Functional therapy and adenotonsillectomy clinical trial for class II malocclusion (FACT-II): protocol for a randomised controlled trial.

INTRODUCTION: Class II malocclusion with mandibular retrognathia is a common complication of paediatric obstructive sleep apnoea (OSA), often accompanied by transverse maxillary deficiency. In early orthodontic treatment, a twin block (TB) is a regular functional appliance for correcting this malocclusion. For paediatric OSA, the most common risk factor is adenotonsillar hypertrophy (AHT). Untreated AHT may lead to the persistence and worsening of obstructive sleep-disordered breathing traits, including habitual mouth breathing. Additionally, the clockwise mandibular rotation associated with AHT-induced pharyngeal crowding can undermine the effectiveness and stability of TB treatment. Adenotonsillectomy (T&A) is currently the first-line treatment for paediatric OSA. This proposed trial will investigate the impact of T&A surgery timing on the efficacy and stability of TB functional treatment in children with class II mandibular retrognathia and ATH. METHODS AND ANALYSIS: This will be a single-centre, parallel-group, superiority randomised controlled trial with participants randomised to intervention (T&A followed by TB treatment) or control arms (TB treatment followed by T&A) in a 1:1 ratio. A total of 40 patients aged 8-14 years, diagnosed with class II mandibular retrognathia and co-existing ATH-induced OSA, and indicated for both T&A surgery and TB treatment, will be recruited at the School and Hospital of Stomatology, Wuhan University. The primary outcomes will be the changes in the apnoea-hypopnoea index and the point A-nasion-point B angle from baseline to postorthodontic treatment between the two groups. Secondary outcomes will include other dental, skeletal, upper airway and soft tissue changes, as well as subjective sleep-related and oral-related quality of life. Outcome changes within each group and between groups will be analysed. ETHICS AND DISSEMINATION: This study is approved by the Ethics Committee of the School and Hospital of Stomatology, Wuhan University (no. 2022-D07). The research findings will be faithfully disseminated through scientific conferences or published articles. TRIAL REGISTRATION NUMBER: ChiCTR2200061703 (https://www.chictr.org.cn).

Oral maxillofacial surgeons and Orthodontists’ perceptions about anterior inferior crowding and indications of mandibular third molar extraction / Percepciones de los cirujanos maxilofaciales y ortodoncistas sobre el apiñamiento anteroinferior y las indicaciones de la extracción del tercer molar mandibular

Background: There are still many doubts about anterior inferior crowding and indications of mandibular third molar extraction, although it is very studied subject in the literature. The aim of this study was to evaluate the perceptions of oral maxillofacial surgeons (OMFSs) and orthodontists about anterior inferior crowding and indications of mandibular third molar extraction. Material and Methods: A web-based survey was developed and sent to professionals in order to collect their opinion about the fact that third lower molars cause crowding and questions about the indication of third molars for orthodontic treatment. Descriptive analysis was performed and Chi-square or G tests were applied with a 95% confidence interval. Results: The study included a total of 218 participants, of whom 115 were OMFSs and 103 were orthodontists. The results showed that 56.5% of OMFSs and 35.0% of orthodontists believe that the lower third molars cause anterior inferior crowding (p<0.001). A total of 91.3% of OMFSs and 70.9% of orthodontists indicate the extraction of lower third molars to aid orthodontic treatment (p<0.001). Conclusions: It can be concluded that in being an oral maxillofacial surgeon, a higher odds ratio is observed to consider that lower third molars cause dental crowding compared to those who are orthodontist. The indication of exodontia of lower third molars for orthodontic treatment was more frequent among OMFSs when compared to orthodontists.(AU)

Clinical Characterisation of Caudal Traumatic Malocclusions and Treatment Outcomes in Cats (2018-2022).

