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Abstract

This case report presents multiple TADs application technique on managing difficult dental and skeletal malocclusion. This 36-year-old female who was diagnosed as rheumatoid arthritis and had been under medication control for 6 years. In addition, she was diagnosed as condyle erosion with bilateral crepitus sound during jaw movement. The characters of occlusion including Class II malocclusion with increased overjet (6 mm), multiple posterior teeth missing and super-erupted teeth 17 and 26, and unstable occlusion. During phase I, patient was referred for occlusal splint treatment, and we followed the progression of condylar condition. At phase II, surgical intervention was suggested but it was refused by the patient. Therefore, a non-surgical orthodontic treatment plan to achieve intrusion of super-erupted teeth and to stabilize the occlusion with the aid of mini-screws anchorage. After 42 months of treatment, the patient was satisfied with the treatment outcomes. Also, the patient’s physical health, TMJ status and occlusion were all in stable condition.

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