Temporomandibular disorders in Class II malocclusion patients after surgical mandibular advancement treatment as compared to non‐treated patients

Abstract

Summary Background Severe malocclusions may cause functional and aesthetic problems and symptoms of temporomandibular disorders (TMD). Studies have investigated association between malocclusions and TMDs and shown controversial findings. Objective Purpose of this investigation was to examine the prevalence of TMD sub‐diagnoses, using Diagnostic Criteria for the TMD (DC/TMD), in patients with Class II malocclusion and retrognathic mandible who had undergone mandibular advancement surgery 4‐8 years previously, and to compare their frequencies with non‐treated patients with a similar pre‐existing condition. Methods Study cohort comprised 151 patients who had orthognathic treatment due to mandibular retrognathia in 2007‐2011. Seventy‐seven (51%) participated in the study (Group 1). Group 2 comprised 22 patients who were planned for orthognathic treatment but had not started their treatment. Patients filled in the Finnish version of the DC/TMD Symptom Questionnaire and were examined using to the DC/TMD Axis I. DC/TMD Symptom Questionnaire were inquired by phone from 24 of the 74 patients who did not participate in the study. Results Results showed that Group 2 had more myalgia (13% vs 50%, P < 0.001) and arthralgia (18% vs 65%, P < 0.001) sub‐diagnoses than Group 1. A tendency was noted that Group 2 had more pain‐related TMD symptoms than Group 1. No differences were found between Groups 1 and 3 in gender and age distribution or frequency TMD symptoms. Conclusion Prevalence of especially pain‐related TMD diagnoses was higher in Group 2 compared to Group 1, thus indicating a possible beneficial effect of this treatment for TMD.

Does Mandibular Advancement Orthognathic Surgery Lead to TMJ Dysfunction in Skeletal Class 2 Patients? A Quasi-Experimental Trial in an Iranian Population

“…The chances of bone resorption may drastically increase after mandibular advancement; this is especially evident in high-risk patients. The amount of mandibular advancement and counterclockwise rotation along with the type of employed surgical technique can highly contribute to the final condition of the TMJ tissues 2 , 12 , 17 , 18 , 21 .…”

“…The effect of orthognathic surgery on the temporomandibular joint (TMJ) is one of the important points in maxillofacial surgeries 1 , 2 . Determining the condyle location as well as the relation between the disk and the condyle is a key factor in orthognathic surgery, to prevent further TMJ problems, which can eventually lead to skeletal relapse 3 - 5 .…”

“…Although the majority of oral and maxillofacial surgeons evaluate their orthognathic surgery success based on postoperative esthetics and patient satisfaction; functional rehabilitation is of much more importance. The temporomandibular joint is the key to occlusion and any intervention, which has a direct or indirect potential effect on the TMJ components, can highly impact one’s quality of life 2 , 4 , 6 , 7 .…”

“…On the other hand, patients manifest a variety of TMJ alterations after mandibular advancement surgery, which can differ from person to person. Therefore, it remains controversial whether or not mandibular advancement can impair the TMJ 2 , 3 , 14 - 18 .…”

Does orthognathic treatment improve patients’ psychosocial well-being?

“…Orthognathic treatment combines orthodontic and surgical treatment and aims at correcting severe dentofacial discrepancies that cannot be treated with conventional orthodontic treatment. Severe dentofacial discrepancies affect patients in many ways: Patients report various symptoms, such as headache, facial pain, temporomandibular joint problems and chewing difficulties [1,2] and prospective orthognathic patients have more symptoms in their head and neck region than young adults not in need of orthognathic treatment [3,4]. Before surgery, patients' quality of life is lower than controls' quality of life [5][6][7][8][9][10].…”