Vanessa A Castro1, Rafael M A Pereira2, Gustavo M Mascarenhas3, Antonio I T Neto4, Daniel E Perez5, Daniel Rodrigues6, Célio J Prado7, Darceny Zanetta-Barbosa7. 1. Postgraduate PhD student, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil; Private Practitioner, Salvador, BA, Brazil. 2. Assistant Professor, School of Dentistry, University Center of Patos de Minas, Patos de Minas, Minas Gerais, Brazil. Electronic address: rafaelmap@unipam.edu.br. 3. Private Practitioner, Salvador, BA, Brazil; Postgraduate PhD student, School of Dentistry, São Leopoldo Mandic, Campinas, SP, Brazil. 4. Private Practitioner, Salvador, BA, Brazil. 5. Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Texas, San Antonio, TX, USA. 6. Private Practitioner, Salvador, BA, Brazil; Assistant Professor, Residency of Oral and Maxillofacial Surgery, Federal University of Bahia, Salvador, BA, Brazil. 7. Adjunct Professor, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil.
Abstract
OBJECTIVE: The aim of this study was to compare the outcomes of 2 surgical treatment options: one for correction of class II malocclusion skeletal deformity and one for pre-existing temporomandibular joint (TMJ) disorders requiring orthognathic surgery (OS) for correction of dentofacial deformity. STUDY DESIGN: This retrospective study evaluated patients who underwent OS with maxillomandibular advancement (MMA) with or without concomitant TMJ surgery for articular disk repositioning (ADR). Patients were divided into 2 groups: group I (MMA) was treated with OS only (18 patients); and group II (MMA-ADR) was treated with OS and concomitant ADR (19 patients). The sample consisted of 74 TMJs (mean patient age 29.86 years). RESULTS: In group I, 38.5% of the disks that were originally in normal position became displaced after OS, and 33.3% of displaced disks with reduction became nonreducing after OS. In group II, 78.9% of disks exhibited normal position in the final evaluation, and 97.3% of patients showed improved disk position after surgery. There was significant symptom improvement in all patients in group II, but no significant improvement in group I. CONCLUSIONS: OS with ADR appears to produce stable and beneficial results in improving symptoms in patients with displaced disk and TMJ pain.
OBJECTIVE: The aim of this study was to compare the outcomes of 2 surgical treatment options: one for correction of class II malocclusion skeletal deformity and one for pre-existing temporomandibular joint (TMJ) disorders requiring orthognathic surgery (OS) for correction of dentofacial deformity. STUDY DESIGN: This retrospective study evaluated patients who underwent OS with maxillomandibular advancement (MMA) with or without concomitant TMJ surgery for articular disk repositioning (ADR). Patients were divided into 2 groups: group I (MMA) was treated with OS only (18 patients); and group II (MMA-ADR) was treated with OS and concomitant ADR (19 patients). The sample consisted of 74 TMJs (mean patient age 29.86 years). RESULTS: In group I, 38.5% of the disks that were originally in normal position became displaced after OS, and 33.3% of displaced disks with reduction became nonreducing after OS. In group II, 78.9% of disks exhibited normal position in the final evaluation, and 97.3% of patients showed improved disk position after surgery. There was significant symptom improvement in all patients in group II, but no significant improvement in group I. CONCLUSIONS: OS with ADR appears to produce stable and beneficial results in improving symptoms in patients with displaced disk and TMJ pain.