Temporomandibular joint dysfunction. Report of a case.

Area of Science:

• Dentistry
• Orthodontics
• Temporomandibular Joint Disorders

Background:

• Chronic temporomandibular joint (TMJ) disorders can be complex to diagnose and treat.
• Orthodontic retention and latent mandibular growth can lead to occlusal interferences, specifically anterior premature centric contacts.
• These interferences can prevent proper posterior tooth occlusion and cause condylar dislocation.

Observation:

• A patient presented with a chronic left TMJ disorder.
• Anterior premature centric contacts were identified as the cause of the TMJ dysfunction.
• The premature contacts restricted mandibular movement, leading to condylar instability.

Findings:

• Occlusal bite splint therapy facilitated a repositioning of the mandible, achieving greater maxillomandibular stability.
• The therapy highlighted the necessity of anterior freedom in the occlusion for proper mandibular function.
• Subsequent orthodontic adjustments, including slight intrusion and axial inclination changes of maxillary incisors, provided centric occlusion freedom and allowed the condyle to seat properly in the glenoid fossa.
• TMJ radiographs confirmed the clinical findings and successful condylar seating.

Implications:

• This case report underscores the efficacy of occlusal bite splint therapy in managing TMJ disorders linked to occlusal disharmony.
• It emphasizes the critical role of functional occlusion and anterior guidance in maintaining TMJ health.
• The findings suggest that orthodontic re-treatment, guided by principles of functional occlusion, can successfully resolve chronic TMJ issues and improve patient outcomes.