TMD in Consecutive Patients Referred for Orthognathic Surgery

Abstract

Objective: To answer the question whether temporomandibular disorders (TMD) were more common in a group of individuals referred for orthognathic surgery than in a control group. The null hypothesis was that neither the frequency of signs and symptoms of TMD or diagnosed TMD would differ between the patient group and a control group. Materials and Methods: A sample of 121 consecutive patients referred for orthognathic surgery at the Department of Oral Maxillofacial Surgery, Malmö University Hospital, Sweden, was interviewed and examined regarding signs and symptoms of TMD and headaches. A control group was formed by 56 age-and gender-matched individuals attending the Department of Oral Diagnosis, Faculty of Odontology, Malmö University, Sweden, and Public Dental Health Clinic in Oxie, County of Skane, Sweden. TMD diagnoses were used according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Results:The patient group showed more myofascial pain without limited opening, disc displacement with reduction, and arthralgia according to RDC/TMD than the control group. The patient group also had more symptoms and signs of TMD in general. Conclusions: The null hypothesis was rejected because patients who were to be treated with orthognathic surgery had more signs and symptoms of TMD and higher frequency of diagnosed TMD compared with the matched control group. (Angle Orthod. 2009;79:621-627.)

A influência de sintomas da disfunção temporomandibular na força máxima de mordida em indivíduos com deformidade dentofacial

“…The statistical difference observed in the comparison of AQ scores between GDFD and CG agrees with the results of some studies that indicated predominance of signs and symptoms of TMD in individuals with DFD during presurgical orthodontic treatment compared to the control group (1,11,12) . It should be highlighted that no study has employed the anamnesis questionnaire used in this study, yet included clinical examination of the TMJ, visual analogue scale, anamnesis index and of dysfunction of Helkimo (21) , or applied the RDC/TMD protocol (22) .…”

“…The dento-occlusal imbalance may be associated with temporomandibular dysfunction (TMD) (7,8) , which corresponds to the generic term to a clinical range of signs and symptoms involving the masticatory muscles, the joint itself and associated structures (9) . Different authors observed predominance of signs and symptoms of TMD in individuals with DFD during presurgical orthodontic treatment compared to a control group (10,11,12) . The literature demonstrates reduced bite force values in individuals with DFD during presurgical orthodontic treatment, compared to a control group with normal occlusion and absence of signs and symptoms of TMD (5,13,14,15) .…”

Ocorrência de disfunção temporomandibular em indivíduos com deformidade dentofacial

“…The differences in relation to the present study may be justified by the fact that, in the study by Abrahamsson et al 29 , despite the larger sample, the control group was not matched by gender and age. The prevalence of articular diagnoses (GII and GIII) in subjects with DFD, in this study, can be attributed to the skeletal and dental imbalance in these individuals, which is not present in the controls, since internal changes in the TMJs of…”

“…The importance of occlusion and its relationship between the cause or maintenance of TMD cases, compared with other factors, specifically in individuals presented with DFD, has been widely discussed in the literature 15,[27][28][29] . The present study found that 97% of subjects with DFD showed some degree of TMD, while in the CG, the percentage of this disorder was 33%, which may be linked to the fact that TMD symptoms such as pain, are often the main complaint of patients presented with malocclusion 30 .…”

“…compared to controls 18,19,20,29 . It is worth noting the methodological differences between the studies, as in the literature, other instruments have been used, different from the anamnesis questionnaire applied in this research, nevertheless, they used the clinical exam of TMJs, analogue visual scale, Helkimo´s anamnesis and dysfunction index or applied the RDC / TMD protocol.…”