Department of Oral and Maxillo-Facial Surgery at Lille 2 University, France.
Head Face Med. 2010 Nov 17;6:27. doi: 10.1186/1746-160X-6-27.
Relations between maxillo-mandibular deformities and TMJ disorders have been the object of different studies in medical literature and there are various opinions concerning the alteration of TMJ dysfunction after orthognathic surgery. The purpose of the present study was to evaluate TMJ disorders changes before and after orthognathic surgery, and to assess the risk of creating new TMJ symptoms on asymptomatic patients.
A questionnaire was sent to 176 patients operated at the Maxillo-Facial Service of the Lille's 2 Universitary Hospital Center (Chairman Pr Joël Ferri) from 01.01.2006 to 01.01.2008. 57 patients (35 females and 22 males), age range from 16 to 65 years old, filled the questionnaire. The prevalence and the results on pain, sounds, clicking, joint locking, limited mouth opening, and tenseness were evaluated comparing different subgroups of patients.
TMJ symptoms were significantly reduced after treatment for patients with pre-operative symptoms. The overall subjective treatment outcome was: improvement for 80.0% of patients, no change for 16.4% of patients, and an increase of symptoms for 3.6% of them. Thus, most patients were very satisfied with the results. However the appearance of new onset of TMJ symptoms is common. There was no statistical difference in the prevalence of preoperative TMJ symptoms and on postoperative results in class II compared to class III patients.
These observations demonstrate that: there is a high prevalence of TMJ disorders in dysgnathic patients; most of patients with preoperative TMJ signs and symptoms can improve TMJ dysfunction and pain levels can be reduced by orthognathic treatment; a percentage of dysgnathic patients who were preoperatively asymptomatic can develop TMJ disorders after surgery but this risk is low.
上下颌畸形与 TMJ 紊乱之间的关系一直是医学文献中不同研究的对象，对于正颌手术后 TMJ 功能障碍的改变存在各种观点。本研究的目的是评估 TMJ 紊乱在正颌手术后的变化，并评估对无症状患者造成新的 TMJ 症状的风险。
2006 年 1 月至 2008 年 1 月，我们向里尔 2 大学医院中心颌面服务处（主席乔尔·费里教授）接受手术的 176 名患者发送了一份问卷。57 名患者（35 名女性和 22 名男性），年龄在 16 至 65 岁之间，填写了问卷。通过比较不同亚组的患者，评估了疼痛、声音、弹响、关节闭锁、开口受限和紧张度等方面的患病率和结果。
对于术前有症状的患者，TMJ 症状在治疗后明显减轻。总体主观治疗效果为：80.0%的患者改善，16.4%的患者无变化，3.6%的患者症状加重。因此，大多数患者对结果非常满意。然而，新出现 TMJ 症状的情况很常见。在 II 类和 III 类患者中，术前 TMJ 症状的患病率和术后结果之间没有统计学差异。
这些观察结果表明：错颌患者 TMJ 紊乱的患病率较高；大多数术前有 TMJ 体征和症状的患者可以改善 TMJ 功能障碍，正畸治疗可以减轻疼痛水平；一部分术前无症状的错颌患者术后可能会出现 TMJ 疾病，但这种风险较低。
