Outcomes of treatment with genioplasty and temporomandibular joint anchorage surgery in temporomandibular joint internal derangement with mandibular deviation/retraction

doi:10.3877/cma.j.issn.1674-1366.2021.04.006

Abstract

Abstract:

Objective

Anterior Disc Displacement without Reduction (ADDwoR) in adolescence can result in condylar resorption which produces mandibular retrusion/deviation (MR/D) in adulthood. This study aims to analyze the therapeutic effect of simultaneous genioplasty and temporomandibular joint (TMJ) anchorage surgery on ADDwoR with MR/D patients.

Methods

During 2016-2019, 35 ADDwoR with MR/D cases were included and underwent TMJ anchorage surgery and genioplasty guided by digital design. Pre-/post-surgical clinical manifestations, facial photography, radiographic data, facial shape satisfaction of clinicians/patients/third-party were recorded and analyzed.

Results

A total of 35 cases (55 joints) were included, in which 20 cases were bilateral and 15 cases were unilateral. The average age was 24.08, ranged from 18 to 33 years old. Ratio of male/female was 4/31. (1) Visual analog pain scale (VAS) score pre-/post-surgical ranged from 2 to 9 and 0 to 3, with an average of (5.7 ± 3.3) and (1.2 ± 1.8) (t = 3.482, P<0.001) . Maximal mouth opening pre-/post-surgical ranged from 16 to 33 mm and 33 to 40 mm, with an average of (25.1 ± 7.8) mm and (36.4 ± 3.5) mm (t = -3.14, P = 0.002) . Before operation, 34 patients had a history of joint sound, accounting for 97.14%. After operation, one patient still had joint sound, accounting for 2.86%. MRI was completed and showed stable disc reduction without recurrence one year postoperatively. Among them, 14 patients (40.00%) showed double contour of new bone on condylar surface. (2) MR/D was corrected and a better face shape was obtained. The satisfaction rate of clinicians, patients and third-parties was 92.23%, 93.94% and 93.94%, with an average of 93.37%.

Conclusions

For ADDwoR with MR/D patients, simultaneous TMJ anchorage surgery and genioplasty can improve TMJ symptoms/functions, correct facial appearance, and enhance the degree of satisfaction. The postoperative effect is stable, safe and reliable, which is worthy of clinical promotion.

Key words: Temporomandibular joint disorders, Genioplasty, Retrognathia, Mandibular deviation, Disc displacement without reduction

Leemui Lee, Yaomin Zhu, Wei Yao, Xiao Liang, Yumeng Wang. Outcomes of treatment with genioplasty and temporomandibular joint anchorage surgery in temporomandibular joint internal derangement with mandibular deviation/retraction[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2021, 15(04): 228-233.

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References 30

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