Kieferorthopädische Behandlung bei Patienten mit kraniomandibulärer Dysfunktion: ein Fallbericht

Zusammenfassung

Kraniomandibuläre Dysfunktionen können auch bei heranwachsenden Patienten vorkommen, die eine kieferorthopädische Behandlung nachsuchen. Der Kieferorthopäde muss also in der Lage sein, solche Dysfunktionen zu erkennen und zu behandeln, um ein gutes Behandlungsergebnis sowohl in okklusaler, als auch in funktioneller Hinsicht sicherstellen zu können. Der vorliegende Fallbericht zeigt, auf welche Weise eine Patientin mit Diskusverlagerung ohne Reposition des Diskus, mit kraniomandibulären Beschwerden und einer Klasse-II-Malokklusion behandelt werden konnte.

Abstract

Temporomandibular disorders (TMD) may also occur in growing patients seeking orthodontic treatment. The orthodontist must be able to identify and manage dysfunction to ensure a good result both for the occlusal and the functional point of view. This case report shows how to manage the treatment of a patient with disc displacement without reduction, temporomandibular pain and a Class II malocclusion.

Schlüsselwörter

kraniomandibuläre Dysfunktion - skelettale Klasse-II-Malokklusion - Diskusverlagerung - kieferorthopädische Behandlung

Key words

temporomandibular ­disorders - skeletal class II malocclusion - disc displacement - orthodontic treatment

• Literatur

• 1 De Boever JA, Nilner M, Orthlieb JD et al. Educational Committee of the European Academy of Craniomandibular Disorders. Recommendations by the EACD for examination, diagnosis, and management of patients with temporomandibular disorders and orofacial pain by the general dental practitioner. J Orofac Pain 2008; 22 (03) 268-278
• 2 Schiffman EL, Truelove EL, Ohrbach R et al. The research diagnostic criteria for temporomandibular disorders. I: Overview and methodology for assessment of validity. J Orofac Pain 2010; 24 (01) 7-24
• 3 Stegenga B. Nomenclature and classification of temporomandibular joint disorders. J Oral Rehabil 2010; 37 (10) 760-765
• 4 Manfredini D. Etiopathogenesis of disk displacement of the temporomandibular joint: a review of the mechanisms. Indian J Dent Res 2009; 20 (02) 212-221
• 5 Kronn E. The incidence of TMJ dysfunction in patients who have suffered a cervical whiplash injury following a traffic accident. J Orofac Pain 1993; 7 (02) 209-213
• 6 Harkins SJ, Marteney JL. Extrinsic trauma: a significant precipitating factor in temporomandibular dysfunction. J Prosthet Dent 1985; 54 (02) 271-272
• 7 Larheim TA, Westesson P, Sano T. Temporomandibular joint disk displacement: comparison in asymptomatic volunteers and patients. Radiology 2001; 218 (02) 428-432
• 8 Gidarakou IK, Tallents RH, Kyrkanides S et al. Comparison of skeletal and dental morphology in asymptomatic volunteers and symptomatic patients with bilateral disk displacement without reduction. Angle Orthod 2004; 74 (05) 684-690
• 9 Gidarakou IK, Tallents RH, Stein S et al. Comparison of skeletal and dental morphology in asymptomatic volunteers and symptomatic patients with unilateral disk displacement with reduction. Angle Orthod 2004; 74 (02) 212-219
• 10 Gidarakou IK, Tallents RH, Stein S et al. Comparison of skeletal and dental morphology in asymptomatic volunteers and symptomatic patients with unilateral disk displacement without reduction. Angle Orthod 2003; 73 (02) 121-127
• 11 Gidarakou IK, Tallents RH, Stein S et al. Comparison of skeletal and dental morphology in asymptomatic volunteers and symptomatic patients with bilateral disk displacement with reduction. Angle Orthod 2002; 72 (06) 684-690
• 12 Gidarakou IK, Tallents RH, Kyrkanides S et al. Comparison of skeletal and dental morphology in asymptomatic volunteers and symptomatic patients with normal temporomandibular joints. Angle Orthod 2003; 73 (02) 116-120
• 13 Michelotti A, de Wijer A, Steenks M et al. Home-exercise regimes for the management of non-specific temporomandibular disorders. J Oral Rehabil 2005; 32 (11) 779-785
• 14 Kraus SL. (ed.). Temporomandibular Disorders. Clinics in Physical Therapy Ser. 2^nd ed. Churchill Livingstone; New York: 1994
• 15 Michelotti A, Iodice G. The role of orthodontics in temporomandibular disorders. J Oral Rehabil 2010; 37 (06) 411-429
• 16 Emshoff R, Moriggl A, Rudisch A et al. Are temporomandibular joint disk displacements without reduction and osteoarthrosis important determinants of mandibular backward positioning and clockwise rotation?. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 111 (04) 435-441
• 17 Kurita H, Ohtsuka A, Kobayashi H et al. Resorption of the lateral pole of the mandibular condyle in temporomandibular disc displacement. Dentomaxillofac Radiol 2001; 30 (02) 88-91
• 18 Bryndahl F, Warfvinge G, Eriksson L et al. Cartilage changes link retrognathic mandibular growth to TMJ disc displacement in a rabbit model. Int J Oral Maxillofac Surg 2011; 40 (06) 621-627
• 19 Bryndahl F, Eriksson L, Legrell PE et al. Bilateral TMJ disk displacement induces mandibular retrognathia. J Dent Res 2006; 85 (12) 1118-1123
• 20 Franchi L, Baccetti T, McNamara Jr JA. Mandibular growth as related to cervical vertebral maturation and body height. Am J Orthod Dentofacial Orthop 2000; 118 (03) 335-340
• 21 Ruf S, Pancherz H. Does bite-jumping damage the TMJ? A prospective longitudinal clinical and MRI study of Herbst patients. Angle Orthod 2000; 70 (03) 183-199
• 22 Heinig N, Göz G. Clinical application and effects of the Forsus spring. A study of a new Herbst hybrid. J Orofac Orthop 2001; 62 (06) 436-450
• 23 Ettlin DA, Mang H, Colombo V et al. Stereometric assessment of TMJ space variation by occlusal splints. J Dent Res 2008; 87 (09) 877-881