Treatment of malocclusion after TMJ disc repositioning with Mitek anchors. A retrospective review

Objective: Evaluate the outcomes of using Class III elastic mechanics to correct the postsurgical malocclusion produced after temporomandibular joint (TMJ) disc repositioning with the Mitek anchor technique. Materials and methods: Retrospective study of 42 patients (72 TMJs) with a Wilkes class II or III internal derangement (ID) that were corrected surgically with Mitek anchors (Mitek Surgical Products, Westwood, MA) for TMJ disc repositioning at the OMS Department, University of Texas Health Science Center at San Antonio. Results: Immediately post-operatively (T2) 23 of the 42 patients (54%) had immediate malocclusion (bilateral posterior open bite, mandibular deviation, and class III malocclusion) requiring elastics. Sixteen of the 23 patients with malocclusion elected to use elastics and the other ones did not desire treatment. Class III elastics patients post-operatively showed 11 patients of 16 (69%) without malocclusion at 7 days after surgery, with all patients (100%) returning to their pre-operative occlusion by one and a half months post-operatively. The patients treated without elastics showed 6 of 7 (85%) with malocclusion at 7 days post-operatively, and 4 of them (57%) exhibited persistent malocclusion after two months that required further treatment. Conclusion: Class III elastics placed immediately after TMJ articular disc repositioning with Mitek anchors provide an effective and predictable resolution of malocclusion at a higher rate than without treatment.