated with splint therapy were evaluated. Postsplint anterior open bite was treated by skeletally anchored molar intrusion. Changes in overjet (OJ), overbite (OB) were measured on articulator mounted models: initially in maximal intercuspidation(MI), centric „de jour”, postsplint centric relation (CR) and postintrusion CR. Changes in ANB (A point-Nasion-B point) angle, mandibular plane–palatal plane angle and facial axis angle were assessed on lateral cephalograms. Morphological changes of the condyle were detected on pre-and posttreatment CBCT images. When compared screening mountings to MI models, significant differences were found in OJ and OB. Following splint wear, there was a significant increase in lower facial height and significant decrease in facial axis angle, which in turn increased ANB angle. OB and OJ showed a significant change on the postsplint mountings when compared to MI. After intrusion, mandible exhibited counterclockwise rotation, which decreased lower facial height, increased OB and facial axis angle and decreased ANB and OJ. Posttreatment CBCTs confirmed improved condylar morphology.Occlusal splint therapy followed by orthodontic molar intrusion provides MI-CR harmony, therefore, it seems to be an effective method for treating TMD patients.

scholarly journals Nonsurgical treatment of skeletal anterior open bite in adult patients: Posterior build-ups

2016 ◽  
Vol 87 (1) ◽  
pp. 33-40 ◽  
Author(s):  
Arturo Vela-Hernández ◽  
Rocio López-García ◽  
Verónica García-Sanz ◽  
Vanessa Paredes-Gallardo ◽  
Felicidad Lasagabaster-Latorre
Keyword(s):  
Open Bite ◽  
Anterior Open Bite ◽  
Retention Period ◽  
Term Stability ◽  
Long Term Stability ◽  
Skeletal Changes ◽  
Molar Intrusion ◽  
Mandibular Plane ◽  
Lateral Cephalograms

ABSTRACT Objective: To (1) evaluate the efficacy of build-ups in the correction of anterior open bite in adults, (2) evaluate their efficacy in producing molar intrusion, (3) analyze skeletal and dental changes, and (4) assess the long-term stability. Materials and Methods: The sample consisted of 93 lateral cephalograms from 31 patients with skeletal and dental anterior open bite. The patients had received orthodontic treatment consisting of bonded resin blocks on the maxillary molars combined with Tip-Edge Plus bracket appliances. Cephalometric measurements were performed on radiographs taken before treatment (T1), after treatment (T2), and after a retention period (T3), which were analyzed and compared. Results: Significant dental and skeletal changes were observed after treatment. Molar intrusion averaging 1 mm; 1.44 and 1.57 mm extrusion of mandibular and maxillary incisors, respectively; and a mean of 3.98 mm overbite increase were observed. The mandibular plane angle showed a mean closure of 1.19°, and there was a mean decrease in anterior facial height of 0.7 mm. A mild relapse tendency was observed, but long-term stability was acceptable. Conclusions: Build-ups are an effective treatment alternative for anterior open bite in adults. Outcomes remain significantly stable during the retention period.

scholarly journals Prediction of mandibular movement and its center of rotation for nonsurgical correction of anterior open bite via maxillary molar intrusion

2018 ◽  
Vol 88 (5) ◽  
pp. 538-544 ◽  
Author(s):  
Kyunam Kim ◽  
Kwangchul Choy ◽  
Young-Chel Park ◽  
Seo Yeon Han ◽  
Heekyu Jung ◽  
...  
Keyword(s):  
Linear Regression Analysis ◽  
Open Bite ◽  
Reference Plane ◽  
Mandibular Movement ◽  
Anterior Open Bite ◽  
Counterclockwise Rotation ◽  
Molar Intrusion ◽  
Lateral Cephalograms ◽  
Maxillary Molar ◽  
The Relationship

