Orthognathic treatment and temporomandibular disorders: A systematic review. Part 2. Signs and symptoms and meta-analyses
Received October 2008; received in revised form February 2009; accepted February 2009.
Refers to article:
Editor's Summary and Q&A: Orthognathic treatment and temporomandibular disorders: A systematic review. Part 2. Signs and symptoms and meta-analyses
Salma Al-Riyami, Susan J. Cunningham, David R. Moles
American Journal of Orthodontics & Dentofacial Orthopedics
November 2009 (Vol. 136, Issue 5, Pages 626-627) Abstract |
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Introduction
There have been conflicting viewpoints in the literature regarding the effects of orthognathic treatment on temporomandibular disorders (TMD). A systematic review was conducted to determine the percentage of orthognathic patients with TMD, establish the range of signs and symptoms, and follow patients longitudinally through treatment for any changes in signs and symptoms.
Methods
Part 1 of this 2-part article described the methodology of this review, with a narrative analysis of the study characteristics and the TMD classification methods. Part 2 describes the percentage of patients suffering from TMD and the signs and symptoms reported. Meta-analyses were conducted on data from clinically similar studies.
Results
Pain decreased after surgery for both self-reported symptoms and clinically diagnosed pain on palpation. However, postsurgical results were more varied for joint sounds. The percentage of patients with clicking had a tendency to decrease postsurgery, but improvements in crepitus were questionable. The results from all meta-analyses in this review were subject to considerable statistical heterogeneity, and it was not possible to draw strong inferences relating to the percentage of orthognathic surgery patients with TMD with any degree of certainty.
Conclusions
Although orthognathic surgery should not be advocated solely for treating TMD, patients having orthognathic treatment for correction of their dentofacial deformities and who are also suffering from TMD appear more likely to see improvement in their signs and symptoms than deterioration.
aPostgraduate student, Orthodontic Unit, UCL Eastman Dental Institute, London, United Kingdom
bSenior lecturer/honorary consultant, Orthodontic Unit, UCL Eastman Dental Institute, London, United Kingdom
cFormer lecturer, Health Services Research; professor of Oral Health Services Research, director of Postgraduate Education and Research, Peninsula Dental School, Plymouth, United Kingdom
Reprint requests to: Salma Al-Riyami, Orthodontic Unit, UCL Eastman Dental Institute, 256 Grays Inn Rd, London WC1X 8LD, United Kingdom.
The authors report no commercial, proprietary, or financial interest in the products or companies described in this article.
ABSTRACT