Orofacial deformities and craniomandibular disorders : combined surgical-orthodontic approach

AIM: To evaluate functional and neuromuscular changes after surgical-orthodontic treatment of orofacial skeletal discrepancies with concomitant craniomandibular disorders. SUBJECTS AND METHOD: Forty-two dysgnathic patients 27 females, 15 males aged 21 to 34 years, who had undergone to bimaxillary (31 subjects) or monomaxillary (11 subjects) surgery. The following aspects were evaluated: skeletal and dental malocclusion type, temporomandibular joint pain, headache, cervical pain, otovestibular symptoms and, by electromyography and kinesiography, muscular activity and mandibular movements. The different parameters collected before and after treatment, and follow up at of 6 months and 1, 2 and 3 years were compared. RESULTS: All craniomandibular symptoms were significantly reduced post-operatively, above all muscular spasms (98%) and headache (60%) and mandibular kinesiology (82%) was improved. Cervical pain, otovestibular and postural symptoms also appeared to benefit from treatment. CONCLUSION: Combined surgical-orthodontic treatment may be of benefit in the correction of severe orofacial deformities associated with temporomandibular disorders and improve the quality of life.