Hybrid treatment of varied orthodontic appliances for a patient with skeletal class II and temporomandibular joint disorders: A case report and review of literature

Figure 1 Pretreatment facial, intraoral and progress photographs. A: Pretreatment facial and intraoral photographs; B: Progress photographs in the 8^th month; C: Progress photographs in the 11^th month of the treatment (after 3 mo rest); D: Progress photographs in the 18^th month; E: Progress photographs in the 19^th month; F: Progress photographs in the 26^th month; G: Photographs after fixed treatment; H: Wearing mandibular advancement to forward the mandibular positioning in the 44^th month of treatment; I: Final photographs; J: Photographs after 1 years of follow-up.

Figure 2 Dental models. A: Pretreatment dental models; B: Dental models after fixed treatment; C: Final intraoral dental models.

Figure 3 Pretreatment lateral cephalometric and panoramic radiographs. A: Initial cephalometric radiograph; B: Cephalometric tracing; C-E: Panoramic radiograph.

Figure 4 Magnetic resonance imaging images, cone-beam computed tomography images and intraoral photos: 8^th month of the treatment. A and B: Magnetic resonance imaging (MRI) images of right and left temporomandibular joints (TMJ) in opening position; C and D: MRI images of right and left TMJ in closed position; E-H: Cone-beam computed tomography images of right and left TMJ in closed position; I-K: Intraoral photos.

Figure 5 Intraoral overbite photographs. A and D: First visit; B and E: 19^th month; C and F: 29^th month.

Figure 6 Dual bite at the 31^st month of treatment. A-C: Intraoral photos in centric relation (CR) position; D-F: Intraoral photos in maximum intercuspation (MI) position; G-H: 3D images of temporomandibular joints (TMJ) in CR and MI positions; I-L: Computed tomography images of TMJ in CR and MI positions.

Figure 7 Cephalometric tracing and cephalometric measurements. A: First visit; B: In centric relation position; C: In maximum intercuspation position.

Figure 8 Wearing stable occlusal splint to improve open-bite: 43^rd month of treatment. Intraoral photographs.

Figure 9 Cephalometric radiograph and superimpositions. A: Final cephalometric radiograph; B: Cephalometric tracing; C: Superimposition of lateral cephalograms (pretreatment: black, post treatment: red)

Figure 10  Orthodontic treatment flowchart.

Figure 11  Computed tomography images of temporomandibular joints after 1 years of follow-up. A: Right temporomandibular joint (TMJ) images; B: Left TMJ images.