Ramieri Guglielmo, Piancino Maria Grazia, Frongia Gianluigi, Gerbino Giovanni, Fontana Paolo Antonio, Debernardi Cesare, Bracco Pietro
Department of Maxillofacial Surgery, University of Turin, Dental School, Turin, Italy.
J Craniofac Surg. 2011 Mar;22(2):527-31. doi: 10.1097/SCS.0b013e31820853e8.
The purpose of this prospective study was to evaluate the temporomandibular joint (TMJ) morphology, the disk position, and the TMJ symptoms before and after surgical-orthodontic correction of skeletal class III malocclusion.Eleven adult patients were recruited to participate in this longitudinal study. Each patient received presurgical and postsurgical orthodontic treatment with fixed appliances. Six patients were corrected exclusively through mandibular setback, whereas 5 received combined mandibular setback and maxillary advancement. All patients were investigated before and 2 years after treatment through (1) clinical examination, (2) magnetic resonance imaging, and (3) Computerized axiography (CA).The incidence of clinical signs and symptoms was reduced 2 years after surgical-orthodontic treatment, the condyle-disk relationship and TMJ appearance at magnetic resonance imaging were unchanged, and CA showed a significant improvement of TMJ border movements.Mandibular setback surgery does not appear to alter the condyle-disk relationship, whereas correction of class III malocclusion seems to improve clinical and CA signs of TMJ function. Further controls and more long-term evaluation of these patients are necessary to assess the maintenance of these improvements in time.
这项前瞻性研究的目的是评估骨性III类错牙合畸形手术正畸矫治前后的颞下颌关节（TMJ）形态、盘位置以及TMJ症状。招募了11名成年患者参与这项纵向研究。每位患者均接受了固定矫治器的术前和术后正畸治疗。6名患者仅通过下颌后缩进行矫治，而5名患者接受了下颌后缩与上颌前突联合矫治。所有患者在治疗前及治疗后2年接受了以下检查：（1）临床检查；（2）磁共振成像；（3）计算机轴性断层摄影（CA）。手术正畸治疗2年后临床体征和症状的发生率降低，磁共振成像显示髁突-盘关系及TMJ外观未改变，CA显示TMJ边缘运动有显著改善。下颌后缩手术似乎并未改变髁突-盘关系，而III类错牙合畸形的矫治似乎改善了TMJ功能的临床及CA表现。有必要对这些患者进行进一步的对照及更长期的评估，以评估这些改善的长期维持情况。
