A case study of temporomandibular joint rheumatoid arthritis treated conservatively. Use of splints to prevent relapse of open bite after intermaxillary elastic traction treatment.

We report on a patient who had TMJ rheumatoid arthritis associated with regression of the mandible and an open bite. She was treated successfully by intermaxillary elastic traction followed by placement of a separate-type splint appliance, without relapse.Case: A 49-year-old woman who had rheumatoid arthritis since 1989 visited our clinic in 1994 because of trismus and an open bite. The open bite was 3.5mm and the trismus was 30mm. Open bite improved to 0mm after elastic traction of the anterior part of the mandible cranially. Traction was applied by using intermaxillary splints for 43 days as well as a mandibular advancing positioner (MAP), common by used to treat sleep apnea syndrome (SAS).We recommend the use of MAP as conservative treatment to prevent relapse after anterior traction of the mandible.