抄録
The symptoms of temporomandibular joint disorder (TMD) in 33 patients indicative for surgical orthodontic treatment (8 males and 25 females, mean age of 22.5 years) were evaluated before treatment, during presurgical orthodontic and after treatment respectively through the questionnaires and the study casts. The patients were divided into 18 mandibular prognathism, 4 mandibular retrusion, 15 asymmetry, and 4 open bite cases.
1. There was a significant difference in incidence of TMD symptoms between before (81.8%) and after (48.5%) treatment in all the patients.
2. Incidence of TMD disorders decreased from 86.7% to 60.0% in asymmetry, from 72.2% to 27.8%(p<0.05) in mandibular prognathism and from 50% to 25% in open bite from before to after treatment, while in mandibular retrusion it remained 75% before and after treatment.
3. The incidence of joint noise was 100% in mandibular retrusion and 46.7% in asymmetry before and after treatment, while it decreased from 44.4% to 22.2%(p<0.05) in mandibular prognathism and from 25% to 0% in open bite. Joint noise showed various changes during presurgical orthodontics in each malocclusion.
4. The incidence of difficulty in mouth opening remained 50% in mandibular retrusion before and after treatment, while it decreased from 26.7% to 6.7% in asymmetry and from 16.7% to 5.6% in mandibular prognathism from before to after treatment. The open bite patients did not show difficulty in mouth opening both before and after treatment. Incidence of difficulty of opening tended to decrease in asymmetry and mandibular prognathism during presurgical orthodontics, while it worsened in mandibular retrusion.
5. Mean value of VAS (Visual analog scale) in mandibular retrusion, which was used as an indicator for pain of temporomandibular joint, decreased from 60.0±42.4 to 40.4±14.1 from before treatment to presurgical prthodontics, however, it increased and showed 65.0±21.2 after treatment. Although VAS in asymmetry and mandibular prognathism showed 27.5±23.3 and 30.0±22.9 before treatment, and 27.0±17.9 and 27.5±19.4 presurgical orthodontics respectively, it decreased to 6.7±2.9 and 5.0 after treatment respectively. Open bite did not show pain of TMJ before and after treatment.
These results suggested that symptoms of TMD in asymmetry and mandibular prognathism tend to be improved by surgical orthodontic treatment, but there were some cases of mandibular retrusion that did not improve.
