Short‐term changes in temporomandibular joint function in subjects with cleft lip and palate treated with maxillary distraction osteogenesis

Abstract

To investigate the short-term effects of maxillary distraction osteogenesis (DO) on temporomandibular joint (TMJ) function in 21 subjects with cleft lip and palate (CLP). Design - Morphological changes in the maxillofacial region were measured using lateral cephalometric radiographs taken immediately before (pre-DO) and after DO (post-DO) and 1 year after DO (1-year follow-up). A questionnaire was evaluated using a visual analog scale. A chi-square test was used to compare the prevalence of TMJ symptoms between pre-DO and 1-year follow-up. The Spearman correlation coefficient was used to determine the correlation between changes in cephalometric variables and TMJ symptoms in association with maxillary DO. Statistical significance was set at p < 0.05. Results - The ANB (anteroposterior relationship of the maxilla with the mandible) angle and the mandibular plane angle at pre-DO, post-DO, and 1-year follow-up were -4.3 degrees , +5.8 degrees , +4.3 degrees and 32.1 degrees , 33.5 degrees , 33.6 degrees , respectively. The average amounts of anterior and downward movement of the maxilla at post-DO and 1-year follow-up were 8.3, -1.3 and 0.9, 1.1 mm, respectively. The prevalence of TMJ symptoms showed no significant increase in association with maxillary DO. Moreover, there was no significant correlation between changes in cephalometric variables and TMJ symptoms. Conclusion - These results suggest that there was no short-term (i.e., up to 1 year after DO) effect of maxillary DO on TMJ function in subjects with CLP.

Systematic review and meta-analysis: Mandibular plane change after orthognathic surgery and distraction osteogenesis in cleft lip and palate patients

“…Therefore, the interpretation of this part should be taken with cautions. For EDO, all papers in our study showed increased SN-MP at post-treatment [13][14][15]34,35]. Some papers reported a nonsignificant opening of the mandibular plane angle with the mean change around 18 after distraction [13,34,35].…”

“…Twelve papers were finally selected for further quantitative meta-analysis, which could be classified as followed; (1) conventional orthognathic surgery (CO: n = 4) [30][31][32][33], (2) extraoral distraction osteogenesis (EDO: n = 5) [13][14][15]34,35] and (3) intraoral distraction osteogenesis (IDO: n = 3) [17,21,24]. Characteristics of selected studies are presented in Table 1.…”