Using the Digital Gothic Arch Tracer for Occlusal Diagnosis and Management of Malocclusion with Osteoarthritis

Purpose: There has been a significant number of malocclusion patients who suffer from the osteoarthritis associated with TMJ, and acquired anterior open bites were reported as a representative example. Treatments for patients with malocclusion often prove difficult, as the condyle position is not stable. It remains unknown as to whether this is due to the disease or the condyle position. This case report documents a clinical application of a Digital Gothic Arch Tracer for occlusal diagnosis and subsequent management and treatment of malocclusion with osteoarthritis.Materials and methods: This case report presents the treatment process of a female patient (51 years, 6 months of age) with an acquired dual-bite malocclusion with severe osteoarthritis in the temporomandibular joint (TMJ). The occlusal condition of the patient was examined by a Digital Gothic Arch Tracer (DGAT, Gothic Display: Shofu Inc.). The GDAT was used as it provides an extra-oral tracing of jaw movements. While it is simple and easy to use, the accuracy remains impressively high, as several jaw motions are included into the final calculation.Results: The ensuing treatment plan was as follows: Upon the first examination, the occlusal position was recorded with DGAT. The DGAT data was then evaluated for correlations between the terminal points of the rapid habitual opening-closing movements (tapping points), apex point and speaking position. The gothic arch figure revealed that when approaching the terminal points of the tapping points and the speaking position, there was a separation at the apex point. From this, we reached a conclusion on the new occlusal position for tapping points and the speaking position. Based on the DGAT results, via the occlusal adjustment method, we set the new occlusal position. On their final visit the patient received Prosthodontics treatment. The DGAT was able to provide an avenue of examination that maintained the original occlusal position without raising the vertical dimension. Therefore, it was rather simple and exact to compare the Tapping points and Apex points.Conclusion: Using a Digital Gothic Arch Tracer, we successfully carried out the occlusal examination and treatment of a patient with osteoarthritis and malocclusion.