John Libbey Eurotext

L'Orthodontie Française


Mandibular repositioning in adult patients. An alternative to surgery in some patients? A two-year follow-up Volume 89, issue 2, Juin 2018

1 Private PracticeArezzo, Italy
2 Private practiceLugano  
3 Section of Orthodontics, Institute of Odontology, Aarhus University, Denmark
4 Department of Orthodontics and Pediatrics, University Center of Dental Health Basel, Basel University, Switzerland
5 Department of Orthodontics at Hannover University Germany, and University of West Australia Perth  
6 Holtevej11, 8000CAarhus, Denmark
* Auteur pour correspondance :

Introduction: A number of adult patients with skeletal discrepancies refuse surgical intervention. Aims: The aim was to assess the reaction to mandibular repositioning in simulating a skeletal correction in such patients. Materials and Methods: 32 consecutive patients without any signs of temporo-mandibular dysfunction (TMD) were offered mandibular repositioning, as a non-invasive alternative and it was explained to them that the approach was based on the results described in case reports. Before initiating any treatment initial records, headfilms, study casts and photos were taken (T0) and the mandible was repositioned to camouflage the skeletal discrepancy by means of an occlusal built-up in Triad® Gel. Results: Three months later (T1) 23 patients had adapted to the new occlusion reflected in absence of functional problems and lack of fracture of the built-up. In these patients the mandibular position was maintained by orthodontics adjusting the occlusion to the built-up position (T1). The skeletal changes occurring during repositioning were assessed on sagittal and frontal head films while intra-articular changes occurring during a 2-year follow-up period (T2) were evaluated on images constructed from CBCT images. No significant changes, neither in the direction of a relapse nor in the direction of further normalization of the condylar positioning, were observed during the 2-year observation period. Conclusions: Repositioning is a non-invasive intervention and may be considered a valid alternative to surgery in some patients. Morphological variables from the radiographs taken at T0 and the results of the initial clinical evaluation of dysfunction yielded only vague and insignificant indications regarding the predictability of adaptation to the repositioning.