Case Study #1

A ten-year-old boy presented for orthodontic consultation in January 1978.
After assembling the base line records (clinical exam, palpation, history,
radiographs, and study models), the probability of a craniomandibular
disorder was ascertained.
The patient had a Class Ⅱ molar relationship, decreased vertical dimension,
an overbite, and flat cusps on the maxillary and mandibular deciduous cusps.
The patient was under the care of a local orthopedist for scoliosis, and the
orthopedist had prescribed exercises for him.
During March 1978, a Gelb mandibular orthopedic repositioning appliance was
inserted to correct the maxillomandibular imbalance in order to begin treatment
of his craniomandibular (TMJ) disorder. From January to November 1978,
while he was being treated for his TMJ disorder, he did not see the orthopedist.
He also did not perform any of the prescribed exercises for the scoliosis. On
December 19, 1978, the child was informed by the orthopedist that his scoliosis
had been cured.
                 
Figure 1-1  shows an x-rays of the spine with a 10。 curve taken September 30,
                   1975.
Figure 1-2   taken on November 30, 1977, exhibits an increase in the curvature
                    of the spine to 25.
Figure 1-3  taken on December 19, 1978, shows a decrease in the curvature
                   to 3。. It should be noted that treatment for a TMJ problem,
                   not scoliosis, was originally planned.