Takahara Namiaki, Kabasawa Yuji, Sato Masaru, Tetsumura Akemi, Kurabayashi Tohru, Omura Ken
a Department of Oral and Maxillofacial Surgery , Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo , Japan.
b Department of Dentistry and Oral Surgery , Tsuchiura Kyodo General Hospital , Ibaraki , Japan.
Cranio. 2017 Jan;35(1):38-45. doi: 10.1080/08869634.2016.1143167. Epub 2016 Mar 24.
This study examined the changes in temporomandibular joint dysfunction (TMD) symptoms and investigated the variations in the disc position, disc and condylar morphology following sagittal split ramus osteotomy (SSRO) with rigid fixation in patients with mandibular prognathism. Furthermore, the authors examined the correlation between mandibular setback and TMD symptoms.
The study included 24 Japanese patients with jaw deformities who were treated using bilateral SSRO and Le Fort I osteotomy. The clinical and magnetic resonance imaging findings in the temporomandibular joint were evaluated preoperatively and at three and six months postoperatively.
The preoperative TMD symptoms were significantly associated with the prevalence of TMD symptoms at six months postoperatively. Anterior disc displacement improved in four joints with slight displacement and with no morphological change. There were no postoperative changes in condylar morphology. There was no significant correlation between mandibular setback and the postoperative TMD symptoms.
Postoperative TMD symptoms may be influenced mainly by preoperative TMD symptoms rather than mandibular setback using SSRO with rigid fixation. Therefore, patients with TMD symptoms require physical examination and MRI for appropriate diagnosis preoperatively.
本研究探讨下颌前突患者行下颌升支矢状劈开截骨术（SSRO）并坚固内固定后颞下颌关节紊乱（TMD）症状的变化，并研究关节盘位置、关节盘和髁突形态的改变。此外，作者还研究了下颌后缩与TMD症状之间的相关性。
本研究纳入24例接受双侧SSRO和Le Fort I截骨术治疗的日本颌骨畸形患者。术前及术后3个月和6个月评估颞下颌关节的临床和磁共振成像结果。
术前TMD症状与术后6个月TMD症状的发生率显著相关。4个关节的关节盘轻度移位且无形态改变，其前移位得到改善。髁突形态术后无变化。下颌后缩与术后TMD症状之间无显著相关性。
使用坚固内固定的SSRO术后TMD症状可能主要受术前TMD症状影响，而非下颌后缩。因此，有TMD症状的患者术前需要进行体格检查和MRI以进行适当诊断。