Caudal malocclusions in cats may result in a variety of traumatic lesions affecting the soft tissues of the ipsilateral mandible such as fovea, gingival cleft, and proliferative lesions. Fifty-one cats diagnosed with a traumatic caudal malocclusion were compared with a control hospital population and evaluated for prevalence with respect to breed and sex. Twenty-two cats that were treated had radiographic, clinical findings, and the outcome of treatment (extraction or odontoplasty) recorded. Maine Coon, Persian, and male neutered cats were overrepresented while Domestic Shorthairs were underrepresented within the study population. Radiographically, 50% of the fovea lesions had an area of decreased bone density in the region of the lesion and none of these had evidence of periodontal disease. All gingival cleft lesions had radiographic changes consistent with periodontal disease. 15.4% of proliferative lesions presented with radiographic changes, with only half of those presenting with both radiographic and clinical evidence of periodontal disease. Eleven cats were treated by odontoplasty and eleven by extraction. One cat treated by odontoplasty developed new lesions caudally, and another had persistence of the initial lesions. Two cats in the extraction group developed new lesions rostral to the extracted teeth. In most instances, odontoplasty or extraction resulted in successful soft tissue lesion resolution. In rare cases, additional treatment was necessary due to either persistence or development of new lesions.

Surgical vs nonsurgical treatments in patients with anterior open-bite have similar effects in occlusal function: A 2-year follow-up study.

INTRODUCTION: This study aimed to investigate changes in bite force (BF) and occlusal contact area after anterior open-bite (AOB) treatment and compare the changes in surgical vs nonsurgical treatment. METHODS: This retrospective study included patients with AOB compared with normal occlusion. AOB was corrected by either intrusion of the maxillary molars (intrusion group, n = 19) or orthognathic surgery (surgery group, n = 37). The control group (n = 35) had a normal overbite relationship. Records of lateral cephalograms, BF, and occlusal contact area taken before (T0), immediately after (T1), and 2 years after (T2) orthodontic treatment were compared within and among the 3 groups. RESULTS: The open-bite group, including intrusion and surgery groups, had a lower BF and less occlusal contact area than the control group at T0 and T1 (P <0.001). However, there were no significant differences among the 3 groups at T2 (P >0.05). The intrusion and surgery groups showed no significant differences throughout the observation period extending from T0 to T2 (P >0.05). Although BF and occlusal contact area decreased at T1 compared with T0, they increased during retention and showed higher values at T2 than at T0. CONCLUSIONS: Treatment of AOB improved BF and occlusal contact area 2 years posttreatment. Orthognathic surgery and molar intrusion using orthodontic miniscrews can improve occlusal function similarly. Orthodontists can select either method depending on malocclusion severity and patient demand.

Oral maxillofacial surgeons and Orthodontists' perceptions about anterior inferior crowding and indications of mandibular third molar extraction.

BACKGROUND: There are still many doubts about anterior inferior crowding and indications of mandibular third molar extraction, although it is very studied subject in the literature. The aim of this study was to evaluate the perceptions of oral maxillofacial surgeons (OMFSs) and orthodontists about anterior inferior crowding and indications of mandibular third molar extraction. MATERIAL AND METHODS: A web-based survey was developed and sent to professionals in order to collect their opinion about the fact that third lower molars cause crowding and questions about the indication of third molars for orthodontic treatment. Descriptive analysis was performed and Chi-square or G tests were applied with a 95% confidence interval. RESULTS: The study included a total of 218 participants, of whom 115 were OMFSs and 103 were orthodontists. The results showed that 56.5% of OMFSs and 35.0% of orthodontists believe that the lower third molars cause anterior inferior crowding (p<0.001). A total of 91.3% of OMFSs and 70.9% of orthodontists indicate the extraction of lower third molars to aid orthodontic treatment (p<0.001). CONCLUSIONS: It can be concluded that in being an oral maxillofacial surgeon, a higher odds ratio is observed to consider that lower third molars cause dental crowding compared to those who are orthodontist. The indication of exodontia of lower third molars for orthodontic treatment was more frequent among OMFSs when compared to orthodontists.

Complications in patients with facial bone fractures before and after conservative and surgical treatment, their comparison and correlation with different factors.

