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Suhyun Lee
Suhyun Lee
Republic of Korea
Main Instructor Sang-jin Sung
Department / Institution Asan Medical Center
Classification Case report
Introduction: Orthognathic surgery (OGS) is required for patients with severe malocclusion or facial asymmetry. The impact of OGS on temporomandibular disorder (TMD) is still controversial. Therefore, orthodontists should carefully evaluate the patient for any symptoms of TMD before starting treatment. In this case report, we present a orthodontic-surgical treatment of a patient with facial asymmetry and TMD.
Diagnosis: A 20-year-old female patient was diagnosed as skeletal Class III malocclusion with facial asymmetry, prognathic mandible, and TMD. Clinical examinations showed concave facial profile, protrusive chin and chin deviation. Also the patient had pain and clicking sound on both TMJ at mouth opening.
Treatment Overview: To correct facial asymmetry and prognathic mandible, OGS was considered. Before preoperative orthodontic treatment, TMD was evaluated and arthrocentesis was performed by an oral and maxillofacial surgeon. After the sign and symptoms of TMD were alleviated, orthodontic treatment began and 2-jaw surgery was performed. Improvement of facial asymmetry and functional occlusion was obtained. The patient had no pain or discomfort associated with TMJ. The total treatment period was 3 years 1 month.
Conclusion: Pre-existing TMD symptoms should be considered prior to treatment planning. Additional surgical procedures, such as arthrocentesis, could be an option for orthognathic patients with TMD before or during orthodontic-surgical treatment.
Orthodontic-surgical Treatment of A Patient with Facial Asymmetry and Temporomandibular Disorder