Song Ming-Yang, Lv Xin, Zhang Zheng, Wang Yu-Xin, Xia Cheng-Wan, Yang Xu-Dong
Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing, China.
Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing, China.
J Stomatol Oral Maxillofac Surg. 2025 Sep;126(4S):102215. doi: 10.1016/j.jormas.2025.102215. Epub 2025 Jan 3.
To analyze dynamic and static changes in the disc-condyle relationship in patients with skeletal Class III malocclusion after orthognathic surgery.
The surgical group comprised 30 patients with skeletal Class III malocclusion, and the magnetic resonance imaging and mandibular movement data were obtained at T0 (preoperatively), T1 (3 months postoperatively), and T2 (at the end of orthodontic treatment). The control group included 20 patients with normal occlusion, and the mandibular movement data were recorded.
The maximum mouth opening at T1 decreased compared with that at T0 and recovered close to the preoperative level at T2. The marginal movement of the mandible at T1 decreased compared with that at T0 (P > 0.05), among which the movement distances of the condyles during mouth opening and closing decreased significantly compared with those at T0(P < 0.05). Following postoperative orthodontics in patients with skeletal Class III malocclusion, RET-L was significantly lower than that in the control group(P < 0.05).Regarding the temporomandibular joint of ADDwR, the CPL at T1 decreased significantly compared with that at T0(P < 0.05). At T2, the LPM, LLM, and CPL increased significantly compared with those at T1(P < 0.05), and the LPM and LLM levels at T2 exceeded those at T0 significantly (P < 0.05).
In the short term, after orthognathic surgery, the marginal movement of the mandible showed a certain degree of decline; however, in the long term, it recovered or even exceeded the preoperative level. Orthognathic surgery results in a particularly significant improvement in the functional movement of the ADDwR joint. In addition, it improves TMD in patients with skeletal Class III malocclusion and has a positive effect on improving the position of the joint disc position.
分析正颌外科手术后骨性III类错牙合患者盘髁关系的动态和静态变化。
手术组包括30例骨性III类错牙合患者，在T0（术前）、T1（术后3个月）和T2（正畸治疗结束时）获取磁共振成像和下颌运动数据。对照组包括20例正常牙合患者，记录下颌运动数据。
与T0相比，T1时最大开口度减小，T2时恢复至接近术前水平。T1时下颌边缘运动较T0时减小（P>0.05），其中髁突在开闭口时的运动距离较T0时显著减小（P<0.05）。骨性III类错牙合患者术后正畸治疗后，RET-L显著低于对照组（P<0.05）。对于ADDwR的颞下颌关节，T1时CPL较T0时显著降低（P<0.05）。T2时，LPM、LLM和CPL较T1时显著增加（P<0.05），且T2时LPM和LLM水平显著超过T0时（P<0.05）。
短期内，正颌外科手术后下颌边缘运动有一定程度下降；然而，长期来看，其恢复甚至超过术前水平。正颌外科手术使ADDwR关节的功能运动有特别显著的改善。此外，它改善了骨性III类错牙合患者的颞下颌关节紊乱病，对改善关节盘位置有积极作用。
