Effects of Chewing Exerciser on the Recovery of Masticatory Function Recovery after Orthognathic Surgery: A Single-Center Randomized Clinical Trial, a Preliminary Study.

Hoon Joo Yang,Akram Abdo Almansoori,Yoojung Son,Bongju Kim,Ik Jae Kwon,Jong-Ho Lee,Soung-Min Kim

doi:10.3390/medicina56090483

Hoon Joo Yang, Akram Abdo Almansoori + Show 5 more

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https://doi.org/10.3390/medicina56090483

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Abstract

Background and Objectives: The aim of this study was to evaluate the effects of the chewing exerciser (CE) on the functional recovery of the masticatory muscles after orthognathic surgery. Material and Methods: This randomized clinical trial was conducted in patients undergoing bimaxillary orthognathic surgery including bilateral sagittal split ramus osteotomy. Postoperative physiotherapy (PT) was performed for 3 weeks starting 3 weeks after the surgery. The patients were randomly divided into two groups: control (Con) (conventional PT) group and CE group (use of CE in addition to conventional PT). The masticatory function was evaluated based on three standards: bite force (BF), amount of mouth opening (MO), and surface electromyography (sEMG) of the anterior temporal muscle (TA), masseter muscle (MM), sternocleidomastoid muscle, and anterior belly of digastric muscle before, 3 weeks (before PT) and 6 weeks after the surgery (after PT). Results: Finally, 22 subjects participated in this study: 10 patients for Con group and 12 patients for CE group. In both groups, the BF, which was reduced significantly after the surgery, recovered after the PT similar to that before the surgery. In both groups, the MO was also significantly reduced by the surgery. However, it did not recover as much, as it was before the surgery after applying the PT. There was no difference in BF and MO between the two groups. All muscles did not show significant changes in sEMG by surgery and PT at both resting and clenching states. Conclusion: Applying CE as a PT after orthognathic surgery did not cause any harmful side effects. In both groups, the weakened muscle activity after orthognathic surgery (OGS) was adequately restored 6 weeks after the surgery. However, CE did not offer a statistically significant benefit to the masticatory function in the recovery process after OGS.

Highlights

Orthognathic surgery (OGS) with/without orthodontic treatment is a commonly widely used approach for correction of the adult’s skeletal maxillomandibular discrepancy [1]
The bite force (BF) and mouth opening (MO) were measured in all 22 patients, and surface electromyography (sEMG) was only completed in 12 patients
There was an individual difference in the recovery period after the PT, all of the 22 patients restored the normal maximum opening, and no patient complained of pain or discomfort in the TMJ or surrounding muscles

Summary

Introduction

Orthognathic surgery (OGS) with/without orthodontic treatment is a commonly widely used approach for correction of the adult’s skeletal maxillomandibular discrepancy [1]. Patients requiring skeletal malocclusion treatment seek it for functional rehabilitation and esthetic improvement [2]. OGS of the mandible is commonly performed using a bilateral sagittal split ramus osteotomy (BSSRO). OGS of the mandible is commonly performed using a bilateral sagittal split ramus osteotomy (BSSRO) technique [3]. The BSSRO results in a detachment of the masticatory muscles and change in the muscles attached to the to some extent. Althoughmuscles it is not and necessary to in strip technique [3].position. The aim of this study was to evaluate the effects of the chewing exerciser (CE) on the functional recovery of the masticatory muscles after orthognathic surgery

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Conclusion