Definitive prosthodontic therapy for TMJ patients. Part II: Posterior and superior condylar displacement.

Abstract

Examples of anterior condylar repositioning were given for fixed and removable partial denture prostheses without changes in the vertical dimension of occlusion. A superior condylar displacement was treated with a temporary acrylic resin inferior repositioning prosthesis, followed by a gold onlay for over a year. Subsequent final porcelain-fused-to-gold restorations preserved the therapeutic inferior condylar repositioning. The treatment procedures are the same in principle for all patients, that is, the diagnosis and the fabrication of the provisional treatment prosthesis and the final prosthesis are carried out with the specific guidance of lateral transcranial TMJ radiographs. The patient must be comfortable in the planned treatment position for at least 3 months before final restorative procedures are initiated. The repositioned condyles in the fossae are reproduced in the final prosthesis and documented at each step of the procedure radiographically. The TMJ lateral transcranial radiograph, then, is a direct guide to the diagnosis, treatment prosthesis, and final prosthodontic restoration.