OBJECTIVE: This study aims to determine the occurrence of complications before and after the treatment of facial fractures, as well as the impact of the factors on the treatment results and evaluation of their relationships. PATIENTS AND METHODS: This is a prospective case-control study comprising 90 patients aged between 18 and 65 with facial fractures. Depending on the treatment method, patients were divided into three groups: those treated surgically using a transcutaneous approach, those treated surgically using a transmucosal approach, and those treated conservatively (control group). Following complications before and after treatment were compared: malocclusions, paresthesias, facial asymmetry, diplopia, and limited mouth opening. The follow-up period after the treatment of choice was six months. RESULTS: There was a significant reduction in complications after treatment: malocclusion, paresthesia, facial asymmetry, and limited mouth opening. Regarding the transcutaneous approach, there is a substantial reduction in the number of complications after treatment, such as malocclusions (p=0.008), paresthesias (p=0.004), and facial asymmetries (p<0.001). Similar results were obtained for the transmucosal approach. Pain intensity positively correlated with preoperative complications: malocclusion, paresthesias, and facial asymmetry. The range of mouth opening had a negative interdependence with malocclusion before and after treatment with infection, fractura male sanata, malocclusion, paresthesias, postoperative level of mouth opening, and damage to the facial nerve. CONCLUSIONS: There is no difference in the reduction of preoperative and postoperative complications related to surgery when an incision is made through the skin or mucosa. Malocclusions, paresthesias, and facial asymmetry are reduced through surgical methods.

Which Factors Affect the Reduction Quality of Open Reduction Internal Fixation of Mandibular Subcondylar Fractures?

BACKGROUND: Open reduction internal fixation (ORIF) of mandibular subcondylar fractures (MSF) involves several variables that could affect decision making. There is insufficient data regarding factors influencing the outcomes of MSF ORIF. PURPOSE: The purpose of this study was to investigate factors associated with quality of bony reduction of MSF and occlusion, after ORIF. STUDY DESIGN, SETTING, AND SAMPLE: We designed a retrospective cohort study of consecutively treated subjects for MSF ORIF, ages 18 to 64 years, by University of Illinois' Department of Oral and Maxillofacial Surgery, between January 1, 2013, and January 26, 2021. PREDICTOR VARIABLE: The primary predictor variable was the vertical level of MSF from the gonial angle. Secondary predictor variables included surgeon, fixation scheme (number and configuration of miniplate), surgical approach, time to surgery, mechanism of injury, vertical fragment overlap, overlying soft tissue thickness, presence of other mandibular fractures, and severity and direction of displacement. MAIN OUTCOME VARIABLES: The primary outcome variable was the mean radiographic reduction score (RRS), rated by 2 blinded observers on a 1 to 5 scale. The secondary outcome variable was presence of postoperative malocclusion as documented in the medical records. COVARIATES: Covariates were age and sex. ANALYSES: Descriptive statistics were computed. To investigate the influence of the predictor variables on reduction quality, multifactorial analysis of variance with post hoc Tukey test was performed. For malocclusion, χ2 test was performed. The level of significance was set at P < .05. RESULTS: Thirty-eight MSF in 37 subjects were included. Mean age was 32.7 years (range 18 to 64), and 83.8% were male. Mean RRS was 4.38 (standard deviation 0.77). Fixation scheme was the only variable that showed significant impact on RRS: single-straight miniplate had lower scores than double-straight (-1.50, P = .011), rhomboid (-1.29, P = .036), and ladder miniplates (-1.38, P = .048). There was 1 incidence of malocclusion (2.7%) which resolved without intervention. CONCLUSIONS AND RELEVANCE: Favorable reduction (anatomic reduction to mild discrepancies) can be achieved without malocclusion using double-straight, or rhomboid-shaped or ladder-shaped miniplates, without influences from patient or injury-related factors. In contrast, single-straight miniplate fixation resulted in moderate discrepancies in reduction, although it did not lead to malocclusion.

Complications and Associated Risk Factors for Bimaxillary Osteotomies: A 15-Year Single-center Retrospective Study.

