Non-extraction Orthodontics in Severe Open Bite with Disc Plication Surgery of the Temporomandibular Joint

Authors

Jessica Chia-Yi Wang, Division of orthodontics, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Meng-Yen Chen, Division of oral maxillofacial surgery, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Kuan-Yu Lin, Division of orthodontics, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Tung-Yiu Wong, Division of oral maxillofacial surgery, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Chen-Jung Chang, Division of orthodontics, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanFollow

Abstract

Open bite malocclusion is among the most challenging orthodontic deformities to correct. Among the etiological factors of anterior open-bite, degenerative change in temporomandibular joints (TMJs) is the most difficult condition to manage. The most appropriate treatment modality for TMJ disorder with disc displacement remains controversal. Disc repositioning surgery is a treatment option when conservative treatment has failed to resolve symptoms. We presented a patient had history of gradual bite opening associated with joint stiffness and clicking. She received occlusal splint therapy for more than 10 years, and the occlusion was stable for 1 year before orthodontic treatment was initiated. Based on magnetic resonance images (MRIs), the diagnosis of the TMJ disorder was anterior disc displacement without reduction in the right joint but with reduction in the left joint. Disc plication surgery was performed to minimize the risk of post-treatment relapse. Molar intrusion in both arches with temporary anchorage devices resulted in a counterclockwise mandibular rotation and an improvement in open bite. Anterior teeth extrusion is an alternative approach for the management of open bite and smile esthetics in patients with insufficient incisor show. Furthermore, tongue and lip training are also crucial procedures for post-treatment stability.

Recommended Citation

Wang, Jessica Chia-Yi; Chen, Meng-Yen; Lin, Kuan-Yu; Wong, Tung-Yiu; and Chang, Chen-Jung (2024) "Non-extraction Orthodontics in Severe Open Bite with Disc Plication Surgery of the Temporomandibular Joint," Taiwanese Journal of Orthodontics: Vol. 35: Iss. 4, Article 2.
https://doi.org/10.38209/2708-2636.1345
Available at: https://www.tjo.org.tw/tjo/vol35/iss4/2

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