Oral function and diet quality in a community-based sample.

Overall diet quality indices, such as the Healthy Eating Index (HEI), are preferred for epidemiological studies, yet studies in dentistry have focused on isolated dietary components. This study investigated the influence of socio-demographic and masticatory variables (masticatory performance, bite force, number of posterior functional tooth units, TMJ disorder, and dentition status) on overall diet quality in a community-based sample (n = 731). Cross-sectional data were derived from clinical examinations, bite force recordings, masticatory performance measurements, and two 24-hour dietary recalls. Females, European-Americans, and older subjects had better HEI scores than males, Mexican-Americans, and younger subjects, respectively. Income, education, and the masticatory variables were not related to diet quality. Analyses according to dentition status (good dentition, compromised dentition, partial denture, and complete dentures) showed no inter-group differences for HEI except for the age groups. The results suggest that the chewing-related factors evaluated in this sample are not predictors of overall diet quality across the socio-demographic groups.

Maintenance of soft tissue changes after rigid versus wire fixation for mandibular advancement, with and without genioplasty.

OBJECTIVE: This multisite prospective randomized clinical trial examined 2-year longitudinal soft tissue profile changes after bilateral sagittal split osteotomy for mandibular advancement by using rigid or wire fixation, with and without genioplasty. STUDY DESIGN: The study sample consisted of 127 subjects. The rigid-fixation group (n = 78) received 2-mm bicortical position screws, whereas the wire-fixation group (n = 49) received inferior border wires. In the rigid-fixation group, 35 subjects underwent genioplasty, whereas 24 subjects underwent genioplasty in the wire-fixation group. Soft tissue profile changes of labrale inferius, B-point, and pogonion were obtained from digitized cephalometric films taken immediately before surgery and up to 2 years after surgery. RESULTS: Regardless of fixation technique, subjects who had genioplasty in conjunction with the mandibular advancement had the largest surgical movement and the largest postsurgical change (P <.05). When all variables were constant, fixation technique was associated with maintenance of soft tissue change. Subjects who underwent rigid fixation maintained more soft tissue change than patients who underwent wire fixation. CONCLUSIONS: These findings suggest that subjects undergoing rigid fixation and genioplasty maintained the most soft tissue advancement.

Determinants of masticatory performance in dentate adults.

Masticatory performance results from a complex interplay of direct and indirect effects, yet most studies employ univariate models. This study tested a multivariate model of masticatory performance for dentate subjects. Explanatory variables included number of functional tooth units, bite force, sex, age, masseter cross-sectional area, presence of temporomandibular disorders, and presence of diabetes mellitus. The population-based sample consisted of 631 dentate subjects aged 37-80 years. Covariance structure analysis showed that 68% of the variability in masticatory performance could be explained by the combined effects of the explanatory variables. Age and sex did not show a strong effect on masticatory performance, either directly or indirectly through masseter cross-sectional area, temporomandibular disorders, and bite force. Number of functional tooth units and bite force were confirmed as the key determinants of masticatory performance, which suggests that their maintenance may be of major importance for promoting healthful functional status.

Positional change of the hyoid bone after bilateral sagittal split osteotomy with rigid and wire fixation.

The purpose of this study was to compare positional changes of the hyoid bone and the amount of postsurgical compensation in mandibular position in patients who received either wire or rigid fixation after surgery. Data were analyzed from 97 patients (25 males and 72 females) who were randomized to receive wire (43) or rigid (54) fixation after mandibular advancement surgery as part of a multicenter clinical trial. Radiographs were digitized before surgery (T2), immediately after surgery (T3), and 8 weeks (T4), 6 months (T5), 1 year (T6), and 2 years (T7) after surgery. The wire group had greater sagittal relapse of the hyoid bone at T6 (P =.007), which persisted at T7 (P =.02). Both groups showed upward movement of the hyoid bone after surgery. There was no relationship between the vertical change in the the hyoid bone position and the vertical position of mandible (B point y coordinate, mandibular plane). However, there was a relationship between the horizontal hyoid bone position and B point during the postsurgical period (rigid, r = 0.450; wire, r = 0.517). The direct distance from the hyoid bone to basion increased (P <.001) in both groups at T3 and then recovered its original length after 8 weeks (P <.001). The rigid group showed no significant change in distance from the hyoid to the genial tubercles, but the wire group showed recovery of the muscle length at T6 (P <.05) and T7 (P <.05).