AIM: The aim of this study was to retrospectively investigate the risk factors and their association on bimaxillary osteotomies to be able to improve patient selection and bimaxillary osteotomy planning. MATERIAL AND METHODS: Patients treated with a bimaxillary osteotomy were included in the study. The complications were collected retrospectively from the patient data records. The effects of certain predictor variables on complication rates were also studied. RESULTS: Sixty-one patients (48.0%) suffered from peri- or postoperative complications, or both. Twenty-five various perioperative complications were reported on 25 patients (19.6%) and 63 postoperative complications on 46 patients (36.2%). Ten patients (7.8%) suffered from both perioperative and postoperative complications. The effect of various predictor variables (sex, age, general health, type of malocclusion, surgery planning, use of bone grafts, and type of maxillary or mandibular movement) on complications was investigated, but we could not find any single factor to affect significantly on complication rate. CONCLUSION: Both perioperative and postoperative complications are common in bimaxillary surgery, which must be noted in patient preoperative information. However, life-threatening complications are rare. Patient profile, bone grafting, type of osteosynthesis, or segmentation of the maxilla do not seem to affect the complication risk.

Three-dimensional evaluation of the temporomandibular joints after unilateral surgically assisted rapid maxillary expansion in adults: A preliminary retrospective study.

BACKGROUND: Unilateral surgically assisted rapid maxillary expansion (U-SARME) is a successful method for correction of true unilateral posterior crossbite (TUPC). OBJECTIVES: This retrospective preliminary study aimed to evaluate the position and morphology of condyles in TUPC cases and the effects of U-SARME on condyle with the help of cone beam computed tomography (CBCT). METHODS: Fifteen patients (mean age: 18.69 ± 1.59 years) who were diagnosed as TUPC and undergone U-SARME were selected. Preoperative (T0) and after 6-month retention (T1) DICOM data of CBCT images were evaluated with MIMICs version 19.0 software. Condylar morphology (medio-lateral and antero-posterior dimensions) and position (anterior, posterior, medial and lateral joint spaces, frontal/axial axis angles, the ratio of posterior to anterior joint space and the percentage of posterior to anterior joint space) were evaluated. Student's t-test was used for intergroup (crossbite, normal) comparisons. Paired-samples t-test was used for intra-group comparisons (p = .05). RESULTS: There were no positional or dimensional asymmetry of the condyles between crossbite and normal sides initially and after expansion. Regarding T0-T1 changes, while significant increase was determined in medial (0.3 ± 0.29 mm; p = .001) and superior (0.39 ± 0.7 mm; p = .045) joint spaces on crossbite side, posterior (0.79 ± 0.99 mm; p = .008), superior (0.5 ± 0.79 mm; p = .029) and lateral joint spaces (0.31 ± 0.54 mm; p = .042) presented significant increases on normal side. However, no significant changes were found between crossbite and normal sides at T0 and T1. CONCLUSIONS: Condyles were symmetrical in true unilateral posterior crossbite cases and the symmetry were not disrupted following U-SARME.

Does Social Media Affect a Patient's Decision to Undergo Orthognathic Surgery?

Orthognathic surgery, also known as corrective jaw surgery, is a procedure that corrects abnormalities of the jaw and face. It is used to treat malocclusions, where the teeth and jaws are misaligned. This surgery can improve the function and appearance of the jaw and face, leading to improved mastication, speech, and quality of life for the patients. To assess if social media had any effect on the patients' decision to undergo orthognathic surgery, a self-administered online questionnaire was distributed to patients who had undergone orthognathic surgery at the Oral and Maxillofacial department through the health information system (BESTCare, 2.0A) to participate in the study. In total, 111 responses were recorded from the patients, with 107 agreeing to answer the questionnaire and 4 refusing to answer. Twitter was a source of information about orthognathic surgery for 61 patients (57%). When using a social media platform, 3 patients (2.8%) were influenced by an advertisement or an educational post on social media that presented the surgical correction of the jaws, while 15 (14%) believed that they had been somewhat influenced, and 25 (23.4%) picked their surgeon through social media. Fifty-six patients (52.3%) took the neutral position regarding whether information on social media had answered their questions and concerns regarding the surgical procedure. Social media did not influence patients' decision to undergo the procedure. Surgeons and specialists must utilize their platforms to answer any concerns or questions from any patient undergoing or having undergone this corrective jaw surgery.

