BONE-SCINTIGRAPHY OF HUMAN TEMPOROMANDIBULAR JOINTS DURING HERBST TREATMENT - A CASE-REPORT

Bone scintigraphy results were compared with changes shown on orthopan tomographic radiographs in a patient with facial asymmetry, before, du ring, and after Herbst treatment, and followed up with control of grow th activity in the temporomandibular joints (TMJs) after long-term ret ention. The present study showed that new bone formation (modelling) w as initiated asymmetrically in TMJs during treatment. The results indi cate that late development of right/left asymmetry in the occlusion ca n be corrected and normalized using the Herbst appliance therapy, stim ulating a differentiated 'catch up' growth (modelling) in the TMJ with condyles. After treatment, original growth with asymmetric activity i n the TMJ was re-established. This growth activity may re-establish th e asymmetry in the sagittal occlusion and the face of the patient. It is therefore recommended that the occlusion should be maintained with an appliance which stabilizes the occlusion until cessation of the pri mary, endochondral growth.