Mandibular range of motion after bilateral sagittal split ramus osteotomy with wire osteosynthesis or rigid fixation.

OBJECTIVES: An analysis was conducted to compare mandibular range of motion among Class II patients treated with wire osteosynthesis or rigid internal fixation after surgical mandibular advancement. STUDY DESIGN: Patients randomly received wire osteosynthesis and 8 weeks of maxillomandibular fixation (n = 49) or rigid internal fixation (n = 78). Mandibular range of motion was measured 2 weeks before surgery and 8 weeks, 6 months, and 1, 2, and 5 years after surgery. RESULTS: Both groups showed decreased mobility in all movement dimensions that progressively recovered to near presurgical levels over the 5-year follow-up period. The difference in range of motion between treatment groups was not statistically significant. Changes in proximal and distal segment position could not explain decreased mobility. CONCLUSIONS: Similar decreases in mandibular mobility occurred with wire and rigid fixation of a bilateral sagittal split ramus osteotomy after surgery. Long-term changes were statistically, but not clinically, significant.

Is use of exogenous estrogen associated with temporomandibular signs and symptoms?

BACKGROUND: Studies of historical data suggest a link between exogenous estrogen use and referral for treatment for temporomandibular disorders, or TMDs. The purpose of the authors' study was to determine the association between exogenous estrogen use and signs and symptoms of TMD assessed by direct physical examination in a randomly selected community sample of primarily postmenopausal women. METHODS: A calibrated clinical examiner examined a stratified random sample of 510 women aged 37 to 82 years using the Craniomandibular Index, or CMI. All medications that subjects were taking at the time of the examination were identified by interview and examination of subjects' medication containers on two occasions. One hundred seventy-four subjects were taking medications containing estrogen, and 336 were taking no such medications. RESULTS: The muscle and joint signs and symptoms of women taking and not taking estrogen were not significantly different after the authors controlled for sociocultural, demographic and health care utilization variables. Estrogen use also failed to distinguish women receiving relatively high and low scores on the CMI. CONCLUSION: Estrogen replacement therapy does not place women at increased risk of developing TMDs. CLINICAL IMPLICATIONS: Clinicians need not be concerned that patients taking oral contraceptives or replacement estrogens are at increased risk of developing TMDs.

Masticatory performance is not associated with diet quality in Class II orthognathic surgery patients.

This study evaluated the association between masticatory function, diet, and digestive system problems in 59 Class II patients 5 years after bilateral sagittal split osteotomy. Dietary intake data were recorded in 4-day diet diaries and analyzed for overall diet quality (Healthy Eating Index) and selected dietary components. Masticatory function was assessed through measurements of masticatory performance, maximum bilateral bite force, and chewing time and number of chewing strokes until the subject felt that the bolus was ready to swallow. Self-reported frequency of digestive system problems was recorded with a 7-point Likert scale questionnaire. Masticatory function was not associated with diet quality or gastrointestinal problems. There was a weak association between intake of foods that require chewing (eg, fiber, protein, meat, and vegetables) and masticatory variables. Fourteen subjects (24%) had a poor diet and 45 subjects (76%) had a diet that needed improvement according to the Healthy Eating Index. Self-reported constipation was the only digestive system problem that was significantly associated with masticatory performance.

Severity, distribution, and correlates of occlusal tooth wear in a sample of Mexican-American and European-American adults.

PURPOSE: The objective of this study was to determine the severity, distribution, and correlates of tooth wear in a sample of Mexican-American and European-American adults drawn from a community-based longitudinal aging study on oral health. MATERIALS AND METHODS: The maxillary teeth of 71 subjects enrolled in a longitudinal aging study were assessed using a previously introduced five-point (0 to 4) ordinal scoring system in which each tooth is given a score describing the severity of wear. The tooth wear scores were compared with data concerning demographic factors, functional/parafunctional habits, soft drink consumption, and bite force measurements to determine specific correlates of tooth wear. RESULTS: The mean wear score for all teeth was 1.50 on the five-point scale. There was a significant difference between the mean wear score of anterior teeth (1.85) and posterior teeth (1.17). Bivariate analyses detected a moderate degree of correlation between maxillary tooth wear and age and bite force. Maxillary tooth wear was significantly greater in males and in subjects with reported teeth clenching/grinding. Multivariate analyses revealed that age, gender, bite force, self-reported teeth clenching/grinding, and number of daily meals/snacks had significant correlations with maxillary tooth wear. CONCLUSION: The overall severity of maxillary tooth wear in this sample of Mexican-American and European-American adults was low, with anterior teeth having a greater degree of wear than posterior teeth. Age, gender, bite force, teeth clenching/grinding, and number of daily meals/snacks are potential factors that may have contributed to tooth wear in the study sample.

