Evaluation of Temporomandibular Joint Dysfunction by a Mandibular Tracing System: A Case Report

Abstract

Objective. The purpose of this case report was to present a digital mandibular tracing technique that is used to
evaluate a patient with temporomandibular joint dysfunction (TMD).
Clinical features. A 65-year-old Caucasian female patient presented with chronic jaw pain in her temporomandibular joint (TMJ) area. The patient describes a dental history of orthodontic and prosthodontic treatment. Orally patient
exhibits super erupted teeth, multiply fractured restorations, facial gingival recession, and rotated teeth. The patient
also had an uneven occlusal plane and non-working side contact at maxillary first and mandibular second molars.
Evaluation and outcome. A digital mandibular tracing technique, cone beam computed tomography, and full-arch
optical impressions were used to evaluate the patient’s condition. The left condyle was slightly flat compared
with the right one on the anterior surface. Limited protrusion and lateral movements and asymmetric border
movements were detected. Apparently, an incomplete orthodontic treatment at the patient’s early age, iatrogenic
mandibular anterior restorations, and hit and slight effect are considered causes of temporomandibular joint
problems. The recommended treatment plan sequence for this patient is an occlusal adjustment, replacement of
defective restorations, and fabrication of an occlusal guard for one of the arches.
Conclusion. A digital mandibular tracing system can help the dentist to diagnose and analyze the causes of TMD
patients specifically and individually. It also provides quick resolution and management for patients with TMD.