Use of Intermaxillary Traction Appliances and Exercises to Strengthen the Masticatory Muscles of Patients with Anterior Open Bite Caused by Temporomandibular Joint Osteoarthritis: Case Reports

Temporomandibular joint osteoarthritis (TMJ OA) causes destruction of the temporomandibular joint (TMJ) and can lead to occlusal changes such as anterior open bite in some patients. Consequently, these patients may experience difficulty in chewing food items and exhibit abnormal functional habits such as bruxism, preventing healing of the TMJ condyles. Treatment protocols include the use of traction appliances to reduce stress on the condyles. Unstable occlusions can lead to weakness of the masticatory muscles which, in turn, worsen the occlusal changes and complicate pain management. Therefore, the current study evaluated the condition of the masseter muscle using ultrasonography and educated patients on the execution of gum-chewing exercises for muscle strengthening. It also aimed to assess the effects of traction appliances and strengthening exercises on the masticatory muscles of patients with occlusal changes caused by TMJ OA.