Neurosensory differences after wire and rigid fixation in patients with mandibular advancement.

PURPOSE: The purpose of this analysis was to compare the frequency and severity of nerve damage with rigid and wire fixation in patients participating in a prospective, randomized clinical trial. PATIENTS AND METHODS: One hundred twenty-six patients who required a bilateral sagittal split osteotomy and mandibular advancement were randomly assigned to receive either rigid or wire fixation. Tactile sensation in the mental nerve region bilaterally was determined presurgically and throughout the subsequent 2 years by using monofilament detection and brush stroke direction. Neurosensory levels were compared between the types of fixation over time. RESULTS: Evaluation with monofilament detection showed no significant difference between types of fixation throughout the 2-year follow-up. However, brush stroke determination showed significantly greater hypesthesia with rigid compared with wire fixation from 8 weeks through 2 years postoperatively. CONCLUSION: Rigid fixation resulted in more anesthesia in the mental nerve distribution than wire fixation when tested with brush stroke direction. However, increased anesthesia was not present when measured with monofilament determination.

Relationship between oral function and occlusal support in denture wearers.

Patients with removable partial dentures or complete dentures do not demonstrate masticatory function to the same level as patients with a full set of natural teeth. The purpose of this study was to characterize the relationship between reduction of masticatory function, in terms of masticatory performance and bite force, and the existence of remaining natural occlusal supports as assessed by the Eichner index. One hundred and eighteen removable partial denture and complete denture wearers were selected for analyses. These subjects were divided into four groups depending upon the number of occlusal supports. Seventy dentate subjects with full occlusal support were designated as a comparison group. Bilateral bite force was measured at the first molar region in all subjects. Masticatory performance was assessed using the modified Masticatory Performance Index. Peanuts were used as the test food. Both bite force and masticatory performance were significantly associated with group classification. Moreover, both bite force and masticatory performance of the four denture groups were significantly reduced compared to the comparison group and this tendency was remarkable for the denture groups without occlusal support. These results suggest that the existence of functional tooth units may be a key factor in preservation of masticatory function.

Skeletal stability after mandibular advancement with rigid versus wire fixation.

PURPOSE: This study examined the stability of skeletal changes after mandibular advancement surgery with rigid or wire fixation up to 2 years postoperatively. PATIENTS AND METHODS: Subjects for this multisite, prospective, clinical trial received rigid (n = 78) or wire (n = 49) fixation. The rigid cases were fixed with three 2-mm bicortical position screws and 1 to 2 weeks of skeletal maxillomandibular fixation with elastics, and the wire fixation subjects were fixed with inferior border wires and had 6 weeks of skeletal maxillomandibular fixation with 24-gauge wires. Cephalometric radiographs were obtained before orthodontics, immediately before surgery, and at 1 week, 8 weeks, 6 months, 1 year, and 2 years after surgery. Linear cephalometric changes were referenced to a cranial base coordinate system. RESULTS: Before surgery, both groups were balanced with respect to linear and angular measurements of craniofacial morphology. Mean anterior sagittal advancement of the mandibular symphysis was 4.92 +/3.01 mm in the rigid group and 5.11 +/- 3.09 mm in the wire group, and the inferior vertical displacement was 3.37 +/- 2.44 in the rigid group and 2.85 +/- 1.78 in the wire group. The vertical changes were similar in both groups. Two years postsurgery, the wire group had 30% sagittal relapse of the mandibular symphysis, whereas there was no change in the rigid group (P < .001). Both groups experienced changes in the orientation and configuration of the mandible. CONCLUSIONS: Rigid fixation is a more stable method than wire fixation for maintaining mandibular advancement after sagittal split ramus osteotomy.

Association of salivary flow rates with maximal bite force.

