Can clinical factors predict postoperative temporomandibular disorders in orthognathic patients? A retrospective study of 219 patients

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology Vol. 119; no. 5; pp. 531 - 538
• Main Authors: Scolozzi, Paolo, MD, DMD, Wandeler, Pierre-Antoine, MD, DMD, Courvoisier, Delphine S., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2015
• Subjects: Adolescent; Adult; Dentistry; Female; Humans; Male; Maxillofacial Abnormalities - surgery; Middle Aged; Orthodontics; Orthognathic Surgical Procedures; Pain Measurement; Postoperative Complications; Predictive Value of Tests; Retrospective Studies; Severity of Illness Index; Surgery; Surveys and Questionnaires; Temporomandibular Joint Disorders - etiology
• ISSN: 2212-4403; 2212-4411
• DOI: 10.1016/j.oooo.2015.01.006

Objective To determine the predictive value of preoperative clinical factors for postoperative temporomandibular disorders (TMDs) in patients receiving combined surgical–orthodontic treatment. Study Design TMDs were classified according to Research Diagnostic Criteria for TMD in 219 patients. The severity of the TMD was scored according to the Helkimo anamnestic index (Ai) and clinical dysfunction index (Di). Results Anamnestic TMJ clicking was the only significant predictor of TMD (odds ratio [OR] = 3.61, P  = .006). The mean difference between clinical dysfunction index points was significant for pain on masticatory muscle palpation. Conclusion This study demonstrated that in orthognathic patients, the following factors had high predictive value: (1) anamnestic TMJ clicking for TMD, (2) TMJ clicking, TMJ pain on palpation and bimaxillary surgery for Ai worsening, (3) maxillary retrusion and mandibular excess for Ai improvement, and (4) pain on masticatory muscle palpation for Di worsening.