Orthodontic treatment combined with temporary anchorage device for a case of Class II with osteoarthrosis of the temporomandibular joint

An adult female patient presented with open bite at Orthodontic Clinic, Niigata University Medical and Dental Hospital. The patient was diagnosed as skeletal Class II open bite with Class III molar relationship, because of temporomandibular joint-osteoarthrosis (TMJ-OA) and the congenital absence of the mandibular lateral incisors. To correct anterior open bite, surgical orthodontic treatment was considered, but post treatment stability was unpredictable and doubtful due to condylar erosion on the CT. We therefore determined that nonsurgical treatment with maxillary first premolars extraction and plate type temporary anchorage device (TAD) placement bilaterally for intruding the maxillary molars would be indicated. At the completion of the active treatment, ideal occlusion was achieved without further resorption of the condyles. Even two years after the treatment, the stable occlusion has been maintained. In conclusion, the orthodontic treatment with TAD is one of the potent devices to provide the ideal occlusion for the patient with TMJ-OA.