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      Efectos de los aparatos propulsores mandibulares fijos en la articulación temporomandibular Translated title: Effects of fixed mandibular propulsive appliances on the temporomandibular joint

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          Abstract

          Resumen Los aparatos propulsores mandibulares fijos son una alternativa en el tratamiento de la maloclusión Clase II con deficiencia mandibular. La propiedad de ser fijo, condiciona a la mandíbula a una posición anterior forzada en reposo y durante todas las funciones mandibulares. Cuando se utiliza un aparato de propulsión, la mandíbula se desplaza hacia delante y hacia abajo. Este movimiento conduce a una nueva posición al cóndilo, que puede afectar el funcionamiento normal de la articulación temporomandibular (ATM). El objetivo de este trabajo fue realizar una revisión de tema sobre los efectos de los aparatos propulsores mandibulares fijos en la ATM. Fueron incluidos estudios con animales o estudios con seres humanos, utilizando radiografías de la ATM, electromiografía postural, tomografía computarizada y resonancia magnética. Los estudios confirman una relación favorable entre el cóndilo y la cavidad glenoidea después de un tratamiento con aparatos fijos de propulsión mandibular

          Translated abstract

          Abstract Fixed mandibular propulsion appliances are an alternative for the treatment of Class II malocclusion in individuals with mandibular deficiency. Since they are fixed appliances, said devices keep the mandible in an anterior-forced position during rest and during all mandibular functions. When a propulsive appliance is used, the lower jaw is displaced forward and downward. This movement leads to a new position of the condyle, which can, ultimately affect the normal functioning of the temporomandibular joint (TMJ). The aim of this paper was to review effects of fixed mandibular propulsive appliance on TMJ. Inclusion criteria considered studies on animals or humans using TMJ radiography, computed tomography, and magnetic resonance imaging. Studies confirm a favorable relation between condyle and glenoid fossa following treatment with fixed mandibular propulsion appliances

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          Classification of malocclusion

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            Components of class II malocclusion in children 8-10 years of age.

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              Temporomandibular joint growth adaptation in Herbst treatment: a prospective magnetic resonance imaging and cephalometric roentgenographic study.

              The aim of this investigation was to analyze three possible adaptive TMJ growth processes contributing to the increase in mandibular prognathism accomplished by Herbst appliance therapy: (1) condylar remodeling; (2) glenoid fossa remodeling; and (3) condyle-fossa relationship changes. The subjects were 15 consecutive Class II malocclusions (11 males and four females, aged 11.5-17.5 years) treated with the Herbst appliance for an average period of 7 months. Condylar remodelling, glenoid fossa remodelling, and condyle-fossa relationship changes were analyzed by means of magnetic resonance imaging (MRI). From each subject, four MR images were evaluated: before treatment, start of treatment (when the Herbst appliance was placed), during treatment (6-12 weeks after appliance placement), and after treatment (when the appliance was removed). 'Effective condylar growth' (= the sum of condylar remodelling, fossa remodelling, and condyle-fossa relationship changes) was analyzed with the aid of pre- and post-treatment lateral cephalometric roentgenograms. In all 15 subjects, Herbst therapy resulted in an increase in mandibular prognathism. After 6-12 weeks of treatment MRI-signs of condylar remodelling were seen at the posterior-superior border in 29 of the 30 condyles. MRI-signs of glenoid fossa remodelling at the anterior surface of the postglenoid spine were noted in 22 of the joints. Condylar remodelling seemed to precede fossa remodelling. The condyle-fossa relationship was, on average unaffected by Herbst therapy. 'Effective condylar growth' during treatment was, on average, approximately five times larger in the Herbst group than in an untreated group with ideal occlusion (Bolton Standards) and the direction of the growth changes was relatively more horizontal in the treated cases. The results indicate that condylar as well as glenoid fossa remodelling seem to contribute significantly to the increase in mandibular prognathism resulting from Herbst treatment, while condyle-fossa relationship changes are of less importance. MRI renders an excellent opportunity to visualize temporomandibular remodelling growth processes.
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                Author and article information

                Journal
                ceso
                CES Odontología
                CES odontol.
                Universidad CES - Facultad de Odontología (Medellìn, Antioquia, Colombia )
                0120-971X
                December 2014
                : 27
                : 2
                : 82-92
                Affiliations
                [01] orgnameUmv Estadual Paullsta orgdiv1Facultad de Odontología de Araraquara Brasll spalominog@ 123456hotmail.com
                [02] orgnameUmv Estadual Paullsta orgdiv1Departamento de Clínica Infantil de la Facultad de Odontología de Araraquara Brasil draveli@ 123456foar.unesp.br
                Article
                S0120-971X2014000200008 S0120-971X(14)02700208
                509d8605-e79e-4a7b-9a61-0106855d7915

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : November 2014
                : September 2014
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 29, Pages: 11
                Product

                SciELO Colombia

                Categories
                Revisión de Tema

                Angle Class II,Malocclusion,Temporomandibular Joint,Functional,Orthodontic Appliances,Maloclusión de Angle Clase II,Articulación Temporomandibular,Aparato Funcional Ortopédico

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