Orthodontic aligners treatment: Designing Problems

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  Design 1 1. Segmentation Problems : The treatment plan exhibited significant segmentation issues. 2. Alignment & Leveling Woes : There were noticeable problems with the alignment and leveling of the upper anterior teeth. This was particularly evident in both the occlusal and submento-vertex views, indicating a need for better planning and execution. 3. Inadequate Arch Shape : The arch shape deviated from the ideal U-shape, which could negatively impact the patient's bite and overall function. This aspect requires immediate attention to ensure proper occlusion. 4. Attachment Issues : The positioning and thickness of attachments were inadequate, particularly on the upper left canine, where the doctor specifically requested no attachment placement. This could lead to ineffective tooth movement and discomfort for the patient. 5. Class III Elastic Mismanagement : The use of Class III elastics on the left side for over three months was a significant oversight. This prolonged applic...
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Tempromandibular Dysfunction Cases - ORTHODONTICS

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Case 1


 

1-     A 19-year-old female college student reported to the dental office complaining of a generalized muscle soreness on the left side of her face. The pain was accentuated with chewing. It had been present for approximately 1 week. In discussing the problem, she revealed that this type of pain had been present on several other occasions, 2, 6, and 8 months ago. She did not report any noticeable change in her occlusion but felt that the pain did limit her mandibular opening. Further questioning revealed that each of the three episodes of pain, as well as this episode, accompanied her college examinations.

The clinical examination revealed tenderness of the right and left masseters (score, 1) and the left temporalis (score, 1) muscles. Functional manipulation of the left inferior lateral pterygoid provoked significant discomfort (score, 3). Her comfortable interincisal opening was measured at 22 mm. She could open maximally to 33 mm, but this was painful. Passive opening by the clinician reached 45 mm (soft end feel). The TMJ examination was negative for pain or sounds. No other significant findings occurred during the clinical examination.

 




Case 2

 


2- A 27-year-old insurance salesman came to the dental office complaining of a single click in the right TMJ on opening. He reported that the joint sound had begun 2 days after his third molars were removed (under general anesthesia) 3 weeks earlier. Some relatively slight pain (3/10) was associated with the clicking, but the patient was able to function normally. The pain was not aggravated with jaw function.

The single click occurred in the right TMJ at an interincisal distance of 4 mm of opening immediately. The muscle and joint examinations did not reveal any pain or tenderness except when the mouth was opened to the point of the click. At this moment slight pain was felt. Biting on a single tongue depressor between the posterior teeth eliminated the click. The occlusal examination revealed a healthy dentition with no missing or carious teeth.

 

Comments

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