Analysis of orthodontic treatment with mandibular relocation on temporomandibular joint of class Ⅱ division 2 malocclusion with temporomandibular disorders
Objective To explore the effect of mandibular relocation combined with orthodontic treatment on the morphology and clinical symptoms of the temporomandibular joint in class Ⅱ division 2 malocclusion adolescent with temporomandibular disorder (TMD). Methods A total of 44 adult orthodontic patients who visited the Department of Orthodontics at the Second Affiliated Hospital of Shandong First Medical University from December 2019 to December 2023 were selected (including 19 class Ⅱ division 2 malocclusion patients with TMD and 25 individual normal occlusion patients). The cone-beam computed tomography (CBCT) images were used to compare the morphology of temporomandibular joint,the change of joint snapping and the active opening degree before and after treatment,as well as the measurement values of temporomandibular joint with TMD class Ⅱ division 2 and individual normal occlusion. Results The anterior space in class Ⅱ division 2 malocclusion were greater than those in individual normal occlusion patients;while posterior space,inner diameter,condylar medialateral diameter,condylar anteroposterior diameter and condyle height were smaller (P<0.05). Furthermore,After treatment,the anterior articular space of class Ⅱ division 2 malocclusion adolescent with temporomandibular disorder was reduced,and the height of the fossa,the supra-articular space,the posterior articular space,the condylar anteroposterior diameter and the condyle height were increased (P<0.05). 78.95％ of class Ⅱ division 2 malocclusion with TMD was in the middle of the articular fossa after treatment. Conclusion There are differences in temporomandibular joint morphology between Class Ⅱ division 2 patients with TMD compared to individual normal occlusion patients. Orthodontic reconstruction can effectively improve symptoms of temporomandibular joint disorders in these patients as well as address issues related to occlusal relationship and abnormal condylar position.
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