Long-term effects of orthognathic surgery on the temporomandibular joint: comparison of rigid and nonrigid fixation methods.

Sixty-six patients were examined between 2 and 9.5 years after bilateral sagittal split mandibular ramus osteotomy. Thirty-two patients had nonrigid fixation consisting of superior border wires and intermaxillary fixation, while 34 patients had rigid plate fixation of the osteotomy sites with immediate function. There were no demonstrable long-term differences between the two groups with respect to mandibular vertical opening, crepitance, and temporomandibular joint pain. Masticatory muscle pain and temporomandibular joint clicking improved with rigid fixation and worsened with nonrigid fixation.