Orthodontic Treatments and Temporomandibular Joints: Dos and Don’ts

교정치료와 측두하악관절: 조절이 가능한 것과 불가능한 것

For successful orthodontic treatment, it is necessary to understand what is possible and what is impossible. Since orthodontic treatment is a type of occlusal treatment, the treatment goals of aesthetics, function, and stability must be achieved based on good occlusion. Good occlusion does not mean simply the interlocking of the upper and lower teeth. For good function, a healthy condition of the temporomandibular joint must be premised. In this paper, we considered the following questions about the points to consider during orthodontic treatment to maintain a healthy temporomandibular joint. I. Is it possible to grow the mandible? II. Is it possible to put the displaced joint disc back in place? III. What can be done to create a healthy temporomandibular joint? And, we came to the following conclusion. 1. The use of the mandibular anterior positioning device (functional appliance) may temporarily promote mandibular bone formation, but in the long run, significant growth of the mandibular bone cannot be obtained, and TMD symptoms may occur in the process of positioning the mandibular forward, so care should be taken. 2. Attempts to re-position the displaced disc are generally unsuccessful due to morphological change of the disk, and can only be tried in acute lock within a week. 3. In patients with displacement of the joint disc, using stabilizing splint to form a pseudo-disc is the right treatment direction to follow to maintain a healthy temporomandibular joint. (Clin J Korean Assoc Orthod 2024;14(1):70-79)