Mean salivary secretion and bite force decrease with advancing age. Previous studies have shown that salivary flow rates are influenced by mastication. In the present study, we examined the relationship between salivary flow rates and maximal bite force in a community-based sample of men and women 35 years of age or older. Salivary flow rates for unstimulated whole and unstimulated submandibular/sublingual (SMSL) saliva as well as citrate-stimulated parotid and SMSL saliva were measured in 399 subjects. Bite force was assessed with a bilateral force transducer. Pearson correlation analysis yielded significant positive correlations between bite force and flow rates for unstimulated whole saliva (r = 0.24, p < 0.0001), stimulated parotid saliva (r = 0.13, p < 0.03), unstimulated SMSL (r = 0.14, p < 0.0001), and stimulated SMSL (r = 0.16, p < 0.003). When adjusted for age and gender, the partial correlations between bite force and salivary flow rates remained significant for unstimulated whole saliva (r = 0.10, p < 0.05), stimulated parotid saliva (r = 0.13, p < 0.02), and stimulated SMSL saliva (r = 0.14, p < 0.006). Subjects were divided into four groups based on their maximal bite force score (low, medium low, medium high, and high). For each saliva type, the flow rate of the high-bite-force group was significantly greater than that of the low-bite-force group as well as that of the medium-high-bite-force group. These results confirm an age-related decrease in bite force and salivary flow rates and show that, regardless of age or gender, bite force is correlated with salivary flow.

Patients' own reasons and patient-perceived recommendations for orthognathic surgery.

In an attempt to learn more about patients' decision-making processes, an analysis was performed to examine patients' reasons for undergoing orthognathic surgery and their understanding of the reasons surgery was recommended. Before surgery, 105 females and 38 males completed an open-ended questionnaire in which they listed their reasons for choosing orthognathic surgery and their perceptions of their orthodontists' recommendations. Three raters classified the responses into 7 categories: esthetics, psychosocial, functional, TMJ/pain, authority, prevention, and other. Rater agreement ranged from a kappa of.55 to 1.00. Patients reported undergoing orthognathic surgery primarily for esthetic, functional, and TMJ improvements, 71%, 47%, and 28%, respectively. Females reported more TMJ-related reasons than males (P <.05). Patients reporting function (P <. 05), TMJ (P <.05), and prevention of future problems (P <.05) were older than patients not reporting these reasons. Mexican American patients indicated more psychosocial reasons (P <.05) than European Americans. Patients understood that orthognathic surgery was recommended primarily for esthetic, functional, and TMJ improvements, 52%, 44%, and 18%, respectively. Males reported receiving more preventative recommendations (23%) than females (10%). Mexican American patients reported receiving more psychosocial recommendations (P <.05) than European Americans. Agreement between each paired patient/patient-perceived reason was highest for TMJ problems (kappa = 0.588). In conclusion, patients underwent orthognathic surgery to improve esthetic, functional and TMJ problems and interpreted orthodontists' recommendations for similar reasons. On a case-to-case basis, agreement between patient and orthodontist-represented reasons was modest, suggesting differences between patients' own reasons and their perceptions of orthodontists' recommendations.

A comparative study of skeletal and dental stability between rigid and wire fixation for mandibular advancement.

This study examined the skeletal and dental stability after mandibular advancement surgery with rigid or wire fixation for up to 2 years after the surgery. Subjects for this multisite, prospective, randomized, clinical trial were assigned to receive rigid (n = 64) or wire (n = 63) fixation. The rigid cases received three 2-mm bicortical position screws bilaterally and elastics; the wire fixation subjects received inferior border wires and 6 weeks of skeletal maxillomandibular fixation with 24-gauge wires. Cephalometric films were obtained before surgery, and at 1 week, 8 weeks, 6 months, 1 year, and 2 years after surgery. Skeletal and dental changes were analyzed using the Johnston's analysis. Before surgery both groups were balanced with respect to linear and angular measurements of craniofacial morphology. Mean anterior advancement of the mandibular symphasis was 5.5 mm (SD, 3.2) in the rigid group and 5.6 mm (SD, 3.0) in the wire group. Two years after surgery, mandibular symphasis was unchanged in the rigid group, whereas the wire group had 26% of sagittal relapse. Dental compensation occurred to maintain the corrected occlusion, with the mandibular incisor moving forward in the wire group and posteriorly in the rigid group. However, at 2 years after surgery, when most subjects were without braces, the overjet and molar discrepancy had relapsed similarly in both groups.

