Orthodontic/Orthopedic Treatment of Craniomandibular Pain Dysfunction Part 2: Posterior Condylar Displacement

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Abstract
Of the various displacements of the mandibular condyle that can occur, posterior condylar displacement appears to be the most likely to lead to craniomandibular dysfunction problems. Posterior capsulitis, head and neck pain, and anterior disk displacement are among the most common early problems, with longer-standing problems becoming more severe. It is important that orthodontists ascertain the patient's condylar position before treatment so that this essential fact can be taken into consideration during the correction of the malocclusion. Poorly designed orthodontic treatment plans may iatrogenically lead to posterior condylar displacement(s) and to the possibility of future craniomandibular dysfunction problems. In properly diagnosed cases, it is possible to extract bicuspids (or second molars) and still finish the case with the condyles in the therapeutic (or physiological) range. Functional jaw orthopedic appliances may be used to treat the malocclusion and the posterior condylar displacement at the same time, but the clinician must make a complete diagnosis and then choose the appropriate treatment appliances. It should be obvious that no single treatment approach can be used successfully for all patients.