歯科矯正治療中に下顎頭の著しい形態変化を呈した変形性関節症の1例

DOI 被引用文献3件 参考文献20件

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  • A case of TMJ osteoarthrosis with condyar remodeling during orthodontic treatment

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Osteoarthrosis (OA) of the TMJ, a degenerative disease common to human general joints, is defined for the TMJ as deterioration of the articular cartilage layer and exposure of bone associated with anterior disk displacement without reduction. In general, patients with OA have high risk for orthodontic teatment, however, osteoarthrosic change of the joint during orthodontic treatment is unclear. In this article, a case of TMJ OA with suspected adaptative change of the condyle during orthodontic treatment is described.<br>This case is a 20-year-old female patient. She had crowding with Angle Class I and II molar relations on the right and left sides, respectively. Overjet and overbite were 6.5 and 3.0mm, respectively. Anteroposterior relation between the maxilla and mandible was Skeletal 2, as noted by the ANB angle of 9.1 degrees. Divergent mandibular plane (mandib. pl. to SN: 40.7 degrees) and small ramus height (Ar-Go: 39.7mm) were also found. She had a 10-year history of bilateral TMJ dysfunction. The amount of maximum opening was 34mm. Tomograms and MRI revealed bilateral osteoarthrosis with advanced osseous changes such as osteophyte on the right and erosion on the left condyle. Anterior disk displacement without reduction was also recognized. Orthodontic treatment was initiated with multibracket appliance after two-first premolar extraction on the left side. After 18-month treatment, acceptable occlusion was achieved. Tomograms taken after treatment revealed that deformation of the condyle was changed from erosion to osteophyte in the left TMJ indicating suspected adaptive remodeling of the condyle.

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