Management of Temporomandibular Disorder and Subsequent Orthodontic Therapy in an Elderly Patient. Operative Sequence in a Case Report

This article presents a case study of a 64-year-old female patient who underwent orthodontic treatment to enhance the aesthetic appearance of her smile and replace a missing tooth (46). During the preliminary visit, significant gnathological concerns were identified, including headaches, orofacial pain, and muscle fatigue. These issues had to be addressed prior to the start of the orthodontic phase of treatment. Methods: a multidisci-plinary treatment plan was implemented using a sequential approach. The initial phase involved the implementation of techniques to reduce muscle tension and manage orofacial pain, with the objective of achieving clinical stability. Following the attainment of clinical stability, the orthodontic phase commences with the aim of improving occlusion and pos-ture. Results: a significant reduction in muscle tension-related symptoms was observed, along with effective gnathological stabilization. Subsequent orthodontic treatment resulted in aesthetic and functional improvements to the smile, optimizing occlusion and overall posture. The final phase will involve implant-prosthetic rehabilitation to replace tooth 46. Conclusions: a comprehensive and accurate initial gnathological diagnosis is essential for planning effective rehabilitative therapy in patients with partial edentulism and associated conditions. A multidisciplinary approach has proven fundamental in achieving stable and predictable long-term outcomes, even after the implant-prosthetic phase.