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http://dx.doi.org/10.5125/jkaoms.2012.38.5.284

Anterior open bite with temporomandibular disorders treated with intermaxillary traction using skeletal anchorage system  

Kim, Hye-Sun (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University)
Lee, Sang-Hoon (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University)
Youn, Taegyun (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University)
Kim, Hyung-Gon (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University)
Huh, Jong-Ki (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University)
Publication Information
Journal of the Korean Association of Oral and Maxillofacial Surgeons / v.38, no.5, 2012 , pp. 284-294 More about this Journal
Abstract
Objectives: The anterior open bite with temporomandibular disorders (TMD) is one of the most challenging cases both orthodontically and surgically. We introduce an intermaxillary traction treatment for patients with anterior open bite and TMD using a skeletal anchorage system (SAS). Materials and Methods: This study was comprised of 52 patients with anterior open bite and TMD. A total of four mini-screws were inserted, two screws each into the maxilla and mandible, to obtain a class II pattern of elastic application with 120-200 g force. Adjunctive muscle relaxation treatments, such as splint therapy, medication, and botulinum toxin injection were applied during or before intermaxillary traction. At least one treatment among adjunctive muscle relaxation treatment, mentioned above, was applied to 96.2% of patients. We evaluated the clinical characteristics of patients, TMD symptom changes, amount of open bite improved. The degree of open bite improvement was compared between the open bite-reduced group (21 patients) and not-reduced group (5 patients). Results: TMD symptoms (muscle/joint pain, joint sound, mouth opening) remained or improved in most patients, and worsened in about 10% of patients for each items. Anterior open bite was improved by a mean of 1.75 mm (P<0.01) during treatment. The open bite-reduced group exhibited a significant open bite improvement compared to the not-reduced group (P<0.05), with 37% of open bite improvement occurring during the first 3 months of treatment. Conclusion: The intermaxillary traction technique using SAS is a valid modality for correction of anterior open bite and improvement of TMD symptoms.
Keywords
Open bite; Malocclusion; Temporomandibular disorders; Intermaxillary traction;
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Times Cited By KSCI : 1  (Citation Analysis)
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1 Riolo ML, Brandt D, TenHave TR. Associations between occlusal characteristics and signs and symptoms of TMJ dysfunction in children and young adults. Am J Orthod Dentofacial Orthop 1987; 92:467-77.
2 Tanne K, Tanaka E, Sakuda M. Association between malocclusion and temporomandibular disorders in orthodontic patients before treatment. J Orofac Pain 1993;7:156-62.
3 Wiberg B, Wänman A. Signs of osteoarthrosis of the temporomandibular joints in young patients: a clinical and radiographic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86: 158-64.
4 Smithpeter J, Covell D Jr. Relapse of anterior open bites treated with orthodontic appliances with and without orofacial myofunctional therapy. Am J Orthod Dentofacial Orthop 2010;137:605-14.
5 Arnett GW, Milam SB, Gottesman L. Progressive mandibular retrusion--idiopathic condylar resorption. Part I. Am J Orthod Dentofacial Orthop 1996;110:8-15.
6 Arnett GW, Milam SB, Gottesman L. Progressive mandibular retrusion-idiopathic condylar resorption. Part II. Am J Orthod Dentofacial Orthop 1996;110:117-27.
7 Mercuri LG. Surgical management of TMJ arthritis. In: Laskin DM, Greene CS, Hylander WL, eds. TMDs: an evidence-based approach to diagnosis and treatment. Chicago: Quintessence; 2006:455-68.
8 Klasser GD, Greene CS. Oral appliances in the management of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:212-23.
9 Magdaleno F, Ginestal E. Side effects of stabilization occlusal splints: a report of three cases and literature review. Cranio 2010; 28:128-35.
10 Oliveira JA, Bloomquist DS. The stability of the use of bilateral sagittal split osteotomy in the closure of anterior open bite. Int J Adult Orthodon Orthognath Surg 1997;12:101-8.
11 Weinberg LA. Anterior condylar displacement: its diagnosis and treatment. J Prosthet Dent 1975;34:195-207.
12 Weinberg LA. Posterior bilateral condylar displacement: its diagnosis and treatment. J Prosthet Dent 1976;36:426-40.
13 Egermark I, Blomqvist JE, Cromvik U, Isaksson S. Temporomandibular dysfunction in patients treated with orthodontics in combination with orthognathic surgery. Eur J Orthod 2000;22:537-44.
14 Henrikson T, Ekberg EC, Nilner M. Symptoms and signs of temporomandibular disorders in girls with normal occlusion and Class II malocclusion. Acta Odontol Scand 1997;55:229-35.
