Hasanova A.

REPEATED ORTHODONTIC TREATMENT (ORTHODONTIC RETREATMENT): ELIMINATING THE CONSEQUENCES OF FAILED PRIMARY ORTHODONTIC TREATMENT

---

Show/Download

About the author:

Hasanova A.

Heading:

DENTISTRY

Type of article:

Scientific article

Annotation:

In modern clinical practice, the proportion of adult patients requiring retreatment due to unsatisfactory primary orthodontic results is increasing. One of the most challenging treatment scenarios is the combination of an open bite and Angle Class II with concomitant temporomandibular joint dysfunction. At the same time, publications devoted to a comprehensive approach to the diagnosis and retreatment of such cases are rare in the professional literature. The purpose of this article is to demonstrate, using a clinical case, the possibility of bilateral distalization of the upper dentition using orthodontic microimplants (TADs) during re-treatment following an unsatisfactory outcome of the initial orthodontic correction, as well as to evaluate the progression of symptoms of concomitant temporomandibular joint dysfunction after re-treatment. A clinical case of a 21-year-old female patient is presented, who complained of impaired occlusion of the dentition, temporomandibular joint pain, and headache that persisted for two years after completion of primary orthodontic treatment with fixed appliances and were not eliminated by previous physiotherapy. A clinical examination, a photo protocol of the oral cavity, and an analysis of the available archival radiological documentation were performed. Based on the examination results, an open bite and Angle Class II were diagnosed. Repeated orthodontic treatment was carried out using fixed orthodontic appliances in combination with bilateral distalization of the upper dentition on skeletal support using orthodontic microimplants. After completion of the treatment, closure of the open bite, formation of a physiological vertical overlap of the incisors, Angle Class I on both sides, stabilization of occlusal relationships, and improvement of the aesthetics of the dentition were achieved. Temporomandibular joint pain and headache, which were not relieved by physiotherapy before the start of retreatment, completely regressed. This clinical case confirms the possibility of successful retreatment after an unsatisfactory primary correction, provided individualized treatment planning and the use of skeletal support on orthodontic microimplants are employed. The observed regression of temporomandibular joint dysfunction symptoms after retreatment requires further prospective clinical studies to confirm a possible cause-and-effect relationship.

Tags:

Bibliography:

