Clinical predictive factors for temporomandibular disorders following combined orthodontic and orthognathic surgical treatment in patients with Class III malocclusion (original) (raw)

Effects of orthognathic surgery for class III malocclusion on signs and symptoms of temporomandibular disorders and on pressure pain thresholds of the jaw muscles

International journal of oral and maxillofacial surgery, 2007

The aim of this longitudinal study was to determine the effects of orthognathic surgery on signs and symptoms of temporomandibular disorders (TMD) and on pressure pain thresholds (PPTs) of the jaw muscles. Fourteen consecutive class III patients undergoing pre-surgical orthodontic treatment were treated by combined Le Fort I osteotomy and bilateral sagittal ramus osteotomy. The clinical examination included the assessment of signs and symptoms of TMD and the assessment of PPTs of the masseter and temporalis muscles. Anamnestic, clinical and algometric data were collected during five sessions over a 1-year period. Seven out of 14 patients presented with disc displacement with reduction at baseline, whereas four patients (two of them were new cases) did so at the end of follow up (p>0.05). None of the patients were diagnosed with myofascial pain of the jaw muscles at the beginning or end of follow up. PPTs of the masseter and temporalis muscles did not change significantly from bas...

Malocclusion and the need for orthodontic treatment in patients with temporomandibular dysfunction

PubMed, 2007

Objective: The aim of the study was to investigate the signs and symptoms of temporomandibular disorders (TMD) as well as the relationships between TMD, malocclusion and the need for orthodontic treatment. Material and methods: Forty consecutive patients (36 F, 4 M) with a median age of 35 (IQR 18) years. Eighteen patients had Class I, 22 patients Class II malocclusion. A rating scale for the influence of TMJ pain/discomfort on the activities of daily living (ADL) was used simultaneously with clinical examination. Helkimo's Dysfunction Index (D(i)) and the Index of Orthodontic Treatment Need (IOTN) were determined for each participant. Results: Pain/discomfort in the TMJ area was positively correlated with interferences in laterotrusion (p=0.021), pain on palpation over the posterior aspects of TMJ (p=0.012) and pain in the masticatory muscles (p=0.023). The impact of TMJ pain/discomfort was greatest on the performance of a yawn and on opening the mouth wide. There was no statistically significant correlation between malocclusion, D(i)and IOTN. A comparison of Class I malocclusion patients to those with Class II malocclusion revealed no statistically relevant differences in Di and ADL. Conclusion: In patients with malocclusion, pain from TMJ has a significant negative impact on activities of daily living. No significant differences were observed between Angle Class I and Class II groups of patients with respect to TMD. Orthodontic treatment was required for both groups.

Relationship Between Orthodontics and Temporomandibular Disorders: A Prospective Study

Journal of oral & facial pain and headache, 2016

To investigate the possible relationship between the orthodontic treatment of Class II malocclusion and the development of temporomandibular disorders (TMD). A total of 40 patients was evaluated at four time points: the day before the start of treatment employing bilateral Class II elastics (baseline), as well as at 24 hours, 1 week, and 1 month after the start of treatment. The development of TMD pain complaints in the orofacial region and changes in the range of mouth opening were assessed at these times. Shapiro-Wilk, McNemar, and Friedman tests with 5% significance level were used to analyze the data. The treatment produced pain of a transitory, moderate intensity, but there was no significant change from baseline after 1 month. There were no restrictions in the range of jaw motion or any evidence of limitations in mouth opening. Orthodontic treatment with bilateral Class II elastics does not cause significant orofacial pain or undesirable changes in the range of mouth opening. ...

Evaluation of Temporomandibular Disorders before and after Orthognathic Surgery: Therapeutic Considerations on a Sample of 76 Patients

Journal of International Society of Preventive & Community Dentistry

Temporomandibular disorders may be associated with dental and facial malformations. The aim of this study is to record the prevalence of TMDs in patients scheduled for orthognathic surgery, reporting the development of TMDs and symptoms during the entire period of the treatment, and demonstrating the benefits of a team effort on this population. Assessment of temporomandibular status was performed using the RDC/TMD criteria at T0 (prior to orthodontic therapy), T1 (3 months after the surgery), and T2 post-therapeutic cycle (6 to 12 months postoperatively). A total of 76 participants were included in the study; all the patients underwent surgical treatment: 12 had bilateral sagittal split osteotomy, 6 with condylar position devices; 64 had Le Fort I + bilateral sagittal split osteotomy, and 15 with condylar position devices. Results were evaluated with a paired-sample t-test and segmentation analysis. Forty-seven patients were affected by TMDs. At T0, 25 patients experienced TMJ pain...