Long-term stability of conservative orthodontic treatment in a patient with temporomandibular joint disorder

This article reports the orthodontic treatment of a 20‑year‑old patient with dental crowding and temporomandibular joint disorders (TMDs). The patient presented moderate anterior crowding with a Class I molar relationship and masticatory disturbance in the mandibular position induced by previous splint therapy. Orthodontic treatment with multi‑bracket appliance was initiated to correct the anterior crowding in both dental arches, after the extraction of first premolars and third molars, and also to maintain the splint‑induced position of the condyles. After 26 months of treatment, an acceptable occlusion was achieved without any TMD symptoms. After 18‑month retention, flattening on the right condyle was observed, possibly as an adaptative remodeling. After 16‑year retention period, the occlusion was maintained without recurrence of any TMD symptoms, indicating a long‑term stability of occlusion and temporomandibular joint (TMJ) components. Our results suggest the possibility of compromised treatment in patients with TMD to achieve a long‑term stability in occlusion and TMJ function.

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