Temporomandibular Joint Disorder and Airway in Class II Malocclusion: A Review

Abstract

In class II malocclusion, there is an anteroposterior disparity between the upper dentition and the lower dentition, which may or may not be accompanied by a skeletal discrepancy. For orthodontists, this is one of the common malocclusions encountered during clinical practice. This might be due to excess maxillary growth or retarded growth of the mandible or a combination of both. In such types of malocclusion, both the upper and lower airways are affected, the lower one most commonly. Characteristic features seen are a narrow maxillary arch, a proclined upper anterior, and mouth breathing as a developing habit. Also, the position of the condyle in the skeletal type of class II malocclusion plays a vital role in the development of temporomandibular joint disorders. Treating such disparity in a growing individual leads to better results in the long term as well as prevention of malocclusion taking a severe form. Myofunctional appliances are useful for repositioning the mandible as well as the condyle. In adults, extraction of the upper premolars is most commonly done for the correction of class II malocclusion. This provides the patient with a better esthetic appearance. In addition to this, various treatment modalities, such as splint therapy, exercise, and prolotherapy, are beneficial for pain relief and temporomandibular disorder (TMD) correction. This article deals with the characteristics, development, etiology, and comprehensive treatment options of class II malocclusion and its co-relation with the upper and lower airway along with the severity of temporomandibular joint disorders. Repositioning of the condyle in the glenoid fossae is the key to the correction of this disorder.

Keywords: airway disorders; class ii malocclusion; malocclusion of teeth; pain; tmj disorders.

Figure 1. Airway depiction in MRI.

MRI accounts for better soft tissue evaluation, especially in the airway. (A) depicts the airway being divided into the nasopharynx, oropharynx, and hypopharynx, whereas (B) depicts a constricted airway.