Signs and symptoms of TMJ disorders in adults after adolescent Herbst therapy: A 6-year and 32-year radiographic and clinical follow-up study

Abstract

Objective: To analyze radiographic signs of temperomandibular joint (TMJ) osteoarthritis and clinical TMJ symptoms in patients 6 years and 32 years after treatment with a Herbst appliance. Materials and Methods: Fourteen patients were derived from a sample of 22 with Class II division 1 malocclusions consecutively treated with a banded Herbst appliance at the age of 12-14 years old (T1-T2). The subjects were reexamined after therapy at the ages of 20 years (T3) and 46 years (T4). The TMJs of the 14 patients were analyzed radiographically (conventional lateral tomography at T3 and cone-beam computed tomography at T4) and clinically/anamnestically at T3 and T4. Results: Six years after Herbst therapy, signs of osteoarthritis were seen in one patient. At the 32-year follow-up, two additional patients had developed signs of osteoarthritis. At the 6-year followup, TMJ clicking was present in two patients, though none of the patients reported TMJ pain. At the 32-year follow-up, six patients had TMJ clicking and one patient had TMJ pain. Conclusions: This longitudinal very-long-term follow-up study after Herbst therapy revealed only minor problems from the TMJ. The TMJ findings 6 years and 32 years after Herbst treatment corresponded to those in the general population. Thus, in the very long term, the Herbst appliance does not appear to be harmful to the TMJ. (Angle Orthod. 2015;85:735-742.)

Three-dimensional morphologic changes in the temporomandibular joint in asymptomatic patients who undergo orthodontic treatment: A systematic review

“…The 13 articles in this review were published between 2014 and 2020. Ten were prospective [24][25][26][27][28][29][30][31][32][33] and 3 were retrospective studies. [34][35][36] Five of the prospective studies were controlled, [26][27][28]30,32 and 5 were not controlled.…”

Temporomandibular disorders and occlusion effect on orthodontic treatment

“…16 In this context, previous investigations have indicated that conducting orthodontic treatment did not significantly impact the risk of developing temporomandibular joint disorders in patients suffering from class II and III skeletal malocclusions, whether by decreasing or increasing the estimated risk. [17][18][19] Besides, in cases of retracted maxillary teeth, it has been demonstrated that conducting premolar extractions modality was associated with manifestations of a posterior repositioning of the condyles as assessed using cone-beam computed tomography imaging modalities. 20 However, evidence regarding the impact of the approach on the induction of disc displacement is still poorly reported, and further investigations are required to comprehend this association furtherly.…”

Herbst Apareyi̇ İle Yapilan Ortodonti̇k Tedavi̇de Karşilaşilan Kompli̇kasyonlar

“…Sonuç olarak, Herbst tedavisinin uzun süreli takip çalışmasında, hastaların TME bulgularının genel popülasyondaki bireylerle benzer olduğu, TME'de sadece küçük komplikasyonların tespit edildiği ve bu nedenle uzun dönemde Herbst apareyinin TME için zararlı olmadığı iddia edilmiştir. 55 6. Relaps Relaps genel olarak ortodontik anomalilerin tedavisinden sonra kaçınılmaz olarak, değişen oranlarda olmak üzere tüm vakalarda bildirilmektedir.…”