ABSTRACT Objectives: To evaluate quantitatively the relationship between molar intrusion (change [Δ] maxillary first molar [U6]–palatal plane [PP]) and changes in vertical and sagittal cephalometric parameters and to determine the center of mandibular autorotation. Materials and Methods: Twenty-one patients diagnosed with anterior open bite and successfully treated with molar intrusion (overbite [OB] > 0 mm) were retrospectively enrolled. Lateral cephalograms taken before and after molar intrusion were used to measure changes in vertical and sagittal cephalometric parameters. The center of mandibular autorotation was calculated by measuring displacement of gonion (Go) and pogonion (Pog). Paired t-tests were used to compare variables, and linear regression analysis was used to examine the relationship between ΔU6-PP and other variables. Results: The mandible exhibited counterclockwise rotation after maxillary molar intrusion, which led to closure of anterior open bite. Strong linear relationships, in descending order, between ΔU6-PP and ΔOB, Δanterior facial height (AFH), Δvertical reference plane (Pog), and Δsella-nasion to Go-menton (SN-GoMe), were observed. When the maxillary molar was intruded 1 mm, OB increased by 2.6 mm, AFH decreased by 1.7 mm, Pog moved forward by 2.3 mm, and SN-GoMe decreased by 2°. The center of mandibular autorotation was located 7.4 mm behind and 16.9 mm below condylion after molar intrusion. Conclusions: The mandible exhibited counterclockwise rotation after maxillary molar intrusion; the center of mandibular autorotation was located behind and below condylion with individual variations.

scholarly journals Anterior Open Bite Closure: A Case Report

2011 ◽  
Vol 1 (1) ◽  
pp. 63-67
Author(s):  
Deepak Sharma ◽  
Hemant Kumar Halwai
Keyword(s):  
Case Report ◽  
Female Patient ◽  
Active Treatment ◽  
Open Bite ◽  
Anterior Open Bite ◽  
Posterior Teeth ◽  
Titanium Screw ◽  
Molar Intrusion ◽  
Facial Height ◽  
Titanium Screws

Anterior open bite is often caused by a downward rotation of the mandible and/or by excessive eruption of the posterior teeth. In such cases, it is difficult to establish absolute anchorage for molar intrusion by traditional orthodontic mechanics. This article reports the successful treatment of a severe skeletal anterior open bite case using titanium screw anchorage. A female patient of 31 years of age had open bite of 7 mm with increased facial height. The mini screws were implanted on both maxilla and the mandible, and an intrusion force was provided with elastic chains for 13 months. After active treatment of 19 months, her upper and lower first molars were intruded by about 3 mm each, and good occlusion was achieved. Her retrognathic chin and convex profiles were improved by an upward rotation of the mandible. Our result suggests that titanium screws are useful for intrusion of molars in anterior open bite cases.

Predictable and Effective Treatment of Bilateral Subcondylar Fractures Using Closed Reduction With a Novel Acrylic Wedge Splint

FACE ◽  
2020 ◽  
Vol 1 (2) ◽  
pp. 151-159
Author(s):  
Alexandra O. Luby ◽  
Gina N. Sacks ◽  
Alexandra T. Buchman ◽  
Brevin C. Buchman ◽  
Raquel M. Ulma ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Clinical Problem ◽  
Open Bite ◽  
Optimal Management ◽  
Occlusal Splint ◽  
Anterior Open Bite ◽  
Novel Technique ◽  
Facial Height ◽  
Subcondylar Fracture ◽  
Potential Risks

Treatment of bilateral subcondylar fractures is a challenging clinical problem, and optimal management of these fractures remains controversial. Similar to unilateral subcondylar fractures, bilateral injuries present with significant malocclusion due to fracture segment displacement; however, the loss of vertical stops on both sides of the mandible mandate a more concerted approach to surgical management. Closed reduction and maxillomandibular fixation (MMF) alone in bilateral subcondylar fractures carry a higher risk of recurrent anterior open bite postoperatively secondary to the absence of a vertical stop with fracture segment displacement and persistent shortening of the posterior facial height. Therefore, some surgeons consider bilateral subcondylar fractures an indication for open reduction and internal fixation (ORIF). Unfortunately, open approaches involving the proximal subcondylar fracture segment are riddled with potential risks including facial nerve damage, parotid gland injury, and temporomandibular joint (TMJ) damage. Given that neither approach is optimal, investigation of new approaches for the treatment of bilateral subcondylar fractures is warranted. The objective of this paper is to present our novel technique for the treatment of bilateral subcondylar fractures, which utilizes a combination of traditional closed reduction and MMF with a custom “wedge” occlusal splint to overcorrect the traumatic shortening of the posterior mandibular height.

