Assessment of Temporomandibular Joint Disorders Following Orthognathic Surgery: A Literature Review
The objective of this review is to assess the TMJ disorders following Orthognathic surgery, TMJ disorders are multifactorial and have symptoms such as limitation in range of motion of mandible, pain on mastication relating to masticatory muscles and TMJ, joint sounds such as clicking & crepitus, myofascial pain and limitations in other functions. A review was conducted and searched three major databases to locate all pertinent articles published from 2000 to March 2020. All subjects in the various studies were stratified based on sub diagnoses of TMDs. The predictor variables were those patients with pre-existing TMDs that underwent orthognathic surgery in various subgroups. The outcome variables were maximal mouth opening (MMO) and signs and symptoms of a TMD before and after orthognathic surgery based on the type of osteotomy. The patients with Dentofacial deformity undergoing Orthognathic surgery have its impact on TMJ, muscles of mastication and surrounding tissues and the associated TMJ symptoms directly. Therefore, pre-existing symptoms of TMJ should be considered before planning treatment and orthognathic surgery. There was a significant difference in patients with prognathism after isolated BSSO or intraoral vertical ramus osteotomy (IVRO) and for combined BSSO and Le Fort I, but no significant difference after BSSO or bimaxillary surgery (IVRO and Le Fort I. Orthognathic surgery caused a decrease in TMD symptoms for many patients who had symptoms presurgery but created symptoms in a smaller group of patients who were asymptomatic presurgery. The presence of presurgery TMD symptoms or the type of jaw deformity did not identify which patients would improve, remain the same, or worsen after surgery.