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Patient O. from case 1 has undergone CT scan examinations
several months after the completion of the treatment. The
goal of this research was to evaluate the long term effect of
the completed interdisciplinary treatment on the condition
and integrity of the alveolar bone and on the position and
stability of the roots of the teeth within the bone. An image
from this examination can be seen in fig. 19.
The assessments of this and other images for this patient
are consistent with the picture of normal alveolar bone
with roots of the teeth positioned proportionally within
the boundaries of the bone. There is no visible damage,
dehiscences or fenestrations in the buccal alveolar plate and
no bone loss can be observed.
These CT scans illustrate the “whole bone” remodeling
response to successfully performed orthopedic and
orthodontic treatment.
Conclusion
The addition of the orthodontic treatment to interdisciplinary
approach to solve TMD can result in permanent resolution of
the patient’s TMJ issues. The final outcome of this treatment
results in much improved position inside TM joints, significant
enhancement of the patient’s overall facial appearance,
occlusion, function and esthetic aspects of the smile. This
treatment philosophy gives the dentist an opportunity to
assess patients in a different way. The ensuing orthodontic
treatment with special attention paid to dentofacial
orthopedics allows for the remodeling of a patient’s alveolar
bone and whole dentoalveolar complex. The bone movement
creates a proper orthopedic relationship between the jaws
with stable results and healthier TMJ. The implementation
of this phase of the treatment places teeth and jaws in the
position that dramatically improves the dentist’s ability
to perform its restorative part. The overall results of the
treatment are elimination of the majority of TMJ problems,
much improved facial appearance, youthful look and proper
occlusion allowing for better patient’s functional ability and
esthetically attractive smile.
References
1. LeResche L. Epidemiology of temporomandibular disorders: implications for the
investigation of etiologic factors. Crit Rev Oral Biol Med. 1997;8:291-305.
2. Luter F. TMD and occlusion part I. Damned if we do? Occlusion: the interface
of dentistry and orthodontics. British Dental Journal. 2007;202:E2.
3. Luter F, Layton S, McDonald F. Orthodontics for treating temporomandibular
joint(TMJ) disorders (Review). 2010 The Cochrane Collaboration.
4. Wyatt W.E. Preventing adverse effects on the temporomandibular joint through
orthodontic treatment. Am J Orthod Dentofacial Orthop. 1987;91:493-9.
5. Capurso U, Marni I. Orthodontic treatment of TMJ disc displacement with
pain: an 18 year follow-up. Prog Orthod. 2007;8(2):240-50.
6. Dennis R. Brenkert. Orthodontic treatment for the TMJ patient following splint
therapy to stabilize a displaced disk(s): a systemized approach. Part I, TMJ
orthodontic diagnosis. Cranio: The Journal of Craniomandibular Practice.
28.3 (July 2010) p.193.
7. Dennis R. Brenkert. Orthodontic treatment for the TMJ patient following
splint therapy to stabilize a displaced disk(s): a systemized approach. Part II.
Cranio: The Journal of Craniomandibular Practice. 28.4 (Oct. 2010) p.260.
8. Desteno C V, et al.: Phase II rehabilitation of the temporomandibular joint
dysfunction patient. Clin Prey Dent. 1989; 11(5):29-32.
9. Birte Melsen. Biological reaction of alveolar bone to orthodontic tooth
movement. The Angle orthodontist. 1999;69(2):151-6.
10. Birte Melsen. Tissue reaction to orthodontic tooth movement - a new
paradigm. European Journal of Orthodontics. 2001;23:671-81.
11. Cacciafesta V. Dr. Birte Melsen on adult orthodontic treatment. J Clin
Orthod. 2006;12:703-16.
12. Michael O. Williams and Neal C. Murphy. Beyond the Ligament: A Whole-
Bone Periodontal View of Dentofacial Orthopedics and Falsification of
Universal Alveolar Immutability. Seminars in Orthodontics, Vol. 14, No 4
(December), 2008;246-59.
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