The Correlation Between Temporomandibular Joint Clicking And Unilateral Second Molar Buccal Crossbite

Objective : Study the correlation between temporomandibular joint clicking and unilateral second molar buccal crossbite to provid the scientific basis for clinical treatment of temporomandibular joint clicking.Methods: Fifty-nine patients suffering from temporomandibular joint(TMJ) clicking with unilateral second molar buccal crossbite were selected in the study. Thirty-two patients who chose orthodontic treatment to correct second molars(a total of 47 sides TMJ) were enrolled as the experimental group(group A). Twenty-seven patients who rejected the orthodontic treatment and requested occlusal splint therapy(a total of 39 sides TMJ) were enrolled as the control group(group B). Two groups of patients were performed cone beam CT(CBCT) and measured the bilateral TMJ osseous form before and after treatment. Patients in the group A were treated with straight wire technique to correct second molar buccal crossbite. Patients in the group B received the whole dentition occlusal splint therapy. Observed and recorded the improvements of temporomandibular joint clicking symptoms and the improvement of bilateral TMJ osseous morphology changes before and after treatment in all the patients in the two groups.Results:1.The differences of the articular tubercle slope, articular tubercle height and articular fossa height between the experimental buccal crossbite side and the normal side were statistically significant.2. The differences of the articular tubercle slope, articular tubercle height and articular fossa height between the control buccal crossbite side and the normal side were statistically significant.3. The experimental group after an average of 14 months of treatment, the second molar buccal crossbite were corrected, all follow-up coverage anterior are normal, molar relationship is neutral, 46 sides TMJ clicking disappeared, one side TMJ clicking reduced.The clicking disappeared 46 sides TMJ were followed up for 6 to 24 months and only 2sides out of the clicking disappeared 46 sides appeared repeatedly.4. The control group after treatment of 27 sides TMJ clicking disappeared, 12 sides TMJ clicking reduced. In the treatment of 6 to 24 months after the review, 14 sides out of the clicking disappeared 27 sides appeared repeatedly.Conclusion: There is a positive correlation between the temporomandibular joint clicking and second molar buccal crossbite. Correcting the second molars is more effective than just occlusal splint therapy on the treatment of TMJ clicking.