Temporomandibular disorders after orthognathic surgery in patients with mandibular prognathism with depression as a risk factor.
OBJECTIVE
To examine the prevalence of temporomandibular disorders (TMD) after orthodontic-surgical treatment in patients with mandibular prognathism and analyze psychosocial variables related to TMD.


METHODS
The case-control study comprised 40 patients with mandibular prognathism who underwent combined orthodontic-surgical treatment (orthognathic surgery group). Forty-two patients with untreated mandibular prognathism served as a control group. Research diagnostic criteria for temporomandibular disorders was used in order to assess the clinical diagnosis of TMD (Axis I) and to estimate depression, somatization and patient's disability related to chronic pain (Axis II).


RESULTS
The overall prevalence of TMD was not significantly different between the groups. Myofascial pain was significantly higher, while arthralgia, arthritis and arthrosis was significantly lower in the orthognathic group compared with the controls (90.5% vs 50.0%, 0.0% vs 27.8%, respectively) (p < 0.05). Females in orthognathic surgery group showed higher prevalence of TMD (p < 0.05) and myofascial pain (p < 0.01) and increased level of chronic pain (p < 0.05) in comparison with post-operative males. No significant difference in chronic pain, somatization and depression scores was found between investigated groups. With respect to presence of TMD within the groups depression was higher in untreated subjects with dysfunction (p < 0.05).


CONCLUSIONS
Prevalence of TMD immediately after completion of orthodontic-surgical treatment for mandibular prognathism is similar to frequency of dysfunction in untreated subjects, is significantly higher in females and is most commonly myogenic. Furthermore, females show an increased level of chronic pain post-operatively. Somatization and depression levels do not differ between patients with corrected prognathism and untreated prognathic patients.
Department of Prosthodontics, Faculty of Medicine, University of East Sarajevo, Bosnia Herzegovina. eirene14a@yahoo.com
Irena
I
Mladenović
Nebojša
N
Jović
Tatjana
T
Čutović
Goran
G
Mladenović
RuŽica
R
Kozomara
D000328:Adult; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D059350:Chronic Pain / Q000209:etiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008313:Malocclusion, Angle Class III / Q000150:complications* / Q000601:surgery*; D008334:Mandible / Q000002:abnormalities / Q000601:surgery; D056948:Orthognathic Surgical Procedures / Q000009:adverse effects*; D011378:Prognathism / Q000150:complications* / Q000601:surgery*; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000209:etiology; D018709:Statistics, Nonparametric; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis / Q000209:etiology*; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000175:diagnosis / Q000209:etiology; D055815:Young Adult