ISSN : 0376-4672
In the management of temporomandibular joint (TMJ) disorders, dental practioner should conduct the reversible, conservative,and inexpensive treatment modalities prior to the irreversible and invasive treatment. That is to say, behavioral, pharmacologic,and physical therapy should be conducted firstly, and then the occlusal appliance therapy could be considered. If patients do not react to these conservative treatments, we have to consider surgical treatments. If the accurate diagnosis is confirmed by intimate history taking, clinical and imaging examinations, we can rehabilitate the normal TMJ function and relieve the clinical symptoms with only conservative treatments in most TMJ disorder cases.
Temporomandibular joint disorder(TMJD) was mainly characterized with joint pain, motion limitation, joint sound, resulted from pathologic conditions in temporomandibular joint and around tissue. As temporomandibular joint is one of decisive factors determining the occlusion, disorders in temporomandibular joint may cause the occlusal changes. The causes of occlusal changes related with TMJD can be classified into 2 categories; (1) those related to progression of disorder, 2) those related to treatment of the disorder. The clinical manifestation of occlusal changes depend on their causes and affected site. Therefore, whenever possible, treatment should be directed to the relief of the underlying causes. However, it is not always possible to relieve the underlying conditions. Moreover, some occlusal changes may remain irreversible even after the considerable improvement in clinical symptoms. Regarding the treatment of the permanent occlusal changes, it has been reported that the extensive occlusal treatment including occlusal adjustment, prosthodontic treatment, orthodontic treatment should be applied. Here, we present with a case report of occlusal change caused by the progressive temporomandibular joint disorder, together with introducing the intermaxillary traction appliance as the possible treatment option.
Osteoarthritis is one of the most common degenerative disease in the temporomandibular joints (TMJ). Structural changes in the osseous structure is associated with destructive changes such as erosion, flattening and other bony changes. Destructive degenerative changes quite often cause shortening of the condyles which eventually produces the changes in the occulsion and the facial profile which require orthorgnathic surgery and/or orthodontic treatment by the dental professional. The dentists need to understand the nature and the pathophysiology of the osteoarthritis in the TMJ for the better dental treatment, especially in orthodontic and prosthodontic treatment. The possibility of serious complication can not be avoided after any dental treatment is given to the patient if osteoarthritic changes in the TMJ is under progression as undiscovered.