1. Almasri AMH, Hajeer MY, Ajaj MA, Almusawi AOA, Jaber ST, Zakaria AS, Alam MK. Patient satisfaction following orthodontic treatment: a systematic review. Cureus. 2024;16(7):e65339. DOI: https://doi.org/10.7759/cureus.65339
2. Chow L, Goonewardene MS, Cook R, Firth MJ. Adult orthodontic retreatment: a survey of patient profiles and original treatment failings. Am J Orthod Dentofacial Orthop. 2020;158(3):371-382. DOI: https://doi.org/10.1016/j.ajodo.2019.09.010
3. Jedliński M, Grocholewicz K, Mazur M, Janiszewska-Olszowska J. What causes failure of fixed orthodontic retention? Systematic review and meta-analysis of clinical studies. Head Face Med. 2021;17(1):32. DOI: https://doi.org/10.1186/s13005-021-00281-3
4. Bunta O, Filip I, Garba C, Colceriu-Simon IM, Olteanu C, Festila D, et al. Tongue behavior in anterior open bite: a narrative review. Diagnostics (Basel). 2025;15(6):724. DOI: https://doi.org/10.3390/diagnostics15060724
5. Mohd Ali ND, Abdul Ghani SH. Managing unexpected iatrogenic opening of anterior bite during active orthodontic treatment: a case report. Compend Oral Sci. 2020;7:44-51. DOI: https://doi.org/10.24191/cos.v7i0.17493
6. Oğuz F, Özden S, Cicek O. Distalization methods for maxillary molars utilizing temporary anchorage devices (TADs): a narrative review. Appl Sci. 2024;14(23):11333. DOI: https://doi.org/10.3390/app142311333
7. Bayome M, Park JH, Bay C, Kook YA. Distalization of maxillary molars using temporary skeletal anchorage devices: a systematic review and meta-analysis. Orthod Craniofac Res. 2021;24(1):103-112. DOI: https://doi.org/10.1111/ocr.12470
8. Raghis TR, Alsulaiman TMA, Mahmoud G, Youssef M. Efficiency of maxillary total arch distalization using temporary anchorage devices (TADs) for treatment of Class II malocclusions: a systematic review and meta-analysis. Int Orthod. 2022;20(3):100666. DOI: https://doi.org/10.1016/j.ortho.2022.100666
9. Ceratti C, Serafin M, Del Fabbro M, Caprioglio A. Effectiveness of miniscrew-supported maxillary molar distalization according to temporary anchorage device features and appliance design: systematic review and meta-analysis. Angle Orthod. 2024;94(1):107-121. DOI: https://doi.org/10.2319/052223-364.1
10. Smahliuk LV, Dmytrenko MI, Shevchyk AS. Efektyvnist aparatіv dlia dystalizatsii zubiv iz oporoiu na mini-implanty v pidnebinni. Kharkiv Dental Journal. 2025;2(1):92-106. DOI: https://doi.org/10.26565/3083-5607-2025-3-09 [in Ukrainian].
11. Huang L, Xu Y, Xiao Z, Liu Y, Luo F. Temporomandibular disorder prevalence in malocclusion patients: a meta-analysis. Head Face Med. 2025;21:13. DOI: https://doi.org/10.1186/s13005-025-00490-0
12. Fichera G, Ronsivalle V, Santonocito S, Aboulazm KS, Isola G, Leonardi R, et al. Class II skeletal malocclusion and prevalence of temporomandibular disorders: an epidemiological pilot study on growing subjects. J Funct Morphol Kinesiol. 2021;6(3):63. DOI: https://doi.org/10.3390/jfmk6030063
13. Vaden JL, Williams RA, Goforth RL. Class II correction: extraction or nonextraction? Am J Orthod Dentofacial Orthop. 2018;154(6):860-876. DOI: https://doi.org/10.1016/j.ajodo.2018.06.010
14. Kwon TG, Elnagar MH, Shirazi S, Goben AH, Miloro M, Han MD. Orthodontic correction of anterior open bite using skeletal anchorage: systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2024;53(5):393-404. DOI: https://doi.org/10.1016/j.ijom.2023.10.031
15. Soheilifar S, Mohebi S, Ameli N. Maxillary molar distalization using conventional versus skeletal anchorage devices: a systematic review and meta-analysis. Int Orthod. 2019;17(3):415-424. DOI: https://doi.org/10.1016/j.ortho.2019.06.002
16. Tarigan SHP, Sufarnap E, Bahirrah S. The orthodontic mini-implants failures based on patient outcomes: a systematic review. Eur J Dent. 2024;18(2):417-429. DOI: https://doi.org/10.1055/s-0043-1772249
17. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human participants. JAMA. 2025;333(1):71-74. DOI: https://doi.org/10.1001/jama.2024.21972
18. Farronato G, Rosso G, Giannini L, Galbiati G, Maspero C. Correlation between skeletal Class II and temporomandibular joint disorders: a literature review. Minerva Stomatol. 2016;65(4):239-247.
19. Miller JR. Treatment of a twice-relapsed anterior open bite using temporary anchorage devices, myofunctional therapy, and fixed passive self-ligating appliances. Am J Orthod Dentofacial Orthop. 2020;157(6):832-842. DOI: https://doi.org/10.1016/j.ajodo.2019.03.031
20. Le Keux F, Frapier L. Lingual treatment of an adult patient with an iatrogenic Class II anterior open bite: report of a case with a non-surgical orthodontic approach. Int Orthod. 2021;19(1):170-181. DOI: https://doi.org/10.1016/j.ortho.2021.01.006
21. Martinelli F. Class II and anterior open bite malocclusion treated with mini-implants, intermaxillary elastics, speech therapy, and retained with a night-wear palatal crib wraparound. APOS Trends Orthod. 2023;13(2):123-132. DOI: https://doi.org/10.25259/APOS_196_2022

Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 3, 182, 462-469 pages, index UDC 616.314.26-089.23

DOI:

10.29254/2077-4214-2026-3-182-462-469