Treatment approach to patients with distal malocclusion complicated by temporomandibular joint pain-dysfunction syndrome

Abstract

Research is effective sequencing of measures for orthodontic treatment active period and unfavorable course of retention period predictors in patients with distal malocclusion, complicated by temporomandibular joint pain-dysfunction syndrome. The retrospective study consists of 102 case reports of patients from 18 to 37 (average age is 26.75±3.25 years) with distal malocclusion (Angle Class II division 2 subdivision) associated with temporomandibular joint pain-dysfunction syndrome. Cases of successful treatment were 30.4% (n=31), semi-successful - 42.2% (n=43), semi-unsuccessful - 18.6% (n=19), unsuccessful - 8.8% (n=9). ANOVA analysis of orthodontic treatment stages reveals main risk factors for pain syndrome recurrence in retention period. The ineffective morphofunctional compensation and unsuccessful orthodontic treatment predictors are: incomplete pain syndrome elimination, persistent masticatory muscles dysfunction, distal malocclusion recurrence, condylar process distal position recurrence, deep overbite, upper incisors retroinclination for more than 15°, single posterior tooth interference. Thus, pain syndrome recurrence prevention in retention orthodontic treatment period includes pain and masticatory muscles dysfunction elimination in pre-treatment period, physiological dental occlusion and condylar process central position in active period.