Technical factors accounting for stability of a bilateral sagittal split osteotomy advancement: wire osteosynthesis versus rigid fixation.

OBJECTIVE: Relapse after bilateral sagittal split osteotomy has been attributed to various technical factors that are inherent in the surgical procedure. The purpose of this article was to analyze technical factors that predispose to relapse when wire or rigid fixation is used. STUDY DESIGN: Patients were randomized to either rigid or wire osteosynthesis. Cephalometric radiographs were obtained and digitized at multiple time periods before and after surgery. Data were analyzed through use of 2-sample t tests and stepwise regression analyses. RESULTS: Multivariate analysis indicated that the following factors correlated with relapse: initial advancement, change in ramus in inclination, change in the mandibular plane, and fixation type. CONCLUSIONS: Relapse increased with the amount of initial advancement and, to a lesser extent, with control of the proximal segment and change in the mandibular plane. These factors are similar for wire osteosynthesis and rigid fixation.

Bilateral sagittal split osteotomy and temporomandibular disorders: rigid fixation versus wire fixation.

OBJECTIVE: The effects of orthognathic surgery on temporomandibular disorders may be related to the surgical method that is used. Specifically, it has been suggested that the choice of stabilization technique may play a major role in the functional outcome of mandibular advancement surgery. The purpose of this study was to prospectively compare long-term (2 years) signs and symptoms of temporomandibular disorders after orthognathic surgery with bilateral sagittal split osteotomy in 127 patients randomized to receive rigid or wire fixation. STUDY DESIGN: Signs and symptoms of temporomandibular disorders were evaluated before and 2 years after surgery by means of the overall craniomandibular index (CMI), dysfunction index (DI), and muscle index (MI). Patients also reported subjective symptoms of temporomandibular disorders by marking areas of pain on a standard drawing of the head and rating the pain in each area on a scale ranging from 1 (very mild) to 7 (very extreme). Subjective pain was also assessed through use of the Oral Health Status Questionnaire and by a rating of the difficulty in opening the mouth because of pain. RESULTS: There were no statistically significant differences in the CMI, MI, or DI change scores between the wire and rigid fixation groups (mean CMI(wire) = 0.05, mean CMI(rigid) = 0.04; mean DI(wire) = 0.02, mean DI(rigid) = 0. 01; mean MI(wire) = 0.08, mean MI(rigid) = 0.08) 2 years after surgery. Temporomandibular joint sounds also demonstrated no significant differences between the two fixation methods. Subjective pain reports were consistent with the clinical examinations. On average, both wire and rigid scores decreased slightly, but the change scores were not significantly different between groups. CONCLUSIONS: These findings suggest that the long-term (2 years) effects of wire and rigid internal fixation methods on the signs and symptoms of temporomandibular disorders do not differ. Earlier concerns about increased risk for temporomandibular disorders with rigid fixation were not supported by these results.

Psychosocial predictors of satisfaction among orthognathic surgery patients.

This study assessed the usefulness of selected psychosocial tests and demographic measures in identifying satisfied versus dissatisfied patients who received orthognathic surgery. Data were collected prior to placement of orthodontic appliances, 1 to 2 weeks presurgery, and at 1 week, 8 weeks, 6 months, 12 months and and 2 years postsurgery. The Revised Symptom Checklist-90 (SCL-90-R) scales, the Eysenck Personality Inventory (EPI), the Sickness Impact Profile (SIP), and the Oral Health Status Questionnaire (OHSQ) were used as independent variables. Indicators from the Post-Surgical Patient Satisfaction Questionnaire (PSPSQ), which assesses patient satisfaction regarding psychosocial issues, oral functioning, and esthetics, served as a postsurgical dependent measure of patient satisfaction. Thirty-one male and 86 female subjects participated in the multisite randomized trial comparing rigid and wire fixation. Patient age was significantly correlated with patient satisfaction from 8 weeks postsurgery through 2 years postsurgery. Older patients appear to report greater postsurgical satisfaction in comparison to younger patients. The postsurgical OHSQ (esthetics subscale) and postsurgical PSPSQ (satisfaction) were significantly related at 8 weeks, 6 months, 12 months, and 2 years postsurgery. Additionally, PSPSQ (satisfaction) and postsurgical OHSQ (general oral health scale) were correlated at 12 months. The EPI, SIP, and SCL-90-R were not significantly associated with postsurgical satisfaction when assessing the entire study sample. Postsurgical qualitative data from the PSPSQ indicated that 50% of the patients reported positive outcomes in oral functioning. Sixty-five percent reported esthetic improvements, and 37% reported neurosensory loss.