Maxillary expansion in nongrowing patients. Conventional, surgical, or miniscrew-assisted, an update.

Maxillary transverse deficiency can occur in various clinical dentoskeletal deformities and include unilateral or bilateral posterior crossbite, narrow, tapering, or high palatal arch. The development of temporary anchorage devices led to a new generation of tooth-bone-borne expansion appliance using two or four screws to apply the mechanical forces to the bone and reduce the stress to the anchored teeth. The aim of these new devices is to reduce the adverse dentoalveolar effect and achieve more skeletal expansion than conventional tooth-borne rapid palatal expansion. This article reviews the age limitation and complication and soft tissue change of nonsurgical maxillary expansion. We discuss the approach of surgical maxillary expansion with maxillary skeletal expander device. The clinical case will show the benefit of nonsurgical and surgical tooth-bone-borne rapid palatal expansion.

Three-dimensional Reconstruction and Comparison of Temporomandibular Joint Space Volume Before and After Orthognathic Surgery in Patients with Skeletal Class III Malocclusion With Mandibular Deviation.

OBJECTIVE: To look into the association between the degree of deviation and the changing trend in the temporomandibular joint (TMJ) space volume after orthognathic surgery in patients with skeletal Class III malocclusion. METHODS: Twenty patients having combined orthodontic-orthognathic treatment for skeletal Class III malocclusions with mandibular deviation were chosen, and craniofacial spiral CT was performed before (T0), two weeks after (T1), and six months after (T2) surgery. Using 3D volume reconstruction, further partitioning, and analysis of each domain's volume changes over time, the TMJ space volume is to be obtained. The differences in changes between groups A (mild deviation group) and B (severe deviation group) were examined to examine the impact of the degree of deviation on the TMJ space volume. RESULTS: A statistically significant difference ( P <0.05) existed between the postoperative TMJ space volume in group A and the preoperative overall, anterolateral, and anteroinferior space volume; the same difference also existed between the postoperative TMJ space volume in the NDS and the preoperative posterolateral, posteroinferior space volume. In group B, the postoperative TMJ space volume was statistically significant ( P <0.05) compared with the preoperative total and anteroinferior space volume in the DS; the difference between the total volume of the T1 stage on the NDS and the total volume of the T0 stage was statistically significant ( P <0.05). The two groups showed substantial differences in the space volume changes between the T1-T0 phase and the T2-T1 period. CONCLUSION: Patients with skeletal Class III malocclusion and mandibular deviation after orthognathic surgery see a change in the TMJ space volume. All patient types experience a largely consistent space volume change trend two weeks after surgery, and the degree of mandibular deviation is correlated with the intensity and longevity of the alteration.

A pilot investigation of condylar position and asymmetry in patients with unilateral posterior scissors-bite malocclusion based on three-dimensional reconstructive imaging technique.

OBJECTIVE: Unilateral posterior scissors-bite (uPSB) malocclusion is common clinically. This study aimed to investigate the condylar morphological alterations and condyle-fossa relationship in patients with uPSB, through cone beam computed tomography (CBCT) and three-dimensional reconstructive imaging technique. METHODS: A retrospective study was designed to comparatively analyze 95 patients with uPSB between July 2016 and December 2021. They were divided into three subgroups: 12 to 20, 21 to 30, and ≥ 31 years, according the age distribution. The morphological parameters regarding condyle, fossa, and joint space after three-dimensional reconstruction were measured and analyzed by a series of digital software. SPSS 26.0 software package was performed for statistical analysis on data sets, using paired t-test, one-way analysis of variance, Wilcoxon signed-rank sun test, Kruskal-Wallis H test, and Bonferroni correction. RESULTS: The condylar volume (CV) of scissors-bite side was greater than that of the non-scissors-bite side (CV A = 1740.68 ± 559.80 mm3 > CV N = 1662.25 ± 524.88 mm3, P = 0.027). So was the condylar superficial area (CSA) (CSA A = 818.71 ± 186.82 mm2 > CSA N = 792.63 ± 173.44 mm2, P = 0.030), and the superior joint space (SJS) [SJS A = 2.46 (1.61, 3.68) mm) > SJS N = 2.01 (1.55, 2.87) mm), P = 0.018], and the anterior joint space (AJS) (AJS A = 3.94 ± 1.46 mm > AJS N = 3.57 ± 1.30 mm, P = 0.017). The constituent ratios of the different parts of the bilateral condyles were 23% on the posterior slope, 21% on the top, 20% on the anterior slope, 19% on the lateral slope and 17% on the medial slope, respectively. CONCLUSION: Due to long-term abnormal occlusion of uPSB, the pathological bite force in temporomandibular joint would cause changes in the shape of the condyle. Among them, CV, CSA, SJS and AJS had significant changes in the scissors-bite status, which has the greatest damage to the posterior slope of the condyloid process.

