Evaluation of Temporomandibular Joint Dysfunction by A Mandibular Tracing System: A Case Report

Abstract

Objective. The purpose of this case report is to present a digital mandibular tracing technique used to evaluate a patient with temporomandibular joint dysfunction (TMD). Clinical features. A 65-year-old Caucasian female patient presented with chronical jaw pain in her temporomandibular joint (TMJ) area. The patient describes a dental history of orthodontic and prosthodontic treatment. Orally patient exhibits super erupted teeth, multiply fractured restorations, facial gingival recession, and rotated teeth. The patient also had an uneven occlusal plane and non-working side contact at maxillary first and mandibular second molars. Evaluation and outcome. A digital mandibular tracing technique, cone beam computed tomography, and full-arch optical impressions were used to evaluate the patient's condition. The left condyle was slightly flat compared to the right one on the anterior surface. Limited protrusion and lateral movements and asymmetric border movements were detected. Apparently, an incomplete orthodontic treatment at the patient's early age, iatrogenic mandibular anterior restorations, and hit and slight effect are considered as causes for Temporo-mandibular joint problems. The recommended treatment plan sequence for this patient is an occlusal adjustment, replacement of defective restorations and fabrication of an occlusal guard for one of the arches. Conclusion. Digital mandibular tracing system can help the dentist to diagnose and analyze the causes of TMD patient specifically and individually. It also provides quick resolution and management for patients with TMD.