scholarly journals Anterior open bite: cephalometric evaluation of the dental pattern

2006 ◽  
Vol 17 (1) ◽  
pp. 68-70 ◽  
Author(s):  
Adriana Sasso Stuani ◽  
Andréa Sasso Stuani ◽  
Maria Bernadete Sasso Stuani ◽  
Maria da Conceição Pereira Saraiva ◽  
Mírian Aiko Nakane Matsumoto
Keyword(s):  
Open Bite ◽  
Occlusal Plane ◽  
Anterior Open Bite ◽  
Panoramic Radiographs ◽  
Lateral Cephalograms ◽  
Significant Difference ◽  
Dental Origin ◽  
Dental Pattern ◽  
Mandibular Incisors

The purpose of this study was to compare the dental pattern of patients with anterior open bite malocclusion to that of individuals with normal overbite by utilization of lateral cephalograms, panoramic radiographs and study casts. The findings showed that there was no significant difference in the inclination of the occlusal plane (SN.PlO) and position of the maxillary and mandibular incisors (1-NA, 1-NB) between both groups of individuals; but the angles of inclination of the maxillary and mandibular incisors (1.1, 1.NA and 1.NB) differed statistically between patients with anterior open bite of the individuals that presented normal overbite, which suggests that the anterior open bite may be of dental origin.

scholarly journals Internet-Based Multimodal Pain Program With Telephone Support for Adults With Chronic Temporomandibular Disorder Pain: Randomized Controlled Pilot Trial

10.2196/22326 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e22326
Author(s):  
Julia Lam ◽  
Peter Svensson ◽  
Per Alstergren
Keyword(s):  
Pain Intensity ◽  
Temporomandibular Disorder ◽  
Functional Limitation ◽  
Pilot Trial ◽  
The Internet ◽  
Occlusal Splint ◽  
Splint Therapy ◽  
Randomized Controlled ◽  
Temporomandibular Pain

Background Chronic pain from temporomandibular disorders remains an undertreated condition with debate regarding the most effective treatment modalities. Objective The aim of the study was to investigate the treatment effect of an internet-based multimodal pain program on chronic temporomandibular disorder pain and evaluate the feasibility of a larger randomized controlled trial. Methods An unblinded randomized controlled pilot trial was conducted with 43 participants (34 females, 9 males; median age 27, IQR 23-37 years) with chronic temporomandibular pain. Participants were recruited within the Public Dental Health Service and randomized to intervention (n=20) or active control (n=23). The intervention comprised a dentist-assisted internet-based multimodal pain program with 7 modules based on cognitive behavior therapy and self-management principles. The control group received conventional occlusal splint therapy. Primary outcomes included characteristic pain intensity, pain-related disability, and jaw functional limitation. Secondary outcomes were depression, anxiety, catastrophizing, and stress. Outcomes were self-assessed through questionnaires sent by mail at 3 and 6 months after treatment start. Feasibility evaluation included testing the study protocol and estimation of recruitment and attrition rates in the current research setting. Results Only 49% of participants (21/43) provided data at the 6-month follow-up (internet-based multimodal pain program: n=7; control: n=14). Of the 20 participants randomized to the internet-based multimodal pain program, 14 started treatment and 8 completed all 7 modules of the program. Between-group analysis showed no significant difference for any outcome measure at 3- or 6-month follow-up—characteristic pain intensity (3 months: P=.58; 6 months: P=.41), pain-related disability (3 months: P=.51; 6 months: P=.12), jaw functional limitation (3 months: P=.45; 6 months: P=.90), degree of depression (3 months: P=.64; 6 months: P=.65), anxiety (3 months: P=.93; 6 months: P=.31), stress (3 months: P=.66; 6 months: P=.74), or catastrophizing (3 months: P=.86; 6 months: P=.85). Within-group analysis in the internet-based multimodal pain program group showed a significant reduction in jaw functional limitation score at the 6-month follow-up compared to baseline (Friedman: χ2=10.2, P=.04; Wilcoxon: z=–2.3, P=.02). In the occlusal splint group, jaw function limitation was also reduced at the 6-month follow-up (Friedman: χ2=20.0, P=.045; Wilcoxon: z=–2.3, P=.02), and there was a reduction in characteristic pain intensity at the 3- and 6-month follow-up (Friedman: χ2=25.1, P=.01; Wilcoxon 3 months: z=–3.0, P=.003; Wilcoxon 6 months: z=-3.3, P=.001). Conclusions This study was not able to demonstrate a difference in treatment outcome between an internet-based multimodal pain program and occlusal splint therapy in patients with chronic temporomandibular pain. However, the findings suggested that the internet-based multimodal pain program improves jaw function. The results also confirmed the treatment effect of occlusal splint therapy for chronic temporomandibular pain. Furthermore, because of the high attrition rate, this pilot study showed that a randomized controlled trial with this design is not feasible. Trial Registration ClinicalTrials.gov NCT04363762; https://clinicaltrials.gov/show/NCT04363762

