Interdisciplinary Minimally Invasive Occlusal Reconstruction For TMD With Occlusal Dysfunction

This case presents a young male patient with TMD myofascial pain due to occlusal factors. He had inadequate posterior support during ICP, insufficient anterior guidance during protrusion, crossbite, and joint space changes on imaging. Orthodontic-restorative treatment was conducted to alleviate joint symptoms, normalize joint spaces, and restore a healthy occlusion. Three years ago, the patient received a stabilization splint for occlusal discomfort, which alleviated symptoms. He now seeks further restoration. Clinical examination revealed large restorations on posterior teeth, leading to poor morphology, insufficient posterior support during ICP, and anterior guidance issues. There was also crossbite between teeth 17 and 47. CBCT showed widened anterior joint spaces bilaterally. Treatment plan: TMD management with stabilization splint; orthodontic correction of crossbite; removable restoration with vertical dimension increase; fixed restoration with fixed occlusal splint; final restoration with occlusal veneers/inlays; and regular follow-up. This case highlights the necessity of initial stabilization splint therapy for TMD symptoms, followed by orthodontic-restorative treatment. Digital technology was used throughout the process to design and reproduce functional restoration spaces. Orthodontics corrected the crossbite, while removable and fixed occlusal splints adjusted the occlusion. The final restoration used minimally invasive techniques to preserve tooth structure, achieving a balanced occlusal plane and a functional, aesthetic occlusion. Multidisciplinary orthodontic-restorative treatment can effectively improve TMD symptoms and restore occlusal function and aesthetics in patients with occlusal-related TMD. Digital technology plays a crucial role in facilitating minimally invasive occlusal reconstruction.