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

作　　者：Tong Lu Li Mei Bao-Chao Li Zi-Wei Huang Huang Li 

机构地区：[1]Department of Orthodontics,Nanjing Stomatological Hospital,The Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,Jiangsu Province,China [2]Discipline of Orthodontics,Department of Oral Science,Faculty of Dentistry,University of Otago,Dunedin 9016,New Zealand

出　　处：《World Journal of Clinical Cases》2024年第2期431-442,共12页世界临床病例杂志

基　　金：Natural Science Foundation of Jiangsu Province, No. SBK2021021787;the Major Project of the Health Commission ofJiangsu Province, No. ZD2022025;and the Key Project of the Nanjing Health Commission, No. ZKX20048.

摘　　要：BACKGROUND The relation between orthodontic treatment and temporomandibular disorders(TMDs)is under debate;the management of TMD during orthodontic treatment has always been a challenge.If TMD symptoms occur during orthodontic treatment,an immediate pause of orthodontic adjustments is recommended;the treatment can resume when the symptoms are managed and stabilized.CASE SUMMARY This case report presents a patient(26-year-old,female)with angle class I,skeletal class II and TMDs.The treatment was a hybrid of clear aligners,fixed appliances and temporary anchorage devices(TADs).After 3 mo resting and treatment on her TMD,the patient’s TMD symptom alleviated,but her anterior occlusion displayed deep overbite.Therefore,the fixed appliances with TAD were used to correct the anterior deep-bite and level maxillary and mandibular deep curves.After the levelling,the patient showed dual bite with centric relation and maximum intercuspation discrepancy on her occlusion.After careful examination of temporomandibular joints(TMJ)position,the stable bite splint and Invisible Mandibular Advancement appliance were used to reconstruct her occlusion.Eventually,the improved facial appearance and relatively stable occlusion were achieved.The 1-year follow-up records showed there was no obvious change in TMJ morphology,and her occlusion was stable.CONCLUSION TMD screening and monitoring is of great clinical importance in the TMD susceptible patients.Hybrid treatment with clear aligners and fixed appliances and TADs is an effective treatment modality for the complex cases.

关 键 词：Temporomandibular disorder Skeletal class II Deep overbite Dual bite Invisible mandibular advancement appliance Case report 

分 类 号：R78[医药卫生—口腔医学]