[Orthognathic surgery in temporomandibular disorders: not a remedy, and not without risk]

Orthognathic surgery does not unequivocally result in either improvement or deterioration of temporomandibular disorders. Based on a narrative analysis, postoperative pain symptoms decrease in some patients, while in more than half symptoms persist, recur, or new pain develops. Outcomes differ significantly among individuals and are associated with pre-existing joint abnormalities, changes in temporomandibular joint position, and postoperative remodelling. Joint sounds do not follow a predictable course and may either decrease or increase following orthognathic surgery. Moreover, asymptomatic patients may develop symptoms following orthognathic surgery. The case presented illustrates that repeated surgical interventions may contribute to joint degeneration with persistent pain and functional impairment. Orthognathic surgery therefore appears to exert a modulatory, but not a predictably curative effect on temporomandibular disorders.