Temporomandibular joint considerations in orthognathic surgery.

The relationship between the temporomandibular joint and developmental jaw deformities is both undeniable as well as controversial as to its magnitude or importance. This article addresses the importance of a complete temporomandibular joint and orthognathic diagnostic work-up prior to the choice of either temporomandibular joint or orthognathic surgery. The surgical procedure is determined by the internal derangement that is present as well as its response to non-surgical care. The intraoperative techniques for handling the bony fragments, seating the condyle and rigid fixation techniques are also of utmost importance and are discussed for each of the orthognathic procedures. The postoperative physiotherapy is also discussed both for the temporomandibular joint patient as well as the orthognathic patient.