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Class Ⅱ, splint finishing, Orthopedic Corrector I Patient 8, a 19-year-old white girl, presented with a chief complaint of "popping and clicking joints" over the preceding one year. Her medical history was non-contributory. Past history of trauma included trauma to side of head in a skiing accident 10 years ago, and numerous car accidents, the most recent in the past year. She complained of pain and stuffiness in both ears; pain, redness and aching sensation in her right eye; pain in both TMJs; and cracking of her neck and upper back. She had locked open once, and gave a positive history of clenching and bruxing. On examination, late opening clicks of both TMJs were felt, masseters and temporalis were very tender to palpation, and a forward head position was observed. She was treated with a mandibular flat occlusal splint (day wear), and soft maxillary nightguard, and was recommended physical therapy and biofeedback. She responded very well to the above treatment and was asymptomatic with the lower splint in four months (Fig. 14-1).  (Fig. 14-1). Patient 8, asymptomatic with flat occlusal splint. However, without the mandibular splint, she still experienced the opening clicks in both joints. Any reduction of the posterior vertical on the splint resulted in pain. Thus, it was decided to institute splint finishing, with the Orthopedic Corrector I appliance, to erupt the posterior vertical. The appliance was fabricated to the nonclick position, as determine by the splint, and she was asked to wear it all day and all night (at least 18 hours/day) (Figs. 14-2∼14-3).
(Figs. 14-2 ∼14-3). Orthopedic Corrector I inserted to open the bite.
 (Figs. 14-5∼14-6). Pre-treatment convex profile. Profile full and straight, on insertion of Orthopedic Corrector I. In 6 months significant bite opening had been achieve (Figs. 11-25,O and P), and the late clicks were reduced.
(Figs. 14-7∼14-8). Bite opening in six months with appliance. At this juncture, an Occlus-o-guide appliance was inserted to complete the bite opening (Fig. 14-9).  (Fig. 14-9). With Occlus-o-guide appliance as she was tired of the all-day were the Orthopedic Corrector I. Six months later with the Occlus-o-guide, the bite opening was complete (Figs. 14-10∼14-14).  In this instance, the Occlus-o-guide was used as a positioner for final finishing of the case. - The End_ 많은 시간 동안 수고하셨습니다. 감사합니다. 조 경복 올림! |
