TMJ response to mandibular advancement surgery: an overview of risk factors
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Data
2014
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Resumo
Objective: In order to understand the conflicting information on temporomandibular joint
(TMJ) pathophysiologic responses after mandibular advancement surgery, an overview
of the literature was proposed with a focus on certain risk factors. Methods: A literature
search was carried out in the Cochrane, PubMed, Scopus and Web of Science databases
in the period from January 1980 through March 2013. Various combinations of keywords
related to TMJ changes [disc displacement, arthralgia, condylar resorption (CR)] and aspects
of surgical intervention (fixation technique, amount of advancement) were used. A hand
search of these papers was also carried out to identify additional articles. Results: A total
of 148 articles were considered for this overview and, although methodological troubles
were common, this review identified relevant findings which the practitioner can take into
consideration during treatment planning: 1- Surgery was unable to influence TMJ with
preexisting displaced disc and crepitus; 2- Clicking and arthralgia were not predictable after
surgery, although there was greater likelihood of improvement rather than deterioration;
3- The amount of mandibular advancement and counterclockwise rotation, and the rigidity
of the fixation technique seemed to influence TMJ position and health; 4- The risk of CR
increased, especially in identified high-risk cases. Conclusions: Young adult females with
mandibular retrognathism and increased mandibular plane angle are susceptible to painful
TMJ, and are subject to less improvement after surgery and prone to CR. Furthermore,
thorough evidenced-based studies are required to understand the response of the TMJ
after mandibular advancement surgery.
Descrição
Palavras-chave
Temporomandibular joint, Bone resorption, Orthognathic surgery, Mandibular advancement
Citação
VALLADARES-NETO, José et al. TMJ response to mandibular advancement surgery: an overview of risk factors. Journal of Applied Oral Science, Bauru, v. 22, n. 1, p. 2, 2014.