The individuality of the patient and the temporomandibular joints. Part I

Abstract

T h i s clinical report uses the individual case 9 eport method of clinical research. It is directed toward he-individual variations in growth of the mandibular :ondyle and the behavior and pattern of growth of the 'acial skeleton, focusing on the influences on ortholontic treatment and temporomandibular joint dys'unction. 9 Faulty intercuspation of the teeth and dental intru;ions into the freeway space are two of the many eti)logic factors that may lead to joint dysfunction and its ;equelae. lntercuspation of the teeth, which operate hrough the proprioceptive functions of the periodonium, can be a major influence on mandibular position n closure after initial contact. Faulty intercuspation can )verload a joint in various ways. Dysfunction of the oints and musculature may occur before orthodontic reatment, during treatment, or anytime after treatment aas been completed. Whether related directly to treatnent or not, the orthodontist must be alert to recognize ;uch dysfunction and intervene whenever it may occur. The primary team for management and treatment ffthese conditions is the orthodontist and the restorative tentist. One or the other or both, combining their ef:'orts, can correct a majority of these problems related :o abnormal occlusal function. On some occasions, sur;ical intervention may be required to reposition the naxilla or correct other skeletal deformities, but surgical revision of the joint itself is seldom required in ldults and never in young persons. The role of the orthodontist in correcting a mal9cclusion is a complex one that requires moving teeth :o a desired dental occlusion in harmony with normal :elations of the joint structures, and this is best accomalished in a growing face where relationships among ill of the components are in a continual state of flux. rhe ultimate goal is optimal intercuspation of the teeth tnd normal temporomandibular joint (TMJ) function