Clinical evaluation of the temporomandibular joint and masticatory muscles 10-15 years after mandibular setback surgery and six weeks of inter-maxillary fixation

Objectives. The purpose of this study was to clinically evaluate the TMJs and masticatory muscles 10-15 years after orthodontic-surgical treatment of mandibular prognathism. Material and methods. Thirty-six patients where included in this study. All patients had been operated with the intraoral vertical ramus osteotomy (IVRO) technique and subsequent inter-maxillary fixation (IMF) for six weeks. Mean follow-up period after surgery was 12.5 years, and mean age at the long-term follow-up examination was 34.1 years (range 27.2 – 59.8 years). At the long-term follow-up consultation, the masticatory muscles and TMJs were examined according to the Helkimo clinical dysfunction index. The participants also completed a questionnaire. Results. Mean maximum unassisted mouth opening 10-15 years after surgery was 50.1 mm, (range 38-70 mm, SE 1.2). Statistically significantly greater in males compared to females (p=0.004). Mean Helkimo Dysfunction group was 1.5. None of the patients reported to have pain while chewing or opening the mouth on a weekly or daily basis. However, eight patients reported weekly (n=6) or daily (n=2) difficulties with maximum opening of the mouth. Conclusion. The results of the present study show that 10-15 years after IVRO setback surgery and subsequent IMF for six weeks, mandibular range of movement is satisfactory and the patients report few functional limitations or symptoms related to the TMJs and/or masticatory musculature.Prosjektoppgave / Integrert masteroppgaveOD3PROS

A novel method for assessment of human midpalatal sutures using CBCT-based geometric morphometrics and complexity scores

Introduction: Management of dentofacial deficiencies requires knowledge about sutural morphology and complexity. The present study assesses midpalatal sutural morphology based on human cone-beam computed tomography (CBCT) using geometric morphometrics (GMM) and complexity scores. The study is the first to apply a sutural complexity score to human CBCT datasets and demonstrates the potential such a score has to improve objectiveness and comparability when analysing the midpalatal suture. Materials and methods: CBCTs of various age and sex groups were analysed retrospectively (n = 48). For the geometric morphometric analysis, landmark acquisition and generalised Procrustes superimposition were combined with principal component analysis to detect variability in sutural shape patterns. For complexity analysis, a windowed short-time Fourier transform with a power spectrum density (PSD) calculation was applied to resampled superimposed semi-landmarks. Results: According to the GMM, younger patients exhibited comparable sutural patterns. With increasing age, the shape variation increased among the samples. The principal components did not sufficiently capture complexity patterns, so an additional methodology was applied to assess characteristics such as sutural interdigitation. According to the complexity analysis, the average PSD complexity score was 1.465 (standard deviation = 0.010). Suture complexity increased with patient age (p < 0.0001), but was not influenced by sex (p = 0.588). The intra-class correlation coefficient exceeded 0.9, indicating intra-rater reliability. Conclusion: Our study demonstrated that GMM applied to human CBCTs can reveal shape variations and allow the comparison of sutural morphologies across samples. We demonstrate that complexity scores can be applied to study human sutures captured in CBCTs and complement GMM for a comprehensive sutural analysis

Clinical evaluation of the temporomandibular joint and masticatory muscles 10-15 years after mandibular setback surgery and six weeks of inter-maxillary fixation

Objectives. The purpose of this study was to clinically evaluate the TMJs and masticatory muscles 10-15 years after orthodontic-surgical treatment of mandibular prognathism. Material and methods. Thirty-six patients where included in this study. All patients had been operated with the intraoral vertical ramus osteotomy (IVRO) technique and subsequent inter-maxillary fixation (IMF) for six weeks. Mean follow-up period after surgery was 12.5 years, and mean age at the long-term follow-up examination was 34.1 years (range 27.2 – 59.8 years). At the long-term follow-up consultation, the masticatory muscles and TMJs were examined according to the Helkimo clinical dysfunction index. The participants also completed a questionnaire. Results. Mean maximum unassisted mouth opening 10-15 years after surgery was 50.1 mm, (range 38-70 mm, SE 1.2). Statistically significantly greater in males compared to females (p=0.004). Mean Helkimo Dysfunction group was 1.5. None of the patients reported to have pain while chewing or opening the mouth on a weekly or daily basis. However, eight patients reported weekly (n=6) or daily (n=2) difficulties with maximum opening of the mouth. Conclusion. The results of the present study show that 10-15 years after IVRO setback surgery and subsequent IMF for six weeks, mandibular range of movement is satisfactory and the patients report few functional limitations or symptoms related to the TMJs and/or masticatory musculature

