Temporomandibular joint morphology changes with mandibular advancement surgery and rigid internal fixation: a...

The purpose of this systematic review was to evaluate the effect of bilateral sagittal split mandibular osteotomy (BSSO) with rigid internal fixation (RIF) on temporomandibular joint (TMJ) morphology. Controlled trials of BSSO with RIF treatment of Class II patients using transcranial radiographs, submental vertex (SMV) radiographs, tomographic radiography, computed tomography (CT) scan, or magnetic resonance imaging (MRI) to assess TMJ morphology were identified by Medline (1966-2001) and PubMed. Case reports were excluded. On the basis of our search only six studies were included in this review. All studies used internal controls with pre- and posttreatment imaging. Two studies used SMV, one used transcranial radiographs, one used tomography, two used CT scan and one used MRI. Methodological deficiencies prevent major conclusions regarding osseous remodeling and disk status. There was a wide range of individual variability in condyle position change. The reviewed studies have highlighted the importance of further research. Prospective controlled studies using serial MRI and tomography or CT scan are required to establish effect of BSSO with RIF on TMJ morphology.