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TMJ related short-term outcomes comparing two different osteosynthesis techniques for bilateral sagittal split
T Roland-Billecart1, G Raoul2, M Kyheng3
1University Lille, Oral and Maxillofacial Department, Roger Salengro Hospital, CHU Lille, 59000 Lille, France.
Journal of Stomatology, Oral and Maxillofacial Surgery
|April 2, 2020
Summary
This study found no significant difference in temporomandibular joint (TMJ) health between two osteosynthesis techniques following bilateral sagittal split osteotomy (BSSO). Both miniplate and hybrid fixation methods resulted in similar outcomes for TMJ disorders and symptoms.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthognathic Surgery
- Temporomandibular Joint (TMJ) Health
Background:
- Bilateral sagittal split osteotomy (BSSO) is a common orthognathic procedure.
- Post-surgical osteosynthesis techniques may impact temporomandibular joint (TMJ) health.
- Understanding the influence of fixation methods on TMJ disorders (TMD) is crucial for patient outcomes.
Purpose of the Study:
- To evaluate temporomandibular disorders (TMD) and TMJ symptoms after orthognathic surgery.
- To compare TMJ health based on two distinct osteosynthesis techniques used in BSSO.
- To assess the impact of fixation methods on patient-reported jaw pain and function.
Main Methods:
- A cohort of 183 patients undergoing BSSO for dentofacial deformities were studied.
- Two osteosynthesis groups were compared: miniplates with monocortical screws (n=42) and hybrid fixation with bicortical screws and miniplates (n=141).
- TMJ health was assessed pre-operatively and one year post-operatively using Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and the Jaw Pain Function (JPF) questionnaire.
Main Results:
- No statistically significant differences were observed in RDC/TMD assessments between the two osteosynthesis groups (p≥0.91).
- Jaw Pain Function (JPF) scores also showed no significant difference between the groups one year after surgery (p≥0.29).
- Both miniplate and hybrid fixation methods demonstrated comparable effects on TMJ health post-BSSO.
Conclusions:
- The choice of osteosynthesis technique (miniplate vs. hybrid fixation) did not significantly influence TMJ health or TMD development after BSSO.
- The hybrid fixation technique, while offering advantages, did not negatively impact postoperative TMD compared to standard miniplate fixation.
- These findings suggest that BSSO can be performed with either technique without compromising TMJ health in patients with dentofacial deformities.
Keywords:
Hybrid fixationOrthognathic surgeryOsteosynthesisTemporomandibular disordersTemporomandibular joint
