The purpose of this study was to determine if there are any common skeletal or dental characteristics among TMD patients that may be of diagnostic value. Thirty charts of orthodontic patients with pretreatmentTMD symptoms were selected at random.Gender, age, sex, ethnicity, SNA, SNB, ANB,Wits, interincisal angle, missing teeth, prior orthodontic treatment, crossbites, Angle's Class and maxillary and mandibular length were tabulated and analyzed for patterns. The results revealed a clear pattern of excessive mandibular length relative to maxillary length.

Treatment and management of complete entrapment of the maxilla by the mandible can be one of the most difficult orthodontic cases. This affects normal growth and development of the patient. Two entirely different treatment modalities will be demonstrated for correction.

The orthodontic population has a high probability of internal joint and muscles of mastication disorders. In the past orthodontics has been performed with modest consideration of the jaw joints. Reasons why braces are not effective in the treatment of TM disorders are explained. Presently increased emphasis is given to the function and health of the TM joints. The aware orthodontist has an opportunity to address TM disorders and improve the quality of life for his or her patients by doing a few things differently before or concurrent with conventional orthodontics. Application of orthotic and functional jaw orthopedic appliance therapy principles as presented does address the root cause and will help the majority of individuals with internal derangement and associated craniofacial pain in the orthodontic practice. Consulting services are available from author to help with individual case treatment planning or get treatment back on track.

This extensively modified version of the Sassouni Cephalometric Analysis is very beneficial to the dentist treating functional orthodontic and TMD patients. Some practitioners even derive benefits from its application when determining vertical in the edentulous patient. The NFO analysis has been shown to be of great benefit to determine vertical proportion and growth potential of the young patient. The analysis has the ability to show incisor placement relative to opening and closing trajectory and where to place the mandible for functional advancement. Practitioners need a diagnostic cephalogram that is visual and descriptive of the skeletal and dental malocclusion. This analysis provides many tools that will assist the clinician in making those decisions.

There are three traditional dimensions of orthodontic diagnosis--transverse, vertical, and anterior-posterior of the maxilla and mandible. However, there is a "fourth dimension"--proper condylar position. The condyles, at the other end of the teeth, can be influenced by orthodontic treatment. The chief problem in 90% of my patients referred for TMJ dysfunction is posteriorly and/or superiorly displaced condyles. Whether these patients have had a problem for 2 months or 10-20 years, most of them will have major relief (50-70%) of their symptoms within 2 weeks to 2 months. They frequently report 50-70% relief of their symptoms. This is accomplished by placing the condyles in the proper position in the glenoid fossae with an appliance worn full time. This article will discuss how to determine proper condylar position and the construction of a mandibular appliance (VG) to correctly reposition the condyles in the glenoid fossae. After 3-4 months, when symptoms are relieved, an upper inclined biteplane appliance (VMI) is added for nighttime wear and the lower appliance is "shortened" to allow eruption of posterior teeth. Spacers are used to encourage eruption of posterior teeth. Several patient examples are included and the results achieved are written in the patients own words on a progress report form.

The most common type of early Class II Division I malocclusion is dental alveolar in development. It is the type of maloccusion that is etiologically environmental in nature, but delay in treatment can influence negative changes in dental, facial and skeletal pattern. This malocclusion is readily available for interception at age 7 or 8 to achieve a state of dental and skeletal normalcy with a protocol of defined objectives and predictable outcomes. With efficient and effective arch development (NPE) and utility arch wire (UAW) mechanics, a state of normalcy can be achieved within nine to twelve months of treatment.

Edward H. Angle dominated orthodontic armamentarium, diagnosis and treatment planning for almost a half century until Charles Tweed successfully challenged his mentor's nonextraction mantra. The ensuing diagnostic regimen used by Tweed, however, proved to have serious limitations and clearly resulted in the extraction of too many teeth. This caused a subsequent deterioration of soft tissue appearances of patients that neither they nor their doctors liked. This article will describe and illustrate how new expansion techniques differ qualitatively from those of Angle, and how these techniques offer patients and doctors less invasive and more comfortable therapies which do not jeopardize facial appearances.

This article discusses the three usual dimensions of diagnosis - transverse, vertical, and the anterior-posterior position of the maxilla and mandible and the important fourth dimension - condylar position. Also discussed is how the proper diagnosis and treatment of these dimensions lead to: The Seven Keys to Facial Beauty and TMJ Health. An accurate diagnosis of crowding cannot be made from a panorex or study models alone - the panorex can be very misleading. Also, an accurate diagnosis of the transverse width of the maxilla and mandible cannot be made from a lateral cephalogram, a panorex, or study models - how they can also be very misleading. A method of facial diagnosis based on facial esthetics and the patient's smile that more accurately evaluates arch width problems and the need for arch expansion. An early orthopedic phase of treatment in certain types of cases can head off a major crowding problem and/or impacted cuspids. It is important to develop the maxilla to its proper size and arch form to allow for complete mandibular development and positioning. Three patient examples are shown using these methods and the results achieved.