[Functional and orthodontic treatment of a patient with an open bite craniomandibular disorder]

In a 21-year-old man with open bite, myogenic headache and internal derangement of the temporomandibular joint clinical examination was supplemented by radiographs of the joints, cephalometric analysis, electromyographic recordings of the masticatory muscles and tracking of mandibular movements. His condition was characterized by reduced occlusal stability with contact limited to posterior molars, and weak elevator muscles with increased strain during posture and chewing. The purpose of the treatment was to eliminate symptoms with a reflex-releasing stabilizing splint. Secondly, to increase occlusal stability, primarily with the splint and later through orthodontic treatment aiming at closing the bite in the premolar region because the reduced occlusal stability seemed to be a significant etiologic factor. Treatment with the splint reduced signs and symptoms of craniomandibular disorders. During the following orthodontic treatment, contact was established on both premolars and molars, mainly due to extrusion of mandibular premolars. Analysis showed greater elevator strength and decreased muscular loading after treatment. A splint was used for retention accompanied by muscle training with exercise gum. Permanent training with gum was recommended after the retention period.