Orthognathic Surgery as a Treatment for Temporomandibular Disorders

Well-controlled clinical trials supporting orthognathic surgery as the primary management for temporomandibular disorders (TMDs) are lacking. Most published studies lack an adequate experimental design to minimize biases. Studies that did minimize some biases do support an overall reduction in the frequency of TMD signs and symptoms in some Class III and Class II patients who had orthognathic surgery. However, Class II correction with counter-clockwise rotation of the mandible increased TMD. Individual variability precludes the ability to predict TMD outcome after surgery. Irreversible therapies such as orthognathic surgery should not be primary treatments in the management or prevention of TMDs.