Preoperative parafunctional or dysfunctional oral habits are associated with the temporomandibular disorders after orthognathic surgery An observational cohort study

Abstract

Background

Temporomandibular disorders (TMDs) are frequent and disabling, and hence, preventing them is an important health issue. Combining orthodontic and surgical treatments for malocclusions has been shown to affect temporomandibular joint (TMJ) health. However, publications regarding the risk factors that predict negative TMJ outcomes after orthognathic surgery are scarce.

Objective

Present prospective cohort study was conducted to identify an association between preoperative dysfunctional/parafunctional oral habits and presence of TMD symptoms after orthognathic surgery.

Method

We included 237 patients undergoing orthodontics and surgical treatment for malocclusions associated with dento‐facial deformities within the Department of Oral and Maxillofacial Surgery of the University of Lille. Their parafunctional and dysfunctional oral habits were recorded through clinical examination along with presence of TMD symptoms before and after the surgery. According to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) classification, the TMD symptoms studied were myalgia, arthralgia, disc displacement with or without reduction.

Results

Multivariate analysis revealed significant associations among bruxism (odds ratio [OR] 3.17 [1.066; 9.432]), lingual interposition (OR 4.241 [1.351; 13.313]), as well as primary swallowing (OR 3.54 [1.225; 10.234]) and presence of postoperative symptoms of myalgia. Moreover, a significant association was observed between presence of any dysfunctional oral habit and postoperative disc displacement with reduction (OR 4.611 [1.249; 17.021]).

Conclusion

Bruxism and dysfunctional oral habits were shown to be risk factors for presence of TMD symptoms also after combined orthodontic and surgical treatment. Treating such habits before orthognathic surgery should help prevent TMD.

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