Aim: To evaluate signs and symptoms of temporomandibular joint disorder and satisfaction in patients before and after orthognathic surgery. Methods: The sample consisted of 15 patients aged between 19 and 47 years old, indicated for orthodontic-surgical treatment. All patients answered na anamnesis questionnaire based on Helkimo Anamnestic Index to evaluate subjective symptoms and underwent a clinical evaluation based on Helkimo Disfunction Index, applied at three time points: before (T0), three (T1) and six months (T2) after surgery. Statistical models used were χ2 test (Chi-square), Tukey test, confidence interval and analysis of variance (ANOVA). Results: Statistical analysis revealed no significant difference in the incidence of joint sounds, maximum mouth opening, deviation of mouth opening and pain in the TMJ region (p>0.05). No patient presented worsening of the symptomatology. As regards muscular pain, there was a statistically significant improvement with time (p<0.05) and 86.7% of patients reported that they were satisfied with the obtained results. Conclusions: Improvement of TMD after orthognathic surgery may not be the result of correcting malocclusion and satisfaction with the results can be a factor of TMD improvement.
Dantas JFC, Neto JNN, Carvalho SHG, Martins IMCLB, Souza RF, Sarmento VA. Satisfaction of skeletal Class III patients treated with different types of orthognatic surgery. Int J Oral Maxillofac Surg. 2015;44(2):195-202.
Baek SH, Kim TK, Kim MJ. Is there any difference in the condylar position and angulation after asymmetric mandibular setback? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(2):155-63.
Rocha VAC, Trindade Neto AI, Rebello IMCR, Esteves LS, Santos JN, Zanetta-Barbosa D, et al. Skeletal stability in orthognatic surgery: evaluation of methods of rigid internal fixation after counterclockwise rotation in patients with Class II deformities. Br J Oral Maxillofac Surg. 2015;53(8):730-5.
Bernell-Baviera A, Bellot-Arcis C, Montiel-Company JM, AlmerichSilla JM. Effects of mandibular advancementsurgery on the temporomandibular joint and muscular and articular adaptative changes-a systematic review. Int J Oral Maxillofac Surg. 2016;45(5):54552.
Talentts RH, Stein S, Macher DJ, Katzberg RW, Murphy W. Predisposing and precipitating factors in temporomandibular disorders. Semin Orthod. 2012;18(1):10-29.
Wolford LM, Rodrigues DB, Limoeiro E. Orthognatic and TMJ surgery: postsurgical patient management. J Oral Maxillofac Surg. 2011;69(11):2893-903.
Wolford LM, Reiche-Fischel O, Mehra P. Changes in temporomandibular joint dysfunction after orthognathic surgery. J Oral Maxillofac Surg. 2003;61(6):655-60.
Onizawa K, Schmelzeisen R, Vogt S. Alterations of temporomandibular joint symptoms after orthognathic surgery: comparison with heathy volunteers. J Oral Maxillofac Surg. 1995;53(2):117-21.
Nale JC. Orthognatic Surgery and the temporomandibular patient. Oral Maxillofac Surg Clin North Am. 2014;26(4):551-64.
Helkimo M. Studies on function and dysfunction of the masticatory system. Sven Tandlak Tidskr. 1974;67(2):101-21.
Kuhlefelt M, Laine P, Thorén H. Bilateral sagittal split surgery is not a predictable treatment for temporomandibular dysfunction in patients with retrognathia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2016;121(6):595-601.
Athanasiou EA, Melsen B. Craniomandibular disfunction following surgical correction of mandibular prognatism. Angle Orthod. 1992;62(1):9-14.
Dervis E, Tuncer E. Long-term evaluations of temporomandibular disorders in patients undergoing orthognathic surgery compared with a control group. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(5):554-60.
Landes CA, Sterz M. Proximal segment positioning in bilateral sagittal split osteotomy: intraoperative controlled positioning by a positioning splint. J Oral Maxillofac Surg. 2003;61(12):1423-31.
Martin MD. Orthognatic surgical treatment may produce improved temporomandibular functional status in adults with pretreatment dysfunction. J Evid- Based Dent Pract. 2011;11(4):191-3.
Gaggl A, Schultes G, Santler G, Karcher H, Simbrunner J. Clinical and magnetic resonance findings in the temporomandibular joints of patients before and after orthognathic surgery. Br J Oral Maxillofac Surg. 1999;37(1):41-5.
Mladenovic I, Dodic S , Stosic S , Petrovic D, Čutovic T , Kozomara R. TMD in Class III patients reffered for orthognatic surgery: psychological and dentition-related aspects. J Cranio-Maxillofac Surg. 2014;42(8):16049.
