back to contentsClinical treatment of chronic condylar dislocation by restoring anteriorguidance
Koji Sawada, Yoshiaki Arai, Raul Medina, Shoji Kohno,
Tadao Fukui*, Kooji Hanada*
Department of Removable Prosthodontics (Director: Prof. Shoji Kohno)
Department of Orthodontics*(Director: Prof. Kooji Hanada)
School of Dentistry, Niigata University
Abstract:
@The mechanism of condylar dislocation is not exactly understood. Temporomandibular (TMJ)
surgery is a common option in the treatment of chronic condylar dislocation, but some authors have reported disappearance of its symptomatology after occlusal treatment.
@A case in which condylar dislocation disappeared by changing the location of anterior guidance is presented. The patient was an 18 year-old male with an Angle class III malocclusion who had been
suffering from condylar dislocation of the right TMJ upon waking up for almost one year. Clinical inspection showed that the mandibular right second molar was guiding the mandibular eccentric movements. Condylar dislocation of the TMJ disappeared by shifting anteriorly the tooth guidance with a stabilization splint. We recorded jaw and condyle movements with a 6-degree-of-freedom measuring device during lateral excursions with and without wearing of the splints in order to assess the influence of shifting anteriorly the location of tooth guidance on the cure of luxation. We found that the direction of condylar movements
changed markedly during parafunctional grinding tasks. We conclude that correction of anterior guidance is a non-invasive alternative therapy in some cases of condylar dislocation.