Pre‐operative parafunctional or dysfunctional oral habits are associated with the temporomandibular disorders after orthognathic surgery: An observational cohort study

Abstract

Background: Temporomandibular disorders (TMDs) are frequent and disabling, and hence, preventing them is an important health issue. Combining orthodontic and surgical treatments for malocclusions has been shown to affect temporomandibular joint (TMJ) health. However, publications regarding the risk factors that predict negative TMJ outcomes after orthognathic surgery are scarce.Objective: Present prospective cohort study was conducted to identify an association between pre-operative dysfunctional/parafunctional oral habits and the presence of TMD symptoms after orthognathic surgery. Method:We included 237 patients undergoing orthodontics and surgical treatment for malocclusions associated with dentofacial deformities within the Department of Oral and Maxillofacial Surgery of the University of Lille. Their parafunctional and dysfunctional oral habits were recorded through clinical examination along with the presence of TMD symptoms before and after the surgery. According to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) classification, the TMD symptoms studied were myalgia, arthralgia, disc displacement with or without reduction. Results: Multivariate analysis revealed significant associations among bruxism (odds ratio [OR] 3.17 [1.066; 9.432]), lingual interposition (OR 4.241 [1.351; 13.313]), as well as primary swallowing (OR 3.54 [1.225; 10.234]) and the presence of postoperative symptoms of myalgia. Moreover, a significant association was observed between the presence of any dysfunctional oral habit and postoperative disc displacement with reduction (OR 4.611 [1.249; 17.021]). Conclusion: Bruxism and dysfunctional oral habits were shown to be risk factors for the presence of TMD symptoms also after combined orthodontic and surgical treatment. Treating such habits before orthognathic surgery should help prevent TMD. K E Y W O R D S malocclusion, oral health, orthognathic surgery, sleep bruxism, temporomandibular joint disorders

Asemptomatik temporomandibular düzensizliklerin klinikte Fonseca anamnestik indeksi ile araştırılması

“…22 Parafunctional habits, such as bruxism, cause biomechanical changes in structures at the joint surface due to overload. 23,24 This harmful habit was found at its lowest rate in the non-TMD group (4%), whereas this rate was at its highest in the severe TMD group (85.7%). Bruxism, which was divided into two separate classifications (sleep and awake) in 2018, can be considered a movement disorder or sleep disorder and is also observable in healthy individuals.…”

Evaluating the Effectiveness of Orthognathic Surgery on the Pre-existing Temporomandibular Disorders in Patients with Malocclusion: A Systematic Review and Meta-analysis

“…However, this has been exceptionally conceivable: before surgical operations, the patients have been disappointed with their appearances and had lower self-esteem, which induced TMD. Therefore, enhancement in the cosmetic appearances following the surgical operation and the consequent impact on the patients, in general confidence and psychological images, could diminish depression and stress that made a difference in the control of a number of the subjective aspects of TMD [12,33].…”

Matrix Metalloproteinases and Temporomandibular Joint Disorder: A Review of the Literature

“…Further limitations and complications of arthroscopy, arthrocentesis, and orthognathic surgery used for treatment of TMD include arteriovenous fistula, pseudoaneurysm, infection, broken instruments in the joint, and condylar resorption [30,31]. Additionally, bruxism and dysfunctional oral habits have been shown to be risk factors for recurrent TMD symptoms after orthognathic surgery [32]. Due to limitations and complications of surgery, it is necessary to develop more efficacious techniques in non-invasive and pharmaceutical therapies for treating TMD.…”