TY - JOUR
T1 - Effects of surgical mandibular advancement and rotation on signs and symptoms of temporomandibular disorder
T2 - A 2-year follow-up study
AU - Frey, Daniela Rezende
AU - Hatch, John P.
AU - Van Sickels, Joseph E.
AU - Dolce, Calogero
AU - Rugh, John D.
N1 - Funding Information:
Supported by NIH grant DE09630.
PY - 2008/4
Y1 - 2008/4
N2 - Introduction: The possible effects of orthognathic surgery on signs and symptoms of temporomandibular disorder (TMD) are still controversial. We prospectively investigated the association between the amount of advancement and rotation of the mandible during bilateral sagittal split osteotomy (BSSO) and the development of TMD signs and symptoms. Methods: Class II patients (n = 127) received mandibular advancement with BSSO. We used factorial analysis of covariance to assess whether the magnitude (< or ≥7 mm) and the direction (clockwise or counterclockwise) of the movement were associated with the onset or worsening of TMD signs and symptoms during 2 years of follow-up. Results: Counterclockwise rotation of the mandible was associated with more muscle tenderness, especially in patients receiving long advancements. The combination of long advancement with counterclockwise rotation was also associated with increased joint symptoms. All symptoms declined over the 2-year follow-up period. Conclusions: Counterclockwise rotation of the mandible is related to a slight increase in muscle symptoms after BSSO. The combination of counterclockwise rotation with long advancement also might increase joint signs and symptoms. All symptomatology tended to decline over time, suggesting that the amount of advancement and mandibular rotation should not be considered as risk factors for the development of TMD in patients without preexisting conditions.
AB - Introduction: The possible effects of orthognathic surgery on signs and symptoms of temporomandibular disorder (TMD) are still controversial. We prospectively investigated the association between the amount of advancement and rotation of the mandible during bilateral sagittal split osteotomy (BSSO) and the development of TMD signs and symptoms. Methods: Class II patients (n = 127) received mandibular advancement with BSSO. We used factorial analysis of covariance to assess whether the magnitude (< or ≥7 mm) and the direction (clockwise or counterclockwise) of the movement were associated with the onset or worsening of TMD signs and symptoms during 2 years of follow-up. Results: Counterclockwise rotation of the mandible was associated with more muscle tenderness, especially in patients receiving long advancements. The combination of long advancement with counterclockwise rotation was also associated with increased joint symptoms. All symptoms declined over the 2-year follow-up period. Conclusions: Counterclockwise rotation of the mandible is related to a slight increase in muscle symptoms after BSSO. The combination of counterclockwise rotation with long advancement also might increase joint signs and symptoms. All symptomatology tended to decline over time, suggesting that the amount of advancement and mandibular rotation should not be considered as risk factors for the development of TMD in patients without preexisting conditions.
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U2 - 10.1016/j.ajodo.2007.10.033
DO - 10.1016/j.ajodo.2007.10.033
M3 - Article
C2 - 18405810
AN - SCOPUS:41649110027
SN - 0889-5406
VL - 133
SP - 490.e1-490.e8
JO - American Journal of Orthodontics and Dentofacial Orthopedics
JF - American Journal of Orthodontics and Dentofacial Orthopedics
IS - 4
ER -