Kim YK, Kim SG, Kim JH, Yun PY, Oh JS. Temporomandibular joint and psychosocial evaluation of patients after orthognatic surgery: a preliminary study. J Cranio-Maxillofac Surg. 2013;41(5):e83-6.
Farella M, Michelotti A, Bocchino T, Cimino R, Laino A, Steenks MH. Effects of orthognathic surgery for Class II malocclusion on signs and symptoms of temporomandibular disorders and on pressure pain thresholds of the jaw muscles. Int J Oral Maxillofac Surg. 2007;36(7):5837.
Flynn B, Brown DT, Lapp TH, Bussard DA, Roberts WE. A comparative study of temporomandibular symptoms following mandibular advancement by bilateral sagittal split osteotomies: Rigid versus nonrigid fixation. Oral Surg Oral Med Oral Pathol. 1990;70(3):372-80.
Trauner R, Obwegwser HL. The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. Part I. Oral Surg. 1957;10(7):677-89.
Epker BN. Modification in the sagittal osteotomy of the mandible. J Oral Surg. 1977;35:157-9.
Sartoretto SC, Bello YD, Bona AD. [Evidências científicas para o diagnostico e tratamento da DTM e a relação da oclusão e a orthodontia]. RFO 2012;17(3):352-9. Portuguese.
Al-Belasy F, Tosoglu S, Dolwick MF. Mandibular hipomobility after orthognatic surgery: a review article. J Oral Maxillofac Surg. 2013;71(11):1967.e1-1967.e11.
Rodrigues-Garcia RCM, Sakai S, Rugh JD, Hatch JP, Tiner BD, Sickels JE, et al. Effects of major Class II occlusal corrections on temporomandibular signs and symptoms. J Orofac Pain. 1998;12(3):18592.
Abrahamsson C, Henrikson T, Nilner M, Sunzel B, Bondmark L, Eckberg EC. TMD before and after correction of dentofacial deformities by orthodontic and orthognatic treatment. Int J Oral Maxillofac Surg. 2013;42(6):752-8.
Al-Ryiami S, Cunningham S, Moles DR. Orthognatic treatment and temporomandibular disorders: a systematic review. Part 2. Signs and symptoms and meta-analyses. Am J Orthod Dentofacial Orthop. 2009;136(5):626.e1-626.e16.
Silva MMA, Ferreira AT, Migliorucci RR, Nari Filho H, Berretin-Felix G. Influence of orthodontic-surgical treatment on signs and symptoms of temporomandibular dysfunction in subjects with dentofacial deformities. Rev Soc Bras Fonoaudiol. 2011;16(1):80-4.
Togashi M, Kobayashi T, Hasebe D, Funayama A, Mikami T, Saito I, et al. Effects of surgical orthodontic treatment for dentofacial deformities on signs and symptoms of temporomandibular joint. J Oral Maxillofac Surg Med Pathol. 2013;25(1):18-23.
Cascone P, Paolo C, Leonardi R, Pedullà E. Temporomandibular disorders and orthognathic surgery. J Craniofac Surg. 2008;19(3):687-92.
Lindenmeyer A, Eghtessad M, Goulden R, Speculand B, Harrys M. Oral and maxillofacial surgery and chronic painful temporomandibular disorders - a systematic review. J Oral Maxillofac Surg. 2010;68(11):275564.
Nadeshah M, Mehra P. Orthognatic surgery in presence of temporomandibular dysfunction. What happens next? Oral Maxillofac Surg Clin North Am. 2015;27(1):11-26.
Kim YK, Kim SG, Kim JH, Yun PY. Clinical survey of the patients with temporomandibular joint desorders using research diagnostic criteria (axis II) for TMD: preliminary study. J Cranio-Maxillofac Surg. 2012;40(4):366-72.
Guimarães Fo. R, Oliveira Jr. EC, Gomes TRM, Souza TDA. [Quality of life in patients submitted to orthognatic surgery: oral health and selfsteem]. Psicol Cienc Prof. 2014;34(1):242-51. Portuguese.
Silvola A S, Tolvanen M, Rusanen J, Sipila K, Lahti S, Pirttiniemi P. Do changes in oral health-related quality-of-life, facial pain and temporomandibular disorders correlate after treatment of severe malocclusion. Acta Odontol Scand. 2016;74(1):44-50.
Teng TT, Ko EW, Huang CS, Chen YR. The effect of early physiotherapy on the recovery of mandibular function after orthognatic surgery for Class III correction: part I – jaw motion analysis. J Cranio-Maxillofac Surg. 2015;43(1):131-7.
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