Journal of stomatology, oral and maxillofacial surgery · 2020
TMJ related short-term outcomes comparing two different osteosynthesis techniques for bilateral sagittal split osteotomy.
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Roland-Billecart T, Raoul G, Kyheng M, Sciote J J, Ferri J, Nicot R
Аннотация
OBJECTIVES: Bilateral sagittal split osteotomy (BSSO) is a morpho-functional surgery and post-surgical osteosynthesis may influence temporomandibular joint (TMJ) health. Our objective was to evaluate temporomandibular disorders (TMD) and TMJ symptoms after orthognathic surgery according to the type of osteosynthesis used in a population of patients with dentofacial deformities.
MATERIALS AND METHODS: One hundred and eighty-three consecutive patients undergoing orthodontic and maxillofacial surgery treatment for correction of their malocclusion were recruited for a two-year period at Lille University Hospital. All patients had at least a mandibular BSSO using Epker's technique. Each patient was examined before and one year after orthognathic surgery. We compared osteosynthesis by miniplates fixed with monocortical screws (n=42) and the hybrid fixation with bicortical retro-molar screws used with miniplates (n=141). TMJ health was assessed by monitoring TMD signs and symptoms according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and scores obtained from the "Jaw Pain Function" questionnaire.
RESULTS: There was no significant difference in pre-operative and one year post-operative RDC/TMD assessments (p≥0.91) or JPF score (p≥0.29) between the two types of osteosynthesis.
CONCLUSION: There was no difference in TMJ health between the two techniques of osteosynthesis after BSSO.
CLINICAL RELEVANCE: In our experience the hybrid technique fixation affords many advantages and does not influence postoperative TMD compared with osteosynthesis by miniplates.
MATERIALS AND METHODS: One hundred and eighty-three consecutive patients undergoing orthodontic and maxillofacial surgery treatment for correction of their malocclusion were recruited for a two-year period at Lille University Hospital. All patients had at least a mandibular BSSO using Epker's technique. Each patient was examined before and one year after orthognathic surgery. We compared osteosynthesis by miniplates fixed with monocortical screws (n=42) and the hybrid fixation with bicortical retro-molar screws used with miniplates (n=141). TMJ health was assessed by monitoring TMD signs and symptoms according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and scores obtained from the "Jaw Pain Function" questionnaire.
RESULTS: There was no significant difference in pre-operative and one year post-operative RDC/TMD assessments (p≥0.91) or JPF score (p≥0.29) between the two types of osteosynthesis.
CONCLUSION: There was no difference in TMJ health between the two techniques of osteosynthesis after BSSO.
CLINICAL RELEVANCE: In our experience the hybrid technique fixation affords many advantages and does not influence postoperative TMD compared with osteosynthesis by miniplates.