The effect of orthognathic surgery on the temporomandibular joint and oral function: a systematic review.

The objective of this systematic review was to examine the effect of orthognathic surgery (OS) on the temporomandibular joint and oral function. Electronic databases were systematically searched for studies published until October 2015. Articles were assessed against predefined inclusion criteria. The included papers were divided into four groups based on the type of OS performed. The following items were recorded: quality of evidence using the Oxford Centre for Evidence-Based medicine (CEBM) criteria, number of patients, presence/absence of controls, mean age at treatment, follow-up time, clinical examination findings, bite force, use of the Helkimo Index and Research Diagnostic Criteria for Temporomandibular Disorders, imaging findings, and patient questionnaire results. A total of 4669 articles were identified; 76 relevant articles were included in the review. These studies assessed a total 3399 patients and 380 controls, with a mean age of 25.4 years. The great variety of OS techniques, examination techniques, diagnostic criteria, and imaging techniques used in the articles studied, as well as the quality of the study designs, made it difficult to compare studies and to draw conclusions. However, looking at the different aspects studied in general, it can be stated that OS seems to have little or no harmful effect on the TMJ and oral function (level of evidence: levels II, III, and IV).

Disc displacement within the human temporomandibular joint: a systematic review of a 'noisy annoyance'.

To describe the scientific literature about the diagnosis, prevalence, aetiology, natural course and possible treatment modalities of disc displacements within the temporomandibular (TM) joint. PubMed was searched for specific indexing terms. The search yielded 1211 papers. After screening according to title and abstract, 695 papers were excluded, and after full-text reading, 107 papers remained. Hand-searching of the reference lists resulted in an extra 47 papers. Thirteen studies, published since the literature search was carried out, were also included, resulting in 167 papers for this review. A disc displacement is a highly prevalent derangement within the TM joint, with reported prevalence ranging from 18% to 35% in the general population. A disc displacement with reduction is mostly a stable, pain-free and lifelong condition of the joint. In only a small minority of patients, the disc loses its capacity to reduce on opening. Surprisingly, only in rare cases, the loss of disc reduction is accompanied by signs and symptoms of a closed lock (viz. a painful and limited mouth opening). These signs and symptoms have a tendency to reduce and in many cases to resolve within months. The favourable natural course of disc displacements only warrants active treatment for symptomatic disc displacements without reduction. The primary treatment option is a conservative, non-surgical treatment focusing at speeding up the natural process of alleviation of pain and of improvement in mouth opening. For most patients, a disc displacement is just a pain-free, lifelong lasting, 'noisy annoyance' from their TM joint.

[Synovial chondromatosis of the temporomandibular joint. A systematic review of the literature on its characteristics]. / Synoviale chondromatose van het temporomandibulaire gewricht. Een systematisch literatuuronderzoek naar de kenmerken.

Synovial chondromatosis of the temporomandibular joint is a disease which occurs rarely. A systematic review of the literature was carried out to identify its demographical, etiological, radiological, and clinical characteristics. A total of 191 case presentations were discovered. The mean age of patients was 47. The disease has been identified more frequently in women than in men. A part from pre-auricular swelling, the most frequently reported clinical characteristics resembled those of temporomandibular disorders. Abnormalities on radiographs were often evident. Insufficient evidence was found that trauma or rheumatoid arthritis plays a role in the development of this disease. Given the similarities with temporomandibular disorders, synovial chondromatosis should be considered in the differential diagnosis of patients suffering from complaints of temporomandibular dysfunction.

Rendu-Osler-Weber disease: update of medical and dental considerations.

Rendu-Osler-Weber disease, also known as hereditary hemorrhagic telangiectasia (HHT), is an autosomal dominant inherited disorder characterized by an aberrant vascular development. The reported prevalence is approximately 1 per 5,000-10,000. The clinical manifestations consist of recurrent spontaneous nosebleeds, telangiectasias characteristically at the lips, oral cavity, fingers, and nose, and visceral arteriovenous malformations. Timely recognition of this syndrome makes screening for complications, preventive measurements, and genetic counselling possible. The important role of the dental profession in the recognition of this genetic disease is emphasized. In addition, a brief overview of the current literature is presented.