By Dr. Keri Do:
Comprehensive orthodontics is a treatment that needs to target and correct issues beyond malocclusions, such as teeth alignment or damaging overbites. It can affect comprehensive factors that require a multidisciplinary approach such as alignment of the TMJ, opening of the respiratory passage or airway, leveling of the occlusal plane, and stabilization of the occlusion, subsequently creating beautiful smiles and faces. In addition, an important development of treatment that should not be overlooked is the patency of an airway. The position of the mandible can contribute to how much an airway is open or closed. For example, when the mandible is more retruded, which can occur when changing from an upright to a supine position, the airway passage will narrow. (1) A retruded mandible position can also negatively affect the TMJ. Joint derangement has been shown to have a direct correlation with the amount of mandibular retrusion. (2) Treatment goals should include positioning the mandible in the correct condylar position and functional airway position and subsequently moving the teeth to support that position. (3-5) This clinical report illustrates cases where the patient was treated for TMD and obstructive sleep apnea with functional appliances and orthodontics.