Effects of surgical orthodontic treatment for dentofacial deformities on signs and symptoms of temporomandibular joint
Effects of surgical orthodontic treatment for dentofacial deformities on signs and symptoms of temporomandibular joint
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DOI：
10.1016/j.ajoms.2012.05.014
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发表时间：
2013-01-01
影响因子：
0.4
通讯作者：
Saito, Chikara
中科院分区：
文献类型：
--
作者：
Togashi, Masaki;Kobayashi, Tadaharu;Saito, Chikara
目的：了解口腔颌面畸形患者颞下颌关节(TMJ)体征和症状的发生率，并纵向评价正畸手术治疗后TMJ体征和症状的变化。材料和方法：170例牙颌面畸形患者。采用Le Fort I截骨术加双侧矢状劈开截骨术112例，双侧矢状劈开截骨术58例。结果：29.5%的患者出现TMJ症状和体征，22.1%的患者出现关节盘移位，13.4%的患者出现髁状突骨改变。下颌后缩和不对称患者的TMJ症状、关节盘移位和髁突骨质改变的发生率明显高于下颌前突患者。术后1年，TMJ体征和症状的发生率明显下降至12.1%，不同类型的颌面畸形患者TMJ体征和症状的发生率无显著差异。结论：正畸手术治疗对大多数口腔颌面畸形患者的TMJ体征和症状有较好的改善作用。然而，正颌外科手术后，术前无症状的患者有出现TMJ症状和体征的风险，尽管这种风险很低。(C)2012年亚洲AOMS、ASOMP、JSOP、JSOMS、JSOM和JAMI。爱思唯尔有限公司出版。保留所有权利。
Objectives: The purpose of this study was to determine the incidence of temporomandibular joint (TMJ) signs and symptoms in patients with dentofacial deformities and to assess longitudinally the changes in TMJ signs and symptoms after surgical orthodontic treatment.Materials and methods: The subjects consisted of 170 patients with dentofacial deformities. A combination of Le Fort I osteotomy and bilateral sagittal split osteotomies was used in 112 patients, bilateral sagittal split osteotomies were performed in 58 patients. The joints were examined clinically and by computed tomography.Results: TMJ signs and symptoms were recognized in 29.5% of the patients, and disk displacements and condylar bone changes were recognized in 22.1% and 13.4% of the joints, respectively. More patients with mandibular retrusion and asymmetry had TMJ signs and symptoms, disk displacements and condylar bone changes than those with mandibular prognathism. The incidence of TMJ signs and symptoms had significantly decreased to 12.1% at one year after orthognathic surgery, and there were no significant differences in the incidences of TMJ signs and symptoms among the types of dentofacial deformity.Conclusion: Surgical orthodontic treatment has a beneficial effect on TMJ signs and symptoms in most patients with dentofacial deformities. However, there is a risk of TMJ symptoms and signs developing in preoperative asymptomatic patients after orthognathic surgery though the risk is low. (C) 2012 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI. Published by Elsevier Ltd. All rights reserved.