Prof. Dr. Eleonora Schiller
Assoc. Prof. Dr.Eleonora Schiller is a specialist in Orthodontics and Dentofacial Orthopedics. She received her DDS, MSc and PhD degrees at the Faculty of Dental Medicine, University of Medicine and Pharmacy “Victor Babes” Timisoara, Romania. She is the Chief of the Department of Orthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy “Victor Babes” Timisoara. She is also the coordinator of the postgraduate students in Orthodontics. Her main interests are functional orthodontics, TMJ disorders and non-syndromic hypodontia.
MALOCCLUSION AND TMJ DESORDERS
Dental occlusion exerts a great influence on the stomatognathic system. Clinical observation has shown certain occlusal conditions to be either the initiating and/or perpetuating factor responsible for disharmony in the masticatory system.
The objective of these papers is to provide the information necessary for understanding the biomechanical principles of temporo-mandibular joint in relation with malocclusions.
Malocclusion has been implicated in TMJ disorders and vary with facial skeletal types Class II and Class III, deep bite and cross bite (Johnston, Ricketts, Grummons). No universal condylar position is unequivocally for all patients, but posterior condylar displacement appears to be the one most associated with TMJ pain/dysfunction.
If a malocclusion exists and the patient is asymptomatic, adaptation has occurred and the malocclusion must be considered normal for that person. If a malocclusion exists in the symptomatic patient, its elimination is often helpful in treatment.
Another situation is when patients present pre-orthodontic TMJ disorders. Lack of attention and understanding has caused the orthodontist to be held responsible for creating problems that may have preexisted.
For children with class II, functional appliance therapy following TMJ trauma can be helpful to promote favorable condylar regeneration changes.(Graber)
For adults, orthodontic mecanotherapy with various elastics may trigger unfavorable and uncomfortable muscle hyperactivity and joint loading. Grumzat, McNamara, Gianelly recommended for this patients to ,,tripod the mandible’’with an orthopedic/orthodontic appliance which improves TMJ relationships.
TMJ disorders require careful screening, documentation, and clinical management of the orthodontic treatment. Patient comfort and stability before, during and after orthodontic treatment remains a priority.