Retreating orthodontic failures: Part II. 1993

D Keller

Part I of this series (June 1993 JGO) clearly documented the inadequacies of some orthodontic methods to obtain satisfactory stable results for patients. Forty-four patients were selected for this study, as their prior orthodontic treatments--all from orthodontic specialists or orthodontic postgraduate institutions--had failed for a variety of functional reasons. The treatment for the 44 patients would not have been necessary if the initial orthodontic treatment had been successful. Therefore, somewhere in the treatment, problems existed which were not corrected by the treatment methods, or problems arose because of the treatment methods. Part I of this series clearly and precisely showed that some orthodontic methods initiate TMJ problems. In a review of the literature presented in Part I, the following conclusions were reached: 1. The optimum functional relationship of the human temporomandibular joint exists when the force vectors within the joint are directed anteriorly and superiorly. 2. Some orthodontic treatments disrupt this optimum functional relationship by placing posterior or posterior/superior forces on the structures of the temporomandibular joint. 3. There is an increased incidence of joint signs and symptoms for some of the patients treated with those conventional methods which place pathologic forces on the temporomandibular joints. Present treatment methods are inadequate if they damage the patient's structures. The guidelines of treatment are wrong if problems exist because of the treatment methods and these guidelines then need to be corrected. What is offered in this article is a method of treatment that was and is successful in retreating those patients who were initially treated by orthodontic specialists, yet who developed TMJD problems during or after their treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D008310 Malocclusion Such malposition and contact of the maxillary and mandibular teeth as to interfere with the highest efficiency during the excursive movements of the jaw that are essential for mastication. (Jablonski, Illustrated Dictionary of Dentistry, 1982) Angle's Classification,Crossbite,Tooth Crowding,Cross Bite,Angle Classification,Angles Classification,Bite, Cross,Bites, Cross,Classification, Angle's,Cross Bites,Crossbites,Crowding, Tooth,Crowdings, Tooth,Malocclusions
D009971 Orthodontics, Corrective The phase of orthodontics concerned with the correction of malocclusion with proper appliances and prevention of its sequelae (Jablonski's Illus. Dictionary of Dentistry). Corrective Orthodontics
D010347 Patient Care Planning Usually a written medical and nursing care program designed for a particular patient. Nursing Care Plans,Goals of Care,Plans, Nursing Care,Care Goal,Care Goals,Care Plan, Nursing,Care Planning, Patient,Care Plans, Nursing,Nursing Care Plan,Plan, Nursing Care,Planning, Patient Care
D003768 Dental Occlusion, Centric Contact between opposing teeth during a person's habitual bite. Centric Dental Occlusion,Occlusion, Centric Dental
D005157 Facial Pain Pain in the facial region including orofacial pain and craniofacial pain. Associated conditions include local inflammatory and neoplastic disorders and neuralgic syndromes involving the trigeminal, facial, and glossopharyngeal nerves. Conditions which feature recurrent or persistent facial pain as the primary manifestation of disease are referred to as FACIAL PAIN SYNDROMES. Craniofacial Pain,Myofacial Pain,Orofacial Pain,Pain, Facial,Face Pain,Neuralgic Facial Pain,Facial Pain, Neuralgic,Pain, Craniofacial,Pain, Face,Pain, Myofacial,Pain, Neuralgic Facial,Pain, Orofacial
D006261 Headache The symptom of PAIN in the cranial region. It may be an isolated benign occurrence or manifestation of a wide variety of HEADACHE DISORDERS. Cephalgia,Hemicrania,Bilateral Headache,Cephalalgia,Cephalodynia,Cranial Pain,Generalized Headache,Head Pain,Ocular Headache,Orthostatic Headache,Periorbital Headache,Retro-Ocular Headache,Sharp Headache,Throbbing Headache,Unilateral Headache,Vertex Headache,Bilateral Headaches,Cephalalgias,Cephalgias,Cephalodynias,Cranial Pains,Generalized Headaches,Head Pains,Headache, Bilateral,Headache, Generalized,Headache, Ocular,Headache, Orthostatic,Headache, Periorbital,Headache, Retro-Ocular,Headache, Sharp,Headache, Throbbing,Headache, Unilateral,Headache, Vertex,Headaches,Headaches, Bilateral,Headaches, Generalized,Headaches, Ocular,Headaches, Orthostatic,Headaches, Periorbital,Headaches, Retro-Ocular,Headaches, Sharp,Headaches, Throbbing,Headaches, Unilateral,Headaches, Vertex,Ocular Headaches,Orthostatic Headaches,Pain, Cranial,Pain, Head,Pains, Cranial,Pains, Head,Periorbital Headaches,Retro Ocular Headache,Retro-Ocular Headaches,Sharp Headaches,Throbbing Headaches,Unilateral Headaches,Vertex Headaches
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013705 Temporomandibular Joint Disorders A variety of conditions affecting the anatomic and functional characteristics of the temporomandibular joint. Factors contributing to the complexity of temporomandibular diseases are its relation to dentition and mastication and the symptomatic effects in other areas which account for referred pain to the joint and the difficulties in applying traditional diagnostic procedures to temporomandibular joint pathology where tissue is rarely obtained and x-rays are often inadequate or nonspecific. Common diseases are developmental abnormalities, trauma, subluxation, luxation, arthritis, and neoplasia. (From Thoma's Oral Pathology, 6th ed, pp577-600) TMJ Disorders,TMJ Diseases,Temporomandibular Disorders,Temporomandibular Joint Diseases,Disease, TMJ,Disease, Temporomandibular Joint,Diseases, TMJ,Diseases, Temporomandibular Joint,Disorder, TMJ,Disorder, Temporomandibular,Disorder, Temporomandibular Joint,Disorders, TMJ,Disorders, Temporomandibular,Disorders, Temporomandibular Joint,Joint Disease, Temporomandibular,Joint Diseases, Temporomandibular,Joint Disorder, Temporomandibular,Joint Disorders, Temporomandibular,TMJ Disease,TMJ Disorder,Temporomandibular Disorder,Temporomandibular Joint Disease,Temporomandibular Joint Disorder
D017211 Treatment Failure A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series. Failure, Treatment,Failures, Treatment,Treatment Failures

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