Abstract
This study investigated the prevalence of temporomandibular disorder (TMD) among patients before and after orthognathic surgery and assessed the effect of orthognathic surgery on each of the TMD symptoms (clicking, pain, crepitus, and MRI findings). A sample of 100 consecutive patients undergoing bimaxillary surgery for correction of craniofacial deformities (31 male and 69 female), with ages ranging between 17 and 58 years (mean age: 27.7 ± 9.3 years), were interviewed and examined regarding signs and symptoms of TMD. Clinical examination and X-ray and magnetic resonance imaging of the temporomandibular junction were performed at the time of surgery and 1 year thereafter. The prevalence of TMD preoperatively and postoperatively was 35% and 27%, respectively. A high frequency of relief was found in the patients with TMD symptoms (74.3%; 19 (70.3%) of patients had reduced clicking, 7 (87.5%) patients had reduced pain, 4 (100%) patients had reduced crepitus, and 4 (57.1%) patients showed changes in MRI findings), 12 patients who were asymptomatic before surgery developed clicking in TMJ after surgery, 3 developed pain, and 3 developed crepitus. TMD problems can occur in a variety of patients, including those who have facial deformities, and require orthognathic surgery. However, orthognathic surgery may not predictably treat or reduce the symptoms of TMD.
Highlights
Temporomandibular disorder (TMD) is considered to be a common problem in the population, affecting individuals from adolescence to adulthood
It was found that skeletal class II malocclusion with TMD symptoms before surgery was in 16 patients and 15 patients postsurgically
Skeletal class III malocclusion with TMD symptoms before surgery was in 19 patients and 12 patients postsurgically (Table 1)
Summary
Temporomandibular disorder (TMD) is considered to be a common problem in the population, affecting individuals from adolescence to adulthood. Other studies have reported the risk of developing TMD symptoms in the patients that were asymptomatic preoperatively [5]. E objective of this retrospective study was to evaluate TMD symptoms before and after orthognathic surgery in the patients who underwent this procedure and to evaluate the effect of the surgery on symptomatic as well asymptomatic patients. Full medical and dental histories were taken by trained maxillofacial specialists that followed the same examination protocol; a full investigation, including OPG and lateral cephalometric X-rays and computed tomography (CT) scans, was performed for every patient. Magnetic resonance imaging (MRI) was performed presurgically for every patient with a history of TMD-related problems. MRI was performed for every patient at one month and one year as standard medical care was followed in the hospital. Multiresponse frequency and means (shown as mean ± s.d.) were determined, and frequencies are shown as simple bar graphs
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