Huang ZW, Yang R, Gong C, Zhang CX, Wen J, Li H. Treatment of severe open bite and mandibular condyle anterior displacement by mini-screws and four second molars extraction: A case report. World J Clin Cases 2023; 11(15): 3599-3611 [PMID: 37383903 DOI: 10.12998/wjcc.v11.i15.3599]
Corresponding Author of This Article
Huang Li, PhD, Professor, Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, No. 30 Central Road, Nanjing 210000, Jiangsu Province, China. lihuang76@nju.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. May 26, 2023; 11(15): 3599-3611 Published online May 26, 2023. doi: 10.12998/wjcc.v11.i15.3599
Treatment of severe open bite and mandibular condyle anterior displacement by mini-screws and four second molars extraction: A case report
Zi-Wei Huang, Ren Yang, Cheng Gong, Cai-Xia Zhang, Juan Wen, Huang Li
Zi-Wei Huang, Ren Yang, Cheng Gong, Cai-Xia Zhang, Juan Wen, Huang Li, Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210000, Jiangsu Province, China
Author contributions: Huang ZW performed the orthodontic treatments under the supervision of Li H, and made contributions to collecting data and drafting the paper; Yang R made contributions to collecting data and drafting the paper; Gong C made contributions to lateral cephalometric radiographs and CBCT 3D superimposition; Wen J made contributions to revising and editing the manuscript; Zhang CX made contributions to revising and editing the manuscript; Li H made contributions to the conception and design of the paper, and clinical supervision of the treatments.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Huang Li, PhD, Professor, Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, No. 30 Central Road, Nanjing 210000, Jiangsu Province, China. lihuang76@nju.edu.cn
Received: January 28, 2023 Peer-review started: January 28, 2023 First decision: February 28, 2023 Revised: March 7, 2023 Accepted: April 18, 2023 Article in press: April 18, 2023 Published online: May 26, 2023 Processing time: 117 Days and 14.5 Hours
Abstract
BACKGROUND
Temporomandibular joint (TMJ) disorders are closely related to high-angle and skeletal Class II malocclusion. Sometimes pathological changes in the mandibular condyle can cause open bite to occur after growth is complete.
CASE SUMMARY
This article is about the treatment of an adult male patient with a severe hyperdivergent skeletal Class II base, an unusual and gradually occurring open bite and an abnormal mandibular condyle anterior displacement. Because the patient refused surgery, four second molars with cavities and root canal therapy were extracted, and four mini-screws were used for intrusion of the posterior teeth. The treatment duration was 22 mo, and after the treatment, the open bite was corrected and the displaced mandibular condyles were seated back to the articular fossa as shown by cone-beam computed tomography (CBCT). Based on the patient’s open bite history, the result of clinical examinations and CBCT comparisons, we believe it is possible that the occlusion interference was eliminated after the four second molars were extracted and the posterior teeth were intruded, and the patient's condyle spontaneously returned to its physiologic position. Finally, a normal overbite was established, and stable occlusion was achieved.
CONCLUSION
This case report suggested that identifying the cause of open bite is essential, and the TMJ factors for hyperdivergent skeletal Class II cases should be particularly examined. For these cases, intruding posterior teeth may place the condyle in a more appropriate position and provide an environment suitable for TMJ recovery.
Core Tip: This article is about the treatment of an adult male patient with a severe hyperdivergent skeletal Class II base, an unusual and gradually occurring open bite and an abnormal mandibular condyle anterior displacement. This case report suggested that identifying the cause of open bite is essential, and the temporomandibular joint (TMJ) factors for hyperdivergent skeletal Class II cases should be particularly examined. For these cases, intruding posterior teeth may place the condyle in a more appropriate position and provide an environment suitable for TMJ recovery.
