Short-term functional alterations in the stomatognathic system after orthodontic-surgical management of skeletal vertical excess problems.

Abstract

The aim of the present investigation was to study the functional alterations in the stomatognathic system following orthodontic-surgical management of skeletal vertical excess problems. The sample comprised 43 patients who received combined orthodontic-surgical treatment including bilateral vertical ramus osteotomy for posterior repositioning and counterclockwise rotation of the mandible (n = 26) or Le Fort I osteotomy for maxillary impaction (n = 17). All subjects were examined within 1 week before operation and 6 months postsurgery. Methods of examination included: (a) evaluation of dysfunction by means of a clinical index, (b) measurement of mandibular range of motion, (c) assessment of the number and intensity of occlusal contacts, and (d) tomographic evaluation of condyle-fossa relationships. The results of the study indicated that postoperatively (a) there was an increase of patients with dysfunction in the mandibular osteotomy group and a decrease of patients with dysfunction in the maxillary osteotomy group; (b) the maximum interincisal opening decreased significantly in the mandibular osteotomy group; (c) there was a significant increase in the number and intensity of occlusal contacts in both groups; and (d) the shortest posterior and anterior interarticular distances increased significantly in the mandibular osteotomy group.