Temporomandibular joint function 10-15 years after mandibular setback surgery and six weeks of intermaxillary fixation

Intermaxillary fixation (IMF) is a classic method for immobilization of the mandible after mandibular fractures and corrective surgery. However, it has been suggested that IMF may be a risk for developing temporomandibular joint (TMJ)-related symptoms, especially when applied for longer periods. Objective: To evaluate the clinical function of TMJs and masticatory muscles 10-15 years after mandibular setback surgery and subsequent six weeks of IMF. The patients' self-reported TMJ and masticatory muscle symptoms were also addressed. Methodology: Thirty-six patients (24 women and 12 men) treated with intraoral vertical ramus osteotomies and subsequent six weeks of IMF, underwent a clinical examination of TMJs and masticatory muscles 10-15 years after surgery and completed a five-item structured questionnaire reporting subjective TMJ-related symptoms. Mean age by the time of clinical examination was 34.1 years (range 27.2–59.8 years). The clinical outcome was registered according to the Helkimo clinical dysfunction index. Descriptive and bivariate statistics were performed and level of significance was set to 5%. Results: Mean maximum unassisted mouth opening 10-15 years after surgery was 50.1 mm, (range 38-70 mm, SE 1.2), statistically significantly greater in men compared to women (p=0.004). Mean Helkimo dysfunction group was 1.5 (range 1-3, SE 0.10). Eighty-one percent experienced pain on palpation in either the masseter muscle, temporal muscle or both, and 31% experienced pain when moving the mandible in one or more directions. Thirty-one percent reported pain from palpating the TMJs. In the questionnaire, none reported to have pain during chewing or mouth opening on a weekly or daily basis, but 22% reported difficulties with maximum opening of the mouth. Conclusion: Ten to fifteen years after mandibular setback surgery the patient's mandibular range of movement is good. Despite clinically recognizable symptoms, few patients reported having TMJ- or masticatory muscle-related symptoms in their daily life

Temporomandibular joint function 10-15 years after mandibular setback surgery and six weeks of intermaxillary fixation

Intermaxillary fixation (IMF) is a classic method for immobilization of the mandible after mandibular fractures and corrective surgery. However, it has been suggested that IMF may be a risk for developing temporomandibular joint (TMJ)-related symptoms, especially when applied for longer periods. Objective: To evaluate the clinical function of TMJs and masticatory muscles 10-15 years after mandibular setback surgery and subsequent six weeks of IMF. The patients' self-reported TMJ and masticatory muscle symptoms were also addressed. Methodology: Thirty-six patients (24 women and 12 men) treated with intraoral vertical ramus osteotomies and subsequent six weeks of IMF, underwent a clinical examination of TMJs and masticatory muscles 10-15 years after surgery and completed a five-item structured questionnaire reporting subjective TMJ-related symptoms. Mean age by the time of clinical examination was 34.1 years (range 27.2–59.8 years). The clinical outcome was registered according to the Helkimo clinical dysfunction index. Descriptive and bivariate statistics were performed and level of significance was set to 5%. Results: Mean maximum unassisted mouth opening 10-15 years after surgery was 50.1 mm, (range 38-70 mm, SE 1.2), statistically significantly greater in men compared to women (p=0.004). Mean Helkimo dysfunction group was 1.5 (range 1-3, SE 0.10). Eighty-one percent experienced pain on palpation in either the masseter muscle, temporal muscle or both, and 31% experienced pain when moving the mandible in one or more directions. Thirty-one percent reported pain from palpating the TMJs. In the questionnaire, none reported to have pain during chewing or mouth opening on a weekly or daily basis, but 22% reported difficulties with maximum opening of the mouth. Conclusion: Ten to fifteen years after mandibular setback surgery the patient's mandibular range of movement is good. Despite clinically recognizable symptoms, few patients reported having TMJ- or masticatory muscle-related symptoms in their daily life