Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
권호 표지
DOI QR코드

DOI QR Code

Anterior Open Bite with Temporomandibular Joint Osteoarthritis Treated with Skeletal Anchorage Device: A Case Report

  • Seo-Rin Jeong (Department of Orthodontics, College of Dentistry, Chosun University) ;
  • So-Yoon Lee (Department of Orthodontics, Chosun University Dental Hospital) ;
  • Sung-Hoon Lim (Department of Orthodontics, College of Dentistry, Chosun University) ;
  • Hye-Min Kim (Department of Orthodontics, Chosun University Dental Hospital) ;
  • Shin-Gu Kang (Gouni Orthodontic Clinic) ;
  • Hyun-Jeong Park (Department of Oral Medicine, College of Dentistry, Chosun University)
  • Received : 2023.08.28
  • Accepted : 2023.09.12
  • Published : 2023.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

This case report describes the orthodontic treatment of a patient with severe anterior open bite and skeletal class II malocclusion with temporomandibular joint (TMJ) osteoarthritis (OA) of the left condyle. The 21-year-old male patient had open-bite malocclusion, mild crowding, and protrusion of the anterior teeth. Mild erosive changes were detected in the anterior part of the left mandibular condyle on cone-beam computed tomography; however, because no clinical symptoms were present, orthodontic treatment was performed. It is imperative to consider the potential implications of orthodontic treatment on the stability of the TMJ throughout the duration of treatment, as any instability can exacerbate TMJ OA. Hence, it is crucial to opt for the least invasive treatment modality available. In this regard, orthodontic treatment using a skeletal anchorage system as an alternative to conventional orthognathic surgery for patients with open bite holds great promise, as it not only ensures mandibular stability but also significantly ameliorates the open-bite condition.

Keywords

Acknowledgement

This study was supported by research funds from Chosun University Dental Hospital, Korea, 2021.

References

  1. Ng CS, Wong WK, Hagg U. Orthodontic treatment of anterior open bite. Int J Paediatr Dent 2008;18:78-83.
  2. Zuroff JP, Chen SH, Shapiro PA, Little RM, Joondeph DR, Huang GJ. Orthodontic treatment of anterior open-bite malocclusion: stability 10 years postretention. Am J Orthod Dentofacial Orthop 2010;137:302.e1-e8; discussion 302-303. https://doi.org/10.1016/j.ajodo.2009.10.024
  3. Speidel TM, Isaacson RJ, Worms FW. Tongue-thrust therapy and anterior dental open-bite. A review of new facial growth data. Am J Orthod 1972;62:287-295. https://doi.org/10.1016/S0002-9416(72)90267-9
  4. Massilla Mani F, Sivasubramanian SS. A study of temporomandibular joint osteoarthritis using computed tomographic imaging. Biomed J 2016;39:201-206. https://doi.org/10.1016/j.bj.2016.06.003
  5. Byun ES, Ahn SJ, Kim TW. Relationship between internal derangement of the temporomandibular joint and dentofacial morphology in women with anterior open bite. Am J Orthod Dentofacial Orthop 2005;128:87-95. https://doi.org/10.1016/j.ajodo.2004.01.028
  6. Bansal M. Prevalence and diagnostic features of osteoarthrosis of the temporomandibular joint: a review. Int J Res Orthop 2016;2:1-4. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20160708
  7. Kim YK. Temporomandibular joint disorder and occlusal changes. J Korean Dent Sci 2018;11:21-31.
  8. Hart TR, Cousley RR, Fishman LS, Tallents RH. Dentoskeletal changes following mini-implant molar intrusion in anterior open bite patients. Angle Orthod 2015;85:941-948. https://doi.org/10.2319/090514-625.1
  9. Kuroda S, Sakai Y, Tamamura N, Deguchi T, Takano-Yamamoto T. Treatment of severe anterior open bite with skeletal anchorage in adults: comparison with orthognathic surgery outcomes. Am J Orthod Dentofacial Orthop 2007;132:599-605. https://doi.org/10.1016/j.ajodo.2005.11.046
  10. Arai C, Choi JW, Nakaoka K, Hamada Y, Nakamura Y. Management of open bite that developed during treatment for internal derangement and osteoarthritis of the temporomandibular joint. Korean J Orthod 2015;45:136-145. https://doi.org/10.4041/kjod.2015.45.3.136
  11. Al-Moraissi EA, Wolford LM. Does temporomandibular joint pathology with or without surgical management affect the stability of counterclockwise rotation of the maxillomandibular complex in orthognathic surgery? a systematic review and meta-analysis. J Oral Maxillofac Surg 2017;75:805-821. https://doi.org/10.1016/j.joms.2016.10.034
  12. Proffit WR, Bailey LJ, Phillips C, Turvey TA. Long-term stability of surgical open-bite correction by Le Fort I osteotomy. Angle Orthod 2000;70:112-117.
  13. Kato C, Ono T. Anterior open bite due to temporomandibular joint osteoarthrosis with muscle dysfunction treated with temporary anchorage devices. Am J Orthod Dentofacial Orthop 2018;154:848-859. https://doi.org/10.1016/j.ajodo.2017.06.030
  14. Deguchi T, Kurosaka H, Oikawa H, et al. Comparison of orthodontic treatment outcomes in adults with skeletal open bite between conventional edgewise treatment and implant-anchored orthodontics. Am J Orthod Dentofacial Orthop 2011;139(4 Suppl):S60-S68. https://doi.org/10.1016/j.ajodo.2009.04.029
  15. Alsafadi AS, Alabdullah MM, Saltaji H, Abdo A, Youssef M. Effect of molar intrusion with temporary anchorage devices in patients with anterior open bite: a systematic review. Prog Orthod 2016;17:9.
  16. Seo YS, Park HJ, Yu SK, Jeong SR, Ryu JW. Evaluation of cortical bone formation on mandibular condyle in asymptomatic adolescents and young adults using cone-beam computed tomography. Life (Basel) 2022;12:2032.
  17. Park HJ, Ryu JW. Use of intermaxillary traction appliances and exercises to strengthen the masticatory muscles of patients with anterior open bite caused by temporomandibular joint osteoarthritis. J Oral Med Pain 2022;47:95-101. https://doi.org/10.14476/jomp.2022.47.2.95
  18. Chisnoiu AM, Picos AM, Popa S, et al. Factors involved in the etiology of temporomandibular disorders-a literature review. Clujul Med 2015;88:473-478. https://doi.org/10.15386/cjmed-485
  19. Arnett GW, Milam SB, Gottesman L. Progressive mandibular retrusion-idiopathic condylar resorption. Part I. Am J Orthod Dentofacial Orthop 1996;110:8-15. https://doi.org/10.1016/S0889-5406(96)70081-1