Abstract
The aim of this retrospective study was to assess the frequency of orofacial (nonodontogenic, neuropathic, or atypical) and temporomandibular joint (TMJ) and/or masticatory muscle pain in orthognathic patients in a tertiary institution. A total of 286 consecutive patients undergoing sagittal split osteotomy from 2014 to 2016 were included. Thirty-nine (13.6%) patients presented with TMJ pain and 10 (3.5%) with orofacial nonodontogenic pain before orthognathic surgery; 79.6% (39/49) of these patients had no pain 1 year after surgery. Twenty-nine patients (12.2%) with no preoperative orofacial pain and 22 (9.3%) without preoperative TMJ pain presented with pain 1 year after surgery. Fifty-one (17.8%) of the 286 patients treated for orthognathic cases at our center over the 3-year period presented with pain 1 year after surgery. Most patients were managed conservatively with nonsurgical therapeutic modalities including counseling, physical therapy, warmth application, and bilateral chewing and splint therapy. In patients with TMJ pain refractory to conservative treatment, arthroscopic surgery was advised and successful in all patients for both pain reduction and improvement of the maximal interincisal opening. TMJ symptoms do develop after orthognathic surgery in patients with and without a previous history of TMJ complaints. Most patients can be managed with nonsurgical therapeutic modalities.
Highlights
Orthognathic surgery corrects dentofacial deformity and a wide range of minor and major skeletal and dental irregularities
One hundred twenty-two (42.66%) interventions required bimaxillary osteotomies, and 164 (57.34%) required bilateral sagittal split osteotomies (BSSOs). ere was no report of altered sensation and muscle tenderness in any of the patients preoperatively, but 36 patients presented with pain associated with temporomandibular joint (TMJ), 7 patients had orofacial nonodontogenic pain, and 3 patients complained of both TMJ and orofacial nonodontogenic pain
In most of the patients, the pain complaint apart from mild discomfort has little effect on their daily activity. e pain was reported to be intermittent in some patients, whereas others reported pain from time to time; the recorded visual analog scale (VAS) score ranged from 1 to 3 in patients with pain. e number of patients complaining of orofacial pain and TMJ pain decreased during follow-up (Table 1)
Summary
Orthognathic surgery corrects dentofacial deformity and a wide range of minor and major skeletal and dental irregularities. Malocclusion puts excessive strain on the TMJ and increases the risk of developing TMJ disorder, jaw stiffness, chronic headaches, and impaired oral function [1, 2]. Other likely symptoms include radiating pain in the face, jaw, or neck; jaw muscle stiffness; limited movement or locking of the jaw; painful clicking, popping, or grating in the TMJ when opening or closing the mouth; and a change in the way the upper and lower teeth occlude [3]. In some cases with major skeletal jaw discrepancies, orthodontic treatment is indicated in conjunction with orthognathic surgery to correct the occlusal relationship
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
