CASE STUDY “In this article, I will show how I treated the patient with the daytime FACT (Functional Advancing Condylar Translation) appliance and the nighttime Bionator appliance to stabilize the TM joints and allow them to heal.” options at this time. Keep in mind that anterior repositioning therapy (ART) is not definitive treatment. The mild posterior open bite brought about by the slight advance-ment of the mandible is filled in with splint material when the splint is in the mouth. Any time the splint is out of the mouth, the posterior open bite presents. To affect a permanent correction, the posterior open bite space must be orthodontically or prosthetically closed. Prior to that, the patient’s TMD issues needed attention as she started to have a recurrence of symp-toms after her Levandoski Splint had worn down. In this article, I will show how I treated the patient with the daytime FACT (Functional Advancing Condylar Translation) appliance and the nighttime Biona-tor appliance to stabilize the TM joints and allow them to heal. Fig. 3 Fig. 4 Why are many TMD patient chronic migraineurs including my patient? Dr. Spahl describes three phenom-ena that are responsible for chronic migraines commonly experienced by TMD patients: 5 ᕡ Trigeminovascular reflex. When the trigeminal nerve www.orthodontics.com Fig. 5 Winter 2022 33
Journal of the American Orthodontic Society Winter 2022: Page 33
