An adolescent case of skeletal maxillary protrusion with osteoarthritis of the temporomandibular joint

This article is designed to report the treatment of an adolescent patient, aged 13 years and 5 months, with maxillary protrusion and temporomandibular joint-osteoarthritis (TMJ-OA). MRI showed anterior disk displacement without reduction in both TMJs and the left condyle revealed a flattened-structure with undefined cortical bone. TMJ pain disappeared 4 months after splint therapy, and the initiation of orthodontic treatment was postponed until the end of pubertal growth. After extraction of the maxillary first premolars, multi-bracket appliances were placed at the aged 16 years and 11 months. After 2.5-year treatment, an acceptable occlusion was achieved without additional clockwise rotation of the mandible. It is emphasized that careful planning is required to avoid any progress in TMJ-OA throughout the treatment for young patients.