Sebastiani Aline Monise, Baratto-Filho Flares, Bonotto Daniel, Kluppel Leandro Eduardo, Rebellato Nelson Luis Barbosa, da Costa Delson João, Scariot Rafaela
Student of graduate program in dentistry at Federal Univesity of Parana, Curitiba, PR, Brazil.
Professor of the graduate program in dentistry, Positivo University, Curitiba/PR, Brazil.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Feb;121(2):119-25. doi: 10.1016/j.oooo.2015.08.012. Epub 2015 Aug 22.
To evaluate the influence of orthognathic surgery on the clinical signs and symptoms of temporomandibular disorders (TMDs).
In a cohort study, 54 patients undergoing orthognathic surgery were evaluated with regard to the signs and symptoms of TMDs through subjective and objective assessments. These evaluations were performed 1 week preoperatively (T1), 1 month postoperatively (T2), and 6 months postoperatively (T3). The evaluations included patient variables and surgery. Univariate analyzes were performed to verify the association of the variables (P < .05).
The incidence of TMD 6 months after orthognathic surgery was significantly lower (P < .001). TMD intensity decreases significantly in the postoperative period. Females had a higher prevalence of TMD (P = .003) and muscular disorders preoperatively (P = .001). There was a decrease in clicks between T1 and T3 (P = .013). Mouth opening without pain worsened from T1 to T2 (P < .001) and improved from T1 to T3 (P = .015) and T2 to T3 (P < .001). The results were similar for mouth opening with pain (P < .001). In patients undergoing jaw fixation with bicortical screws, mouth opening without pain was significantly less in T3 patients than in patients undergoing fixation with plate and monocortical screws (P = .048).
Orthognathic surgery reduces the clinical signs and symptoms of TMD.
评估正颌手术对颞下颌关节紊乱病（TMD）临床体征和症状的影响。
在一项队列研究中，通过主观和客观评估，对54例接受正颌手术的患者的TMD体征和症状进行了评估。这些评估在术前1周（T1）、术后1个月（T2）和术后6个月（T3）进行。评估包括患者变量和手术情况。进行单因素分析以验证变量之间的关联（P <.05）。
正颌手术后6个月TMD的发生率显著降低（P <.001）。术后TMD强度显著降低。女性术前TMD患病率较高（P =.003），肌肉疾病患病率较高（P =.001）。T1至T3期间弹响减少（P =.013）。无痛开口从T1到T2恶化（P <.001），从T1到T3改善（P =.015），从T2到T3也改善（P <.001）。有痛开口的结果相似（P <.001）。在接受双皮质螺钉颌骨固定的患者中，T3患者的无痛开口明显少于接受钢板和单皮质螺钉固定的患者（P =.048）。
正颌手术可减轻TMD的临床体征和症状。
