Mandibular orthognathic surgery does not alter temporomandibular joint symptoms – A single centre prospective study

Abstract

Aim: Mandibular orthognathic surgery has been considered a risk factor for developing temporomandibular dysfunction (TMD). A prospective follow-up study was initiated to examine the correlation between two surgical techniques for mandibular advancement and setback on mandibular range of movement and temporomandibular joint symptoms. Materials and methods: Thirty-four patients who underwent mandibular orthognathic surgery were included. Twenty patients were operated with the intraoral vertical ramus osteotomy (IVRO) technique and subsequent rigid maxillomandibular fixation (MMF) for 6 weeks; 14 were operated with the bilateral sagittal split osteotomy (BSSO) with internal osteosynthesis. The patients completed a questionnaire regarding subjective symptoms and were examined 1 day before, and 1 year after surgery. Evaluations of tenderness upon muscular and articular palpation, assessment of mandibular mobility and calculation of the Helkimo index were performed. Results: Mean maximum mouth opening was reduced one year after surgery for both experimental groups. The BSSO-group also experienced reduced laterotrusive and protrusive movements. No statistically significant differences within or between the groups were found for the Helkimo clinical dysfunction score. Both groups reported no differences in TMD-related symptoms before and after surgery, and no differences were found between the groups. Conclusions: Maximum mandibular movement was slightly reduced for both surgical techniques. Assisted mouth opening, laterotrusive and protrusive mandibular movements were reduced after BSSO, and maximum mouth opening was reduced after IVRO. However, the differences were small and both groups were well within the normal range. None of the groups experienced changes in TMD-related symptoms.