Department of Prosthodontics, Faculty of Medicine, University of East Sarajevo, Bosnia Herzegovina.
Acta Odontol Scand. 2013 Jan;71(1):57-64. doi: 10.3109/00016357.2011.654239. Epub 2012 Feb 9.
To examine the prevalence of temporomandibular disorders (TMD) after orthodontic-surgical treatment in patients with mandibular prognathism and analyze psychosocial variables related to TMD.
The case-control study comprised 40 patients with mandibular prognathism who underwent combined orthodontic-surgical treatment (orthognathic surgery group). Forty-two patients with untreated mandibular prognathism served as a control group. Research diagnostic criteria for temporomandibular disorders was used in order to assess the clinical diagnosis of TMD (Axis I) and to estimate depression, somatization and patient's disability related to chronic pain (Axis II).
The overall prevalence of TMD was not significantly different between the groups. Myofascial pain was significantly higher, while arthralgia, arthritis and arthrosis was significantly lower in the orthognathic group compared with the controls (90.5% vs 50.0%, 0.0% vs 27.8%, respectively) (p < 0.05). Females in orthognathic surgery group showed higher prevalence of TMD (p < 0.05) and myofascial pain (p < 0.01) and increased level of chronic pain (p < 0.05) in comparison with post-operative males. No significant difference in chronic pain, somatization and depression scores was found between investigated groups. With respect to presence of TMD within the groups depression was higher in untreated subjects with dysfunction (p < 0.05).
Prevalence of TMD immediately after completion of orthodontic-surgical treatment for mandibular prognathism is similar to frequency of dysfunction in untreated subjects, is significantly higher in females and is most commonly myogenic. Furthermore, females show an increased level of chronic pain post-operatively. Somatization and depression levels do not differ between patients with corrected prognathism and untreated prognathic patients.
研究下颌前突患者接受正颌手术后颞下颌关节紊乱病（TMD）的患病率，并分析与 TMD 相关的心理社会变量。
本病例对照研究纳入 40 例接受正颌手术联合正畸治疗的下颌前突患者（正颌手术组），42 例未经治疗的下颌前突患者作为对照组。采用研究诊断标准评估 TMD 的临床诊断（轴 I），并评估与慢性疼痛相关的抑郁、躯体化和患者残疾（轴 II）。
两组 TMD 的总体患病率无显著差异。与对照组相比，正颌组的肌筋膜痛明显更高，而关节痛、关节炎和关节病明显更低（90.5% vs 50.0%，0.0% vs 27.8%，分别）（p<0.05）。正颌手术组女性 TMD（p<0.05）和肌筋膜痛（p<0.01）的患病率以及慢性疼痛的严重程度（p<0.05）均高于术后男性。各组之间慢性疼痛、躯体化和抑郁评分无显著差异。在各组中，存在 TMD 的患者中，功能障碍未治疗的患者抑郁程度更高（p<0.05）。
下颌前突患者接受正颌手术后即刻 TMD 的患病率与未经治疗的功能障碍患者相似，女性患病率更高，最常见的是肌源性。此外，女性术后慢性疼痛水平增加。矫正后下颌前突患者和未治疗的下颌前突患者的躯体化和抑郁水平无差异。
