顎顔面外傷および咬合不正患者における早期術後咬合介入：下顎機能回復への影響

To evaluate the impact of early postoperative occlusal intervention on mandibular border movement and functional recovery in patients with maxillofacial trauma and malocclusion.

In this retrospective 1:1 matched study, 184 patients treated during December 2019 to December 2023 were allocated to intervention (n = 92) and control (n = 92) groups. Controls received conventional postoperative care. The intervention group received additional systematic occlusal intervention initiated within one week post-surgery, comprising intermaxillary traction, occlusal splint therapy, and targeted occlusal training. Outcomes assessed included the mandibular border movement index (MBMI), Visual Analogue Scale (VAS), pressure pain threshold (PPT), Jaw Functional Limitation Scale (JFLS), and Oral Health Impact Profile-5 (OHIP-5). Complications were also recorded.

At 3 months, both groups showed significant improvement in all MBMI parameters (maximum mouth opening, protrusion, lateral excursions) and the composite score, with the intervention group demonstrating superior outcomes (P < 0.05). The intervention group also exhibited significantly greater reductions in VAS scores and greater increases in PPT (P < 0.05). Similarly, significantly greater improvements were observed in the intervention group for all JFLS domains (mastication, vertical mobility, emotional/verbal expression) and OHIP-5 items, along with their total scores (P < 0.05). The complication rate did not differ significantly between groups (P > 0.05).

Early systematic occlusal intervention effectively promotes mandibular border movement recovery, alleviates orofacial pain, and enhances jaw function and oral health-related quality of life in patients with maxillofacial trauma and malocclusion, without increasing complication risks, representing a safe and effective adjunctive treatment strategy.