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Abstract: Objectives: The purpose of this study was to determine the incidence of temporomandibular joint (TMJ) signs and symptoms in patients with dentofacial deformities and to assess longitudinally the changes in TMJ signs and symptoms after surgical orthodontic treatment. Materials and methods: The subjects consisted of 170 patients with dentofacial deformities. A combination of Le Fort I osteotomy and bilateral sagittal split osteotomies was used in 112 patients, bilateral sagittal split osteotomies were performed in 58 patients. The joints were examined clinically and by computed tomography. Results: TMJ signs and symptoms were recognized in 29.5% of the patients, and disk displacements and condylar bone changes were recognized in 22.1% and 13.4% of the joints, respectively. More patients with mandibular retrusion and asymmetry had TMJ signs and symptoms, disk displacements and condylar bone changes than those with mandibular prognathism. The incidence of TMJ signs and symptoms had significantly decreased to 12.1% at one year after orthognathic surgery, and there were no significant differences in the incidences of TMJ signs and symptoms among the types of dentofacial deformity. Conclusion: Surgical orthodontic treatment has a beneficial effect on TMJ signs and symptoms in most patients with dentofacial deformities. However, there is a risk of TMJ symptoms and signs developing in preoperative asymptomatic patients after orthognathic surgery though the risk is low. [Copyright &y& Elsevier]

Abstract: When it is difficult to treat impacted teeth with orthodontic traction, surgical techniques including intentional luxation, autografts and distraction osteogenesis may be performed. However, these techniques are associated with problems such as root resorption, gingival recession and pulp circulatory disorders after extrusion. Single tooth dento-osseous osteotomy is considered to be a surgical technique with minimal effect on the pulp and periodontium. We used this method to treat a patient with impacted permanent canine teeth. After concomitant single tooth dento-osseous osteotomy and orthodontic treatment, root resorption of the bilateral canines was kept to a minimum and pulp vitality was confirmed. This method may be effective in patients in whom ordinary traction is difficult. [Copyright &y& Elsevier]

Preoperative and postoperative temporomandibular disorders (TMDs) were observed in 72 patients before surgical-orthodontic treatment and about 2 years after bilateral sagittal split osteotomy. Prevalence and degree of TMD were assessed using the modified clinical dysfunction index of Helkimo. A total of 49 women and 23 men (mean age 32 years) were included in the study. To find out which patients benefit most from the treatment, the sample was classified into subgroups--myogenous, arthrogenous, or both components of TMD. The prevalence of clicking and headache decreased significantly with the treatment, while the incidence of crepitation increased. In general, severity of the dysfunction was greatly reduced. Furthermore, multiple regression analysis showed that patients with excessive overjet and previous occlusal splint therapy benefit most from orthognathic treatment. In addition, patients with signs of mainly myogenous origin got more relief from their dysfunction than patients with mainly arthrogenous components of TMD. The results suggest that in patients with severe maxillomandibular discrepancy surgical-orthodontic therapy is a good choice of treatment for reducing myogenous TMD pain and discomfort. [ABSTRACT FROM AUTHOR]