Long-term follow up of improvements of anterior disc displacement with reduction using combination therapy: a case report

Abstract

This article is to review our approach to disc displacement with reduction case by using combination therapy of modified functional appliance (mFA) and multibracket appliance (MBA). This patient was a 17-year-old Japanese female who was complaining of right-side temporomandibular joint (TMJ) clicking, pain during mouth opening, and limitation of condylar movement at initial medical examination. We assumed that the clicking during mouth closing occurred in the mandibular position in which the displaced disc returned to normal position on the condyle, as we called therapeutic reference position (TRP), and performed mFA therapy, by which disappearance of clicking and subjective symptoms were obtained. We stabilized the occlusion by mFA and MBA setting at TRP and reconstructed occlusion was obtained with disappearance of all the clinical symptoms passed about 4 years of postretention. Therefore, it is possible that the combination therapy of mFA and MBA of occlusal reconstruction seems to be an effective treatment for the disc displacement with reduction cases.