Abstract
BackgroundThis study are to identify the symptomatic changes and condylar stability after 2 jaw surgery without preceding treatments for Temporomandibular joints(TMJ) in class III patients with the TMJ symptoms; and to assess therapeutic effect of 2 jaw surgery and the necessity of preceding treatment for alleviation of TMJ symptoms.Methods30 prognathic patients with preexisting TMJ symptoms were divided into 2 groups according to presence or absence of preceding treatments before the surgery. We evaluated symptomatic changes on both TMJ by questionnaires and clinical examinations. And we reconstructed 3D cone beam computed tomography images before 2 jaw surgery, immediately after the surgery, and 6 months or more after the surgery with SimPlant software, and analyzed the stability of condylar position on 3D reconstruction model. Significances were assessed by the Wilcoxon signed rank test on SPSS ver. 20.0.ResultsBoth groups had favorable changes of TMJ symptoms after orthognathic surgery. And postoperative position of condyle had good stability during follow-up period.Conclusion2 jaw surgery without preceding treatments for TMD can have therapeutic effect for TMD patients with class III malocclusion.
Highlights
This study are to identify the symptomatic changes and condylar stability after 2 jaw surgery without preceding treatments for Temporomandibular joints(TMJ) in class III patients with the temporomandibular joints (TMJ) symptoms; and to assess therapeutic effect of 2 jaw surgery and the necessity of preceding treatment for alleviation of TMJ symptoms
The significances of symptomatic changes after orthognathic surgery are analyzed statistically, but the statistical process of limitation of mouth opening (LOM) was excluded because LOM was rare in patients (Table 7)
Study group Ten patients (66.7%) experienced TMJ noises without TMJ pain before orthognathic surgery, and there were decrease to 6 patients (40%) after the surgery. 5 patients (33.3%) reported both TMJ pain and noise before the surgery were reduced to 2 patients (13.3%) after the surgery and those with no symptom increased from none to 7 (46.7%)
Summary
This study are to identify the symptomatic changes and condylar stability after 2 jaw surgery without preceding treatments for Temporomandibular joints(TMJ) in class III patients with the TMJ symptoms; and to assess therapeutic effect of 2 jaw surgery and the necessity of preceding treatment for alleviation of TMJ symptoms. Many patients with dentofacial deformity often have various symptoms and signs on temporomandibular joints (TMJ) and its related structures. Many studies have been reported various degree of improvement, deterioration or no effect in symptoms and signs of TMD after orthognathic surgery [3,4,5,6,7,8,9,10,11,12,13]. It is generalized that there is no contraindication related with TMD in orthognathic surgery except for acute symptoms or inflammatory diseases on TMJ. There is still controversial about the necessity of preceding treatment for stabilization of preoperative TMJ condition
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