Does chewing performance depend upon a specific masticatory pattern?

The purpose of this article is to review the literature concerning the ideal chewing pattern for best chewing performance. We conclude that at this time there is not one ideal chewing pattern which can be used clinically or in research to assess the health of the mastication apparatus nor to predict chewing performance. It is clear that human masticatory behaviour is one of the most complex human behaviours. Chewing is under the control of the central pattern generator located in the brain stem but is influenced by dental and temporomandibular joint morphology. The most important portion of the chewing cycle is the area entering and leaving the intercuspal position where gliding contacts occur. Maximal chewing capability will likely occur when the chewing pattern follows the dental anatomy unique to the individual. The chewing cycle appears to increase the lateral component of its movement when increased chewing efficiency is required. These situations include increased hardness or the size of bolus, the position of the bolus and the results of the proceeding chewing stroke. The chewing pattern for any one cycle is influenced by a number of factors, thus it is not surprising that the question of the ideal chewing pattern remains unresolved.

Psychological function in orthognathic surgical patients before and after bilateral sagittal split osteotomy with rigid and wire fixation.

A multisite randomized controlled trial was conducted to compare the psychological function of patients who undergo surgical correction of a Class II malrelation with bilateral sagittal split osteotomy with either wire or rigid fixation. Subjects were 31 male and 86 female patients referred by orthodontists. Psychopathological symptoms and psychological distress were measured with the Symptom Checklist-90 Revised at the following times: before placement of orthodontic appliances, 1 to 2 weeks presurgery, and 1 week, 8 weeks, 6 months, and 2 years postsurgery. Patients' satisfaction with their surgical outcome was measured with a 3-item questionnaire. Results showed no statistically significant differences in psychological function or satisfaction between patients treated with wire or rigid fixation. Psychological function was within normal limits immediately before surgery. Psychological parameters did not determine patient satisfaction, even among patients who met an operational definition of "psychopathological caseness." Psychological symptoms and general distress increased modestly immediately after surgery for both groups and then progressively declined over the succeeding 2 years, eventually reaching levels that were significantly lower than presurgical levels. It was concluded that (1) rigid and wire fixation do not differ in their effects on psychological function and satisfaction; (2) patients who seek orthognathic surgery for a Class II malocclusion are psychologically healthy, ie, comparable to normal populations, immediately before surgery; (3) presurgical psychological function does not determine satisfaction with surgical outcome; and (4) psychological function tends to improve during the 2 years after surgery.

Short-term changes of condylar position after sagittal split osteotomy for mandibular advancement.

OBJECTIVE: The goal of this study was to quantify condylar position changes after mandibular advancement surgery with rigid fixation (screws). Radiographic changes in condylar position were determined in all planes (X, Y, and Z). Computed tomography with image reconstruction was used. STUDY DESIGN: A consecutive population of patients who elected to have rigid fixation for surgical stabilization method were studied (n = 21). Computed tomography data were acquired in the axial plane through use of abutting 1.5-mm-thick slices. Data acquisition occurred 1 week preoperatively and 8 weeks postoperatively. Measurements were made from 2-dimensional reconstructions. RESULTS: The averages were as follows: lateral displacement from midline, 1.2 mm (55% of patients); medial displacement from midline, 1.5 mm (45% of patients; range, 3.2 mm); condyle angle increase from coronal plane, 3.5 degrees (60% of patients); condyle angle decrease from coronal, 4.3 degrees (40% of patients; range, 8.5 degrees); superior rotation of proximal segment, 3.2 degrees (39% of patients); inferior rotation of proximal segment, 8.6 degrees (61% of patients; range, 15.6 degrees); superior displacement, 1.2 mm (60% of patients); inferior displacement, 1.0 mm (40% of patients; range, 2.5 mm); anterior displacement, 1.6 mm (33% of patients); posterior displacement, 1.6 mm (67% of patients; range, 2.8 mm). CONCLUSIONS: Changes occurred in all planes, but the most common postoperative condyle position was more lateral; with increased angle, the coronoid process was higher and the condyle was more superior and posterior in the fossa.