15 Aghabeigi B, Hiranaka D, Keith DA, Kelly JP, Crean SJ. Effect of orthognathic surgery on the temporomandibular joint in patients with anterior open bite. Int J Adult Orthodon Orthognath Surg 2001;16:153-60.
16 Kuroda S, Sugawara Y, Tamamura N, Takano-Yamamoto T. Anterior open bite with temporomandibular disorder treated with titanium screw anchorage: evaluation of morphological and functional improvement. Am J Orthod Dentofacial Orthop 2007; 131:550-60.
17 Kaku M, Koseki H, Kawazoe A, Abedini S, Kojima S, Motokawa M, et al. Treatment of a case of skeletal class II malocclusion with temporomandibular joint disorder using miniscrew anchorage. Cranio 2011;29:155-63.
18 Seedorf H, Scholz A, Kirsch I, Fenske C, Jüde HD. Pivot appliancesis there a distractive effect on the temporomandibular joint? J Oral Rehabil 2007;34:34-40.
19 Stansbury CD, Evans CA, Miloro M, BeGole EA, Morris DE. Stability of open bite correction with sagittal split osteotomy and closing rotation of the mandible. J Oral Maxillofac Surg 2010;68: 149-59.
20 Umemori M, Sugawara J, Mitani H, Nagasaka H, Kawamura H. Skeletal anchorage system for open-bite correction. Am J Orthod Dentofacial Orthop 1999;115:166-74.
21 Denison TF, Kokich VG, Shapiro PA. Stability of maxillary surgery in openbite versus nonopenbite malocclusions. Angle Orthod 1989;59:5-10.
22 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.
23 Kuroda S, Katayama A, Takano-Yamamoto T. Severe anterior open-bite case treated using titanium screw anchorage. Angle Orthod 2004;74:558-67.
24 Williamson EH. Temporomandibular dysfunction in pretreatment adolescent patients. Am J Orthod 1977;72:429-33.
25 Hoppenreijs TJ, Stoelinga PJ, Grace KL, Robben CM. Longterm evaluation of patients with progressive condylar resorption following orthognathic surgery. Int J Oral Maxillofac Surg 1999; 28:411-8.
26 Fu AS, Mehta NR, Forgione AG, Al-Badawi EA, Zawawi KH. Maxillomandibular relationship in TMD patients before and after short-term flat plane bite plate therapy. Cranio 2003;21:172-9.
27 Arnett GW, Tamborello JA, Rathbone JA. Temporomandibular joint ramifications of orthognathic surgery. In: Bell WH, ed. Modern practice in orthognathic reconstructive surgery. Philadelphia: WB Saunders; 1992:523-94.
28 Ellis E 3rd, Hinton RJ. Histologic examination of the temporomandibular joint after mandibular advancement with and without rigid fixation: an experimental investigation in adult Macaca mulatta. J Oral Maxillofac Surg 1991;49:1316-27.
29 Lopez-Gavito G, Wallen TR, Little RM, Joondeph DR. Anterior open-bite malocclusion: a longitudinal 10-year postretention evaluation of orthodontically treated patients. Am J Orthod 1985; 87:175-86.
30 Lee HA, Park YC. Treatment and posttreatment changes following intrusion of maxillary posterior teeth with miniscrew implants for open bite correction. Korean J Orthod 2008;38:31-40.
31 Chang YI, Moon SC. Cephalometric evaluation of the anterior open bite treatment. Am J Orthod Dentofacial Orthop 1999;115:29-38.
32 Reitan K, Rygh P. Biomechanical principles and reactions. In: Graber TM, Vanarsdall RL, eds. Orthodontics: current principles and techniques. 2nd ed. St. Louis: Mosby; 1994:168-9.
33 Proffit WR, Bailey LJ, Phillips C, Turvey TA. Long-term stability of surgical open-bite correction by Le Fort I osteotomy. Angle Orthod 2000;70:112-7.
34 Deshpande RG, Mhatre S. TMJ disorders and occlusal splint therapy: a review. International Journal of Dental Clinics 2010;2: 22-9.
35 Cha YH, Kim BJ, Lim JH, Park KH, Kim HG, Huh JK. Analysis of treatment patterns of temporomandibular disorders. J Korean Assoc Oral Maxillofac Surg 2010;36:520-7.
36 Dionne RA. Pharmacologic approaches. In: Laskin DM, Greene CS, Hylander WL, eds. TMDs: an evidence-based approach to diagnosis and treatment. Chicago: Quintessence; 2006:347-57.
37 De Laat A, Stappaerts K, Papy S. Counseling and physical therapy as treatment for myofascial pain of the masticatory system. J Orofac Pain 2003;17:42-9.