A 5-Year Follow-Up of Temporomandibular Disorder Treatment Emphasizing Condylar Asymmetry

Abstract

The purpose of this study was to investigate the long-term effect of temporomandibular disorder (TMD) treatment giving priority to oral stability, i.e. creating stability for the mandible in the individual retruded position of the mandible (RPM), focusing condylar asymmetry. Twenty-nine (29) patients treated for TMD participated in the study. A standardized TMD examination was executed originally and an identical examination was performed at the follow-up in a private TMD practice. In general, the patients showed a significant increase of their maximum active mouth opening capacity (p < 0.01) and a significant decrease of dynamic and static pain at the performed tests (p < 0.001). Patients initially suffering facial pain showed a significant reduction of their pain with treatment (p < 0.01). The patients with condylar asymmetry >10%, and who underwent treatment aiming at permanent oral stability, showed the greatest improvement.

Orthodontic Treatment and Craniocervical Posture in Patients with Temporomandibular Disorders: An Observational Study

“…Although it has been established that orthodontic therapy neither causes nor prevents TMDs [11], this therapeutic intervention provides dental and orthopedic stability in the masticatory structures, which will most likely reduce the patient's risk factors for developing TMDs [72]. Concerning occlusal changes, mispositioned teeth associated with some malocclusions with steeper occlusal planes, posterior prematuries, and mandibular lateral displacement are often associated with craniomandibular dysfunction [73][74][75]. Having this, before planning orthodontic treatment, it is imperative to identify the location of an asymmetry, as treatment protocols will vary depending on the underlying etiology [76,77].…”

“…A midline discrepancy is one of the symptoms of mandibular lateral displacement and the major objective of orthodontic correction should be the elimination of any posterior discrepancy and the differential control of the occlusal plane. Therefore, by increasing the occlusal vertical height of the shifted or affected side, balanced muscle and articular disc positions can be restored, which is expected to contribute to the patient's TMD symptom resolution [74]. Furthermore, orthodontic treatment is aimed at controlling the occlusal plane, with consequent improvement of occlusal and articular functions [73,75,78].…”