Impact of Orthognathic Surgery on Stress Distribution in the Jaw of Class ll Women: An Integrated Analysis of Finite Element and DC/TMD.

Abstract

Abstract Objectives Orthognathic surgery aims to correct dentofacial deformities to improve both function and aesthetics. However, it can affect the position of the jaw head in the mandibular fossa, impacting the temporomandibular joint (TMJ) and leading to temporomandibular dysfunction (TMD). Computational simulations using the finite element method (FEM) help measure changes that may occur in the TMJ, simulating in vivo situations. The goal of this study is to investigate the effects of orthognathic surgery on TMJ and TMD symptoms, using computational simulations and clinical analysis methods to assess changes in stress distribution in the jaw head. Materials and Methods Five women with Class II malocclusion undergoing orthognathic surgery were analyzed, with clinical and computed tomography assessments performed one week before and six months after the procedure. Results Statistical analysis showed a mean reduction in preoperative stress (723.82 ± 306.70 MPa) to postoperative stress (465.53 ± 268.27 MPa) without significance (p = 0.115). Four out of five patients did not present TMD after surgery (p = 0.250), while three out of four patients with previous articular TMD no longer had it after surgery (p = 0.500). Conclusions In conclusion, there was a trend of reduced stress in the jaw head and TMD symptoms six months after orthognathic surgery. Clinical Relevance: This study can contribute to the improvement of surgical techniques, development of postoperative follow-up protocols, and enhancement of clinical outcomes and quality of life for patients undergoing orthognathic surgery.