Effect of temporomandibular joint articular disc repositioning on anterior open-bite malocclusion: An orthodontic-surgical approach

Abstract

An anterior open bite is a challenge to orthodontic treatment; it has a multifactorial etiology and a wide range of intervention options. Temporomandibular joint (TMJ) disorders are a risk factor for the development of malocclusions such as the anterior open bite, especially in patients who have TMJ osteoarthritis with disc displacement. Articular disc repositioning surgery is an available option for treating this pathology, and it contributes to maintaining the condyles in a more stable position. The aim of this article was to report the case of a 20-year-old woman diagnosed with anterior open bite and TMJ osteoarthritis with bilateral disc displacement. The patient received both orthodontic treatment and TMJ disc repositioning surgery. Cone-beam computed tomography was used to create 3-dimensional models of the condyles with regional superposition, and assessment of bone remodeling was performed at different time intervals. Complete orthodontic and surgical treatment time was approximately 12 months. The results provided a stable correction of the patient's anterior open bite with a 2-year follow-up and favorable bone remodeling of the condyles due to functional improvement of the TMJ.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

“…Bianchi et al 345 submitted an interesting case study of the effect of TMJ articular disk repositioning in an AOOR malocclusion. Clinical characteristics of the anterior open malocclusion include excessive gonial, mandibular, and occlusal plane angles; small mandibular body and ramus; increased lower anterior facial height; decreased upper anterior facial height; class II tendency; and inadequate lip coverage.…”

Open Bite Treatment with Combined Aligners and Myofunctional Appliances: A Case Report

“…In some cases, the aetiology can be identified in incorrect habits like oral respiration or non-nutritive sucking, whose severity and impact on the malocclusion depend on duration, frequency, and severity, as well as the age of the patient [7]. There are several treatment options for reducing the aetiological factors that sustain an AOB [4,6,8,9] and for limiting the excessive vertical growth of the facial skeletal components [5,7,10].…”

Open bite in adult patients

“…4,5 Depending on the duration, frequency, intensity and age, non-nutritive sucking habits and mouth breathing may cause deformities on the dentofacial complex as a response to the continuous pressure. 2,6 Several treatment options are presented in the literature, 1,7,8 aiming to inhibit the mechanical factors that maintain the anterior open bite and/or limit the excessive vertical growth of facial skeletal components. 2,4,9,10 The removal of harmful habits is a complex therapy with psychological, emotional and family involvement.…”