Virtually Guided Palate Lateral Wall, TAD-Supported Expansion in Craniofacial Skeletally Mature Adolescents and Young Adults.

Different temporary anchorage device (TAD)-assisted rapid palatal expanders may be used to treat malocclusions involving the transverse dimension and, in many instances, prevent more complex situations in the future. Each style of expander has advantages and disadvantages. The acrylic type of TAD-supported palate lateral wall expander is a reliable and cost-effective appliance for expansion treatment in adolescents and young adults (ie, aged 13 to 21). In comparison, other palatal expander designs are more suitable for older patients. One advantage of an acrylic TAD-supported palate lateral wall expander system is that it can be used for both orthopedic expansions (ie, nonsurgical TAD-supported only) and surgically assisted rapid palatal expansions (ie, with the aid of minimally invasive corticotomies) in patients who do not respond to nonsurgical expansion. This article presents general diagnostic considerations regarding maxillary transverse deficiencies, discusses the importance of palatal expansion in managing malocclusions, and describes protocols for nonsurgical and surgical management of transverse deficiencies with an acrylic TAD-supported virtually guided palate lateral wall expander.

Occlusal characteristics and oral health-related quality of life in adults operated due to sagittal synostosis in childhood: a case-control study with 26 years of follow-up.

PURPOSE: The aim of this case-control study was to investigate occlusal characteristics, received orthodontic treatment, oral health-related quality of life (OHRQoL), and satisfaction with dental esthetics in adults operated due to sagittal synostosis. METHODS: The study group consisted of 40 adults (25 males, 15 females, mean age 27.4 years, range 18-41) who were operated due to isolated sagittal synostosis in childhood. The control group comprised 40 age and gender-matched adults. Occlusal characteristics were evaluated clinically during study visits. Information on the previous orthodontic treatment was collected from dental records. OHRQoL was measured using the 14-item Oral Health Impact Profile (OHIP-14), and satisfaction with dental esthetics was evaluated using a visual analogue scale. RESULTS: No statistically significant differences were found between the patient group and the controls in malocclusion traits (overjet, overbite, molar relationships, crossbite, scissor bite), previous orthodontic treatment, pre-treatment malocclusion diagnoses, OHIP variables, or satisfaction with dental esthetics. However, there was a tendency toward increased overjet and overbite in scaphocephalic patients. CONCLUSION: It seems that adults with scaphocephaly operated in childhood do not differ from the average population in terms of occlusion, received orthodontic treatment, or oral health-related well-being.

A retrospective analysis of redo orthognathic surgery: Underlying causes, strategy, and outcome.

The aim of this study was to investigate the underlying causes of the need for redo orthognathic surgery, address surgical strategies, and evaluate postoperative outcomes. A retrospective chart review was conducted involving patients who underwent redo orthognathic surgery between January 2018 and April 2020. A total of 32 patients were included in this study. Prior to the procedures, patients' chief complaints were unfavorable facial profile, asymmetry, relapse, malocclusion, obstructive sleep apnea, and long face. To address these issues, we performed redo orthognathic surgery: this resulted in satisfactory aesthetic and functional outcomes in most cases. Considering the challenging nature of a redo orthognathic surgery, it is crucial for surgeons to accurately evaluate the patient's chief complaints and tailor individualized surgical plans to meet the patient's expectations.