The functional treatment of anterior-open bite: three case reports

2001 ◽  
Vol 25 (4) ◽  
pp. 275-286
Author(s):  
Banu Dinçer ◽  
Serpil Hazar
Keyword(s):  
Case Reports ◽  
Post Treatment ◽  
Open Bite ◽  
Functional Treatment ◽  
Posterior Region ◽  
Anterior Open Bite ◽  
Facial Height ◽  
Skeletal Open Bite ◽  
Vertical Development

Functional treatment of three skeletal open-bite patients with Bionator, Frankel IV and Posterior biteblock appliances is presented. Pretreatment and post treatment records were evaluated. Correction of malocclusion by changing direction of the mandibular development, adaptive bony development of the condyle, vertical development in posterior region, an increase in ramus length, a decrease in the lower facial height were observed in this report. The results of functional treatment of three appliances had different effect mechanisms.

scholarly journals Cephalometric evaluation of adult anterior open bite non-extraction treatment with Invisalign

2017 ◽  
Vol 22 (5) ◽  
pp. 30-38 ◽  
Author(s):  
Shuka Moshiri ◽  
Eustáquio A. Araújo ◽  
Julie F. McCray ◽  
Guilherme Thiesen ◽  
Ki Beom Kim
Keyword(s):  
Open Bite ◽  
Therapeutic Modality ◽  
Occlusal Plane ◽  
Anterior Open Bite ◽  
Lower Incisor ◽  
Mandibular Plane ◽  
Lateral Cephalograms ◽  
Treatment Changes ◽  
Extraction Treatment ◽  
Lower Molar

ABSTRACT Objective: The purpose of this study was to evaluate, by means of cephalometric appraisal, the vertical effects of non-extraction treatment of adult anterior open bite with clear aligners (Invisalign system, Align Technology, Santa Clara, CA, USA). Methods: Lateral cephalograms of 30 adult patients with anterior open bite treated using Invisalign (22 females, 8 males; mean age at start of treatment: 28 years and 10 months; mean anterior open bite at start of treatment: 1.8 mm) were analyzed. Pre- and post-treatment cephalograms were traced to compare the following vertical measurements: SN to maxillary occlusal plane (SN-MxOP), SN to mandibular occlusal plane (SN-MnOP), mandibular plane to mandibular occlusal plane (MP-MnOP), SN to mandibular plane (SN-MP), SN to palatal plane (SN-PP), SN to gonion-gnathion plane (SN-GoGn), upper 1 tip to palatal plane (U1-PP), lower 1 tip to mandibular plane (L1-MP), mesiobuccal cusp of upper 6 to palatal plane (U6-PP), mesiobuccal cusp of lower 6 to mandibular plane (L6-MP), lower anterior facial height (LAFH), and overbite (OB). Paired t-tests and descriptive statistics were utilized to analyze the data and assess any significant changes resulting from treatment. Results: Statistically significant differences were found in overall treatment changes for SN-MxOP, SN-MnOP, MP-MnOP, SN-MP, SN-GoGn, L1-MP, L6-MP, LAFH, and OB. Conclusions: The Invisalign system is a viable therapeutic modality for non-extraction treatment of adult anterior mild open bites. Bite closure was mainly achieved by a combination of counterclockwise rotation of the mandibular plane, lower molar intrusion and lower incisor extrusion.

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