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Condylar resorption during active orthodontic treatment and subsequent therapy: report of a special case dealing with iatrogenic TMD possibly related to orthodontic treatment.

Shen YH, Chen YK, Chuang SY

Department of Oral and Maxillofacial Surgery, College of Dental Medicine, Kaohsiung Medical University, Kaosiung, Taiwan. shenyh@cc.kmu.edu.tw

A 28-year-old female underwent orthodontic treatment for approximately 22 months. During the later stages of this treatment, the patient reported right shoulder and neck-muscle pain. In addition, temporomandibular joint disorder (TMD) with a 'clicking' sound during mastication commenced 5 months prior to treatment completion. Specific medication to deal with these symptoms was suggested by medical specialists, as were some stress-relief methods, although the pain still progressed, and subsequent clinical and radiographical examinations were undertaken by another orthodontist. Right mandibular condylar resorption was observed from both the panorex and temporomandibular joint (TMJ) radiographs. No clinical signs of rheumatic disease were observed, although bruxism was noted. Following the termination of the orthodontic treatment by the second practitioner, the patient was treated with splint therapy 1 month subsequent to which, the previous symptoms of pain in the shoulder and neck, and the clicking sound during mastication had subsided. During the 14-month period of splint therapy and follow-up, new bone growth in the right condyle was observed from radiographs.

Published 21 April 2005 in J Oral Rehabil, 32(5): 332-6.
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