Temporomandibular joint symptoms before and after surgical-orthodontic treatment

AIM: To evaluate temporomandibular joint (TMJ) symptoms, the functional and neuromuscular changes after surgical-orthodontic treatment of orofacial deformities with temporomandibular dysfunction (TMD). SUBJECTS AND METHODS: Four hundred and twenty orthognathic patients their skeletal and dental malocclusion type, TMJ symptoms, headache, cervical and neck pain, otovestibular symptoms were evaluated. Electromyography and kinesiography were used to assess the muscular activity and the mandibular movements. RESULTS: TMJ symptoms in low and normal angle mandibular retrognatism patients have improved (p<0,01). CONCLUSION: Combined surgical-orthodontic treatment may be of a great benefit in the correction of discrepancies in occlusion and maxillo-mandibular relationship particularly in patients with TMD. Conversely orthognathic surgery can produce TMJ symptoms by changing the position of the mandible and the maxilla and thus position of the condyle in the glenoid fossa. Mandibular ramus, osteotomies have a direct influence on this position, whilst in maxillary osteotomies the influence is indirect because of autorotation.