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Abstract

The aim was to present the treatment of an adult patient with idiopathic condylar resorption (ICR) who exhibited good adaptation of condyles after orthodontic treatment and to discuss management of anterior open bite when it is related with TMJ problems. A case of 47 y/o female with skeletal Class II, anterior open bite and ICR history under bite-plate therapy and regular follow up. Intraoral examination noted premature contact and occlusal interference over bilateral posterior teeth. Our treatment plan is orthodontic camouflage treatment to correct anterior open bite and remove all 3rd molars and hopeless UL 2nd molar. An implant was placed after treatment completion. As ICR with condylar head resorption was noted in this patient, thus no TAD and only light force was applied. By using cutting edge (TP plus) bracket, thermoelastic NiTi, light force elastic combining modified MEAW technique, a normal overbite and overjet was achieved within 1 year and 7 months. Her profile became more harmony after correction of anterior open bite. Although the occlusal stability relies on the health of TMJ, the current occlusal and facial results provide a better quality of life for her. Orthodontic treatment in ICR patient should be very careful. Proper diagnosis and etiology, good selection of bracket and wire should be confirmed before treatment. In addition, the operator must monitor the TMJ condition from time to time. It is suggested to use light force and minimal invasive treatment to prevent unpredictable complications.

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