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Related Experiment Videos

Changes in temporomandibular joint dysfunction after orthognathic surgery.

Larry M Wolford1, Oscar Reiche-Fischel, Pushkar Mehra

  • 1Oral and Maxillofacial Surgery, Baylor College of Dentistry, Texas A&M University System, Dallas, TX, USA. lwolford@swbell.net

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|June 11, 2003
PubMed
Summary

Orthognathic surgery can worsen temporomandibular joint (TMJ) dysfunction, especially pain and sounds, in patients with pre-existing TMJ issues. Careful evaluation and monitoring are crucial post-surgery.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthodontics
  • Temporomandibular Joint Disorders

Background:

  • Orthognathic surgery is used to correct dentofacial deformities.
  • Temporomandibular joint (TMJ) dysfunction, including internal derangement, can be a concern in these patients.
  • The impact of orthognathic surgery on pre-existing TMJ dysfunction requires thorough investigation.

Purpose of the Study:

  • To evaluate the effects of orthognathic surgery on TMJ dysfunction in patients with known presurgical TMJ internal derangement.
  • To assess changes in TMJ pain, mandibular motion, and TMJ sounds following double-jaw surgery.
  • To determine the long-term stability of TMJ symptoms after orthognathic procedures.

Main Methods:

  • Retrospective evaluation of 25 patients undergoing double-jaw surgery with confirmed preoperative TMJ disc displacement.

Related Experiment Videos

  • Assessment of TMJ dysfunction signs and symptoms (pain, range of motion, sounds) using visual analog scales and objective measures.
  • Analysis of surgical changes and long-term stability using cephalometric and tomographic tracings over an average 2.2-year follow-up.

    • Main Results:

    • Prevalence of TMJ pain increased from 36% pre-surgery to 84% post-surgery.
    • TMJ sounds were present in 64% pre-surgery and 60% post-surgery.
    • Average pain scores significantly increased post-surgery, with no relief for pre-existing TMJ pain. Condylar resorption occurred in 24% of patients.

    Conclusions:

    • Orthognathic surgery, particularly mandibular advancement, is associated with significant worsening of TMJ dysfunction in patients with pre-existing TMJ issues.
    • Pre-existing TMJ dysfunction requires close evaluation, treatment, and monitoring in patients undergoing orthognathic surgery.
    • Increased TMJ pain and the development of condylar resorption are significant post-surgical complications to consider.