TMJ and Cross Bite

[akabugs]

I’m new here and I plan on getting braces within the next 6-8 weeks. I am currently using Invisalign, but I have a posterior cross bite that is not moving. My ortho suggested moving me to traditional braces to fix my cross bite and since I’m 22 he believes I will be able to achieve palatal expansion without surgery. I’m hopeful that fixing my cross bite will fix my TMD since I have a functional shift when I open and close my mouth. Has anyone here gotten TMD relief through fixing a cross bite, regardless of how the cross bite was treated (SARPE, expander, etc.)?

[SinkFullOfDinner]

Hi akabugs -

Your description is exactly what my ortho has been working on: TM joint pain caused by functional shift (and rotation); crossbite; stubborn molar movement; etc. Feel free to PM me and I'll do my best to answer any questions, but the most important one you probably have is "has it helped with the TMD?" The answer is that we've made a ton of progress, so I'm now very optimistic about the end result, but it's taken a ridiculously long time and it's been more involved than I expected. But again, the improvement has been undeniable and even if we made no further progress, I'd say it's already been worth the effort and hassle and time.

Good luck in the meantime!

- Sink

[akabugs]

SinkFullOfDinner wrote:
> Hi akabugs -
>
> Your description is exactly what my ortho has been working on: TM joint
> pain caused by functional shift (and rotation); crossbite; stubborn molar
> movement; etc. Feel free to PM me and I'll do my best to answer any
> questions, but the most important one you probably have is "has it
> helped with the TMD?" The answer is that we've made a ton of
> progress, so I'm now very optimistic about the end result, but it's taken a
> ridiculously long time and it's been more involved than I expected. [i]But
> again,[/i] the improvement has been undeniable and even if we made no
> further progress, I'd say it's already been worth the effort and hassle and
> time.
>
> Good luck in the meantime!
>
> - Sink

Thanks for the response! I do not have the ability to send PMs yet because my account is new and I do not have enough posts, but I definitely have a few questions, if you don’t mind.
- How much longer has your treatment gone over than originally expected?

- What method is your orthodontist using to fix your bite? If you have an expander, have you noticed any tipping in your teeth instead of actual skeletal expansion?

- What physical/functional changes have you noticed? I’m hoping that my sinus issues/headaches will improve and I also hope that some facial asymmetry that I’ve noticed in the last few years will improve. I’ve also heard some people complain about protruding cheekbones and sunken cheeks. Have you experienced any of this?

If you do not have an answer for all of these that is okay. Thank you in advance!

[SinkFullOfDinner]

- How much longer has your treatment gone over than originally expected?

• My ortho initially hoped we might wrap up by Mar, then by the end of summer. So I guess we're 5 mo and counting. Tipping molars can be a slow process, as you might have guessed with your Invisalign experience. However, we'd already finished an initial round of braces, followed by some time with an occlusal splint to determine bite and condyle positioning to address the functional shift and pain issues, so I consider this entire second phase of braces to be "overtime" It sounds like your ortho has already determined the issue and how to approach it, so you already have a head start!

- What method is your orthodontist using to fix your bite? If you have an expander, have you noticed any tipping in your teeth instead of actual skeletal expansion?

• No expander; no skeletal expansion (unlike you, I'm not 22 and my bones are closer to being petrified than they are to being in their growth phase!). However, a TPA and lower arch are part of the process to create the good kind of tipping and anchorage to go along with cross elastics and a secondary wire they call a "piggyback" wire.

- What physical/functional changes have you noticed? I’m hoping that my sinus issues/headaches will improve and I also hope that some facial asymmetry that I’ve noticed in the last few years will improve. I’ve also heard some people complain about protruding cheekbones and sunken cheeks. Have you experienced any of this?

• Headaches and sinus issues weren't a TMD issue for me. Just pretty intense pain. If you're experiencing that on a daily/nightly basis, you know what I'm talking about. The changes so far have been related to pain level, which has come down and is less frequent...a game-changer, really. If you also happen to achieve some improvement in symmetry, I'd just consider that a nice bonus. However, if your ortho is able to eliminate the posterior crossbite and TMD pain, count your blessings and call it a huge win!