Informationen aus Orthodontie & Kieferorthopädie 2005; 37(2): 143-153
DOI: 10.1055/s-2005-836583
Fallbericht

© Georg Thieme Verlag

Interdisziplinäre Behandlung eines Scherenbisses mit kraniomandibulärer Dysfunktion

Interdisciplinary Treatment of a Patient with Severe Mandibular Displacement and Craniomandibular DysfunctionK. Tamaki1 , A. G. Čelar2 , R. Slavicek3 , S. Sato4
  • 1Department of Prosthodontics, Kanagawa Dental College, Yokosuka, Japan
  • 2Abteilung für Kieferorthopädie, Medizinuniversität Wien, Österreich
  • 3Department of Environmental and Medical Sciences, Center for Interdisciplinary Dentistry, Donau-Universität Krems, Austria
  • 4Department of Craniofacial Growth and Development Dentistry, Kanagawa Dental College, Yokosuka, Japan
Further Information

Publication History

Publication Date:
06 July 2005 (online)

Zusammenfassung

Die Therapie des Scherenbisses erfordert äußerst schwierige Behandlungsstrategien. Schließlich kann dieser Fehlbiss mit komplexen Symptomen wie Kiefergelenk-, Kopf- und Nackenschmerzen, Rückenbeschwerden und funktionellen Störungen des kraniomandibulären Systems einhergehen. Der vorliegende Beitrag beschreibt das interdisziplinäre Vorgehen bei der endodontischen, kieferorthopädischen und prothetischen Behandlung einer ausgeprägten Seitbisslage des Unterkiefers mit kraniomandibulären Symptomen einschließlich der Kopf- und Nackenmuskulatur sowie weiterer somatischer Beschwerden. Die klinische Untersuchung und die Funktionsanalyse der Kiefergelenke mit Hilfe einer computergestützten Axiographie ergaben, dass der Unterkiefer aufgrund falscher Artikulation der Zähne und fehlender Okklusion im Seitenzahnbereich verlagert war. Die kieferorthopädische Korrektur der Zahnreihen ermöglichte die Verlagerung des Unterkiefers und hatte eine Verbesserung der muskulären Funktionalität zur Folge. Durch die prothetische Versorgung wurde die korrigierte Unterkieferposition stabilisiert und eine gute Artikulation erreicht. Die abschließende Untersuchung ergab eine deutliche Linderung der Schmerzsymptomatik und ließ eine gleichmäßige, störungsfreie Bewegung der Kondylen erkennen. Das kombinierte kieferorthopädische und prothetische Verfahren ermöglichte die Behandlung dieser komplexen Fehlbisslage ohne chirurgische Intervention.

Abstract

Mandibular lateral displacement (MLD) malocclusion requires one of the most difficult treatment modalities. It can be associated with complex symptoms such as TMJ pain, head and neck pain, cervical pain, and functional disturbances of the craniomandibular system (CMS). This report describes the interdisciplinary approach including endodontic, orthodontic, and prosthodontic treatment of MLD malocclusion with severe problems regarding CMS, head and neck muscles including other somatic symptoms as well. Clinical examination and instrumental analysis of the functional condylar paths using computerized axiography recordings of hinge axis movement indicated a displaced mandible due to incorrect articulation of the teeth and failure of posterior occlusal support. Orthodontic correction of the dentition provided a mandibular repositioning with relief of the muscle pain and the dysfunction. Prosthodontic occlusal reconstruction resulted in a stabilization of the corrected mandibular position, and ensured proper occlusal guidance and occlusal support. Post-treatment examinations indicated that most of the pain dysfunction symptoms had disappeared and smooth condylar movements without any limitation were achieved. A combined approach of orthodontic and prosthodontic treatment resolved a complex malocclusion and its functional disturbances without surgical intervention.

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Prof. Dr. S. Sato

Department of Craniofacial Growth and Development Dentistry · Kanagawa Dental College

82 Inaoka cho

Yokosuka

Kanagawa

Japan

Email: satos@kdcnet.ac.jp

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