Yu LY, Xia K, Sun WT, Huang XQ, Chi JY, Wang LJ, Zhao ZH, Liu J. Orthodontic retreatment of an adult woman with mandibular backward positioning and temporomandibular joint disorder: A case report. World J Clin Cases 2022; 10(2): 691-702 [PMID: 35097096 DOI: 10.12998/wjcc.v10.i2.691]
Corresponding Author of This Article
Jun Liu, DDS, PhD, Professor, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu 610041, Sichuan Province, China. junliu@scu.edu.cn
Research Domain of This Article
Dentistry, Oral Surgery & Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 14, 2022; 10(2): 691-702 Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.691
Orthodontic retreatment of an adult woman with mandibular backward positioning and temporomandibular joint disorder: A case report
Li-Yuan Yu, Kai Xia, Wen-Tian Sun, Xin-Qi Huang, Jing-Yu Chi, Ling-Jie Wang, Zhi-He Zhao, Jun Liu
Li-Yuan Yu, Kai Xia, Wen-Tian Sun, Xin-Qi Huang, Zhi-He Zhao, Jun Liu, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
Jing-Yu Chi, Department of Stomatology, Strategic Support Force Medical Center of PLA, Beijing 10010, China
Ling-Jie Wang, Department of Stomatology, Qingyang People's Hospital, Qingyang 745000, Gansu Province, China
Author contributions: Xia K, Sun WT and Huang XQ performed reviewing and editing; Yu LY wrote original draft; Chi JY and Wang LJ contributed to software, measurement and data curation; Liu J and Zhao ZH conceptualization; all authors have read and approved the manuscript.
Informed consent statement: Written informed consent for publication of clinical details and clinical images were obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Liu, DDS, PhD, Professor, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu 610041, Sichuan Province, China. junliu@scu.edu.cn
Received: July 3, 2021 Peer-review started: July 3, 2021 First decision: September 28, 2021 Revised: October 9, 2021 Accepted: December 2, 2021 Article in press: December 2, 2021 Published online: January 14, 2022 Processing time: 192 Days and 17.8 Hours
Abstract
BACKGROUND
The role of occlusal factors on the occurrence of temporomandibular joint disorders (TMDs) is still unclear and it is tricky for orthodontists to treat malocclusions in patients with TMDs. We report the case of the second orthodontic treatment of an adult female with Class II division 2 malocclusion associated with TMD. With the removal of anterior occlusal interference, TMD symptoms were alleviated and cone beam computed tomography (CBCT) images showed the bilateral condyles shifted forward.
CASE SUMMARY
This case report presented an orthodontic retreatment of an adult female with TMD and mandibular backward positioning based on CBCT examination and Joint Space Index (JSI) analysis. The left and right JSI values of -38.5 and -52.6 indicated that the position of bilateral condyles had posterior displacement. Ten years prior to this evaluation, she underwent orthodontic treatment resulting in the extraction of two upper premolars and one lower central incisor. The joint symptoms, including pain and sounds, were alleviated along with verified mandibular forward repositioning by extraction of another lower central incisor.
CONCLUSION
Mandibular backward positioning could be associated with TMD. JSI analysis based on CBCT is a convenient way to examine condylar positions quantitatively.
Core Tip: Class II division 2 malocclusion is considered to be a risk factor for temporomandibular joint disorders (TMDs). In this case of the second orthodontic treatment of an adult female with Class II division 2 malocclusion associated with TMD, we measured the joint space to assess the condylar position and found that the bilateral condyles were located in the posterior position. We suspected that this patient’s TMD was a manifestation of mandibular backward positioning. Temporomandibular joint symptoms were alleviated with the removal of anterior occlusal interference, and the posttreatment cone beam computed tomography images showed that bilateral condyles shifted forward after orthodontic treatment.