Outcome of Surgical Extraction of Linguoverted Deciduous Mandibular Canine Teeth, Performed as an Interceptive Orthodontic Procedure in Puppies, on Permanent Occlusion.

Linguoversion of deciduous mandibular canine teeth can be a painful condition, interferes with the development and growth of the jaws, and potentially leads to further malocclusions affecting permanent dentition. Extraction of linguoverted deciduous mandibular canines is considered an interceptive orthodontic procedure that would allow unimpeded development of the jaws and permanent teeth. This study assessed clinical records of 124 dogs that had linguoverted deciduous mandibular canine teeth surgically extracted between October 2010 and September 2019 in a veterinary dental referral clinic. Seventy-seven cases fulfilled the study criteria. Fifty-one percent of these patients required further orthodontic treatment of the permanent occlusion and forty-nine percent demonstrated atraumatic permanent occlusion. The study found no correlation of the outcome with age at the time of surgery. The class of malocclusion (class 1 or class 2) at the time of surgery was also not associated with the outcome.

Prevalence and associated factors of myofascial pain in orthognathic patients with skeletal class II malocclusion.

Orthognathic patients with skeletal class II malocclusion frequently suffer from myofascial pain (MP). PURPOSE: This study aimed to evaluate the prevalence and associated factors of MP in these patients. METHODS: This cross-sectional study was performed in adult patients with skeletal Class II malocclusion requiring orthognathic surgery. They were divided according to the presence or absence of MP. The predictor variables were craniofacial morphology, sex, temporomandibular disorders, chronic pain, depression, and polymorphisms of dopamine receptors DRD2 (rs6275 and rs6276) and ANKK1 (rs1800497) genes. Data were submitted to statistical analyses using the linear regression model and Poisson regression with a significance level of 0.05. RESULTS: Sixty-five individuals were selected, of which 50 (76.92%) were females. A total of 21 (32.3%) patients had MP. Individuals with MP showed a decrease in the mandible gonial angle (p = 0.042) and an increased risk of having temporomandibular joint (TMJ) disc displacement (p = 0.003), TMJ pain (p = 0.030), chronic pain (p = 0.001), and severe depression (p = 0.015). Additionally, individuals carrying AA and AG genotypes in rs6275, and CC genotype in rs6276, were more likely to have MP (p < 0.05). CONCLUSION: In this study, 32.3% of skeletal class II orthognathic patients had MP, which was associated with a decreased gonial angle, TMJ disc displacement, TMJ pain, chronic pain, depression, and polymorphisms in the DRD2 gene.

Changes in the occlusal function of orthognathic patients with vertical malformations after combined orthodontic surgical therapy: a prospective clinical study.

The aim of this study was to assess the changes in occlusal patterns during combined surgical and orthodontic therapy in patients with vertical jaw malformations. Twenty-six orthognathic patients (18 female, eight male; median age 25 years, interquartile range 11.5 years) and 10 control patients (five female, five male; median age 29.8 years, interquartile range 13.5 years) recruited from neutral configured patients attending the Department of Orthodontics, were investigated. Based on cephalometry, the patients were grouped into vertical skeletal configurations of either open, deep, or natural bite cases. Registrations of the occlusal contacts were taken using a digital occlusal sensor immediately before surgery and at 9 months after the surgical intervention. Before the intervention, open and deep bite patients showed significantly less efficient occlusal patterns than the untreated controls regarding total tooth contact (P < 0.001), time of occlusion (P = 0.002), occlusal asymmetry (P = 0.001), anterior tooth contact (P < 0.001), and posterior tooth contact (P < 0.001). After surgery, the parameters in the deep bite patients were similar to those in the controls; however, in open bite patients, total tooth contact (P = 0.003), occlusal asymmetry (P = 0.011), and posterior tooth contact (P = 0.035) differed significantly. In conclusion, combined orthodontic and surgical correction of vertical malocclusions was found to improve occlusal function in patients with deep bite to the level of controls.