“Closed reduction” principles can manage diverse conditions of temporomandibular joint vertical height loss: from displaced condylar fractures to idiopathic condylar resorption

Publication date: Available online 7 February 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Dorrit W. Nitzan, Sandro Palla
PurposeThe aim of this case series was to describe a modification of the classic "closed reduction" therapy to manage a unilateral or anterior open bite due to loss in vertical height (LVH) caused by several disorders /pathologies other than displaced condylar fractures.MethodsThe protocol included insertion of an occlusal appliance increasing the height of the premature contact and the width of the open bite, stabilization of the dental arches by rigid arches, and the use, during sleep, of rubber bands located in the open bite region to pull the mandible cranially. In addition, when awake the patient performed physiotherapy exercises to guide the mandible into maximum intercuspation. The increased open bite enhanced the effect of the rubber bands in guiding the mandible into the original habitual occlusion while the rigid arches serve to minimize tooth eruption.ResultsThe presented cases demonstrated the favorable outcome of this low-risk treatment in the re-establishment of the original habitual occlusion within one to four weeks and without reconstruction of the deficient vertical height.ConclusionThe efficacy of this complication-free approach to correct the occlusion in various conditions of LVH suggests that this protocol should be applied before venturing into surgical intervention.



http://ift.tt/2kJLzTj