• Bone mechanics
• Finite element analysis
• Mandible mechanics
• Occlusal plane
• Orthognathic surgery

• Class III dentofacial deformity
• Condylar remodeling
• Condylar resorption
• Orthognathic surgery

• Humans
• Mandibular Condyle/diagnostic imaging
• Mandibular Condyle/pathology
• Malocclusion, Angle Class III/surgery
• Malocclusion, Angle Class III/diagnostic imaging
• Orthognathic Surgical Procedures/methods
• Imaging, Three-Dimensional/methods
• Osteotomy, Sagittal Split Ramus/methods

• Aesthetics
• Botulinum toxin type A
• Gingiva
• Le fort osteotomy
• Orthognathic surgery
• Smile

• Humans
• Smiling
• Female
• Male
• Retrospective Studies
• Adult
• Maxilla/surgery
• Gingiva/anatomy & histology
• Esthetics, Dental
• Botulinum Toxins, Type A/therapeutic use
• Orthognathic Surgical Procedures/methods
• Young Adult
• Neuromuscular Agents/therapeutic use
• Botulinum Toxins/therapeutic use
• Orthodontists
• Dentists/psychology

• idiopathic condylar resorption
• management
• progressive condylar resorption
• treatment

• Oral surgery
• Prognostic
• Treatment

• Humans
• Mandibular Condyle/surgery
• Mandibular Condyle/pathology
• Orthognathic Surgical Procedures/methods
• Temporomandibular Joint Disorders/surgery
• Temporomandibular Joint Disc/surgery
• Temporomandibular Joint Disc/pathology
• Osteoarthritis/surgery

• Humans
• Maxillofacial Abnormalities/surgery
• Malocclusion/surgery

• Adolescent
• Arthroscopy
• Mandibular condyle
• Temporomandibular joint
• Temporomandibular joint disorders

• Bibliometrics
• Citation Analysis
• Orthognathic Surgery
• Scientometrics
• Temporomandibular joint disorders
• Top-cited articles

• Humans
• Orthognathic Surgery
• Osteotomy
• Dental Occlusion
• Language
• Temporomandibular Joint Disorders/epidemiology
• Temporomandibular Joint Disorders/surgery

Temporomandibular joint (TMJ) disorders are closely related to high-angle and skeletal Class II malocclusion. Sometimes pathological changes in the mandibular condyle can cause open bite to occur after growth is complete.

This article is about the treatment of an adult male patient with a severe hyperdivergent skeletal Class II base, an unusual and gradually occurring open bite and an abnormal mandibular condyle anterior displacement. Because the patient refused surgery, four second molars with cavities and root canal therapy were extracted, and four mini-screws were used for intrusion of the posterior teeth. The treatment duration was 22 mo, and after the treatment, the open bite was corrected and the displaced mandibular condyles were seated back to the articular fossa as shown by cone-beam computed tomography (CBCT). Based on the patient’s open bite history, the result of clinical examinations and CBCT comparisons, we believe it is possible that the occlusion interference was eliminated after the four second molars were extracted and the posterior teeth were intruded, and the patient's condyle spontaneously returned to its physiologic position. Finally, a normal overbite was established, and stable occlusion was achieved.

This case report suggested that identifying the cause of open bite is essential, and the TMJ factors for hyperdivergent skeletal Class II cases should be particularly examined. For these cases, intruding posterior teeth may place the condyle in a more appropriate position and provide an environment suitable for TMJ recovery.

• Temporomandibular joint
• Open bite
• Mini-screw
• Condylar displacement
• Case report

• OMENS+
• hemifacial microsomia
• temporomandibular joint disc

• 82071096 National Natural Science Foundation of China
• 82001027 National Natural Science Foundation of China

Disc repositioning by Mitek anchors for anterior disc displacement (ADD) combined with orthognathic surgery gained more stable results than when disc repositioning was not performed. But for hypoplastic condyles, the implantation of Mitek anchors may cause condylar resorption. A new disc repositioning technique that sutures the disc to the posterior articular capsule through open incision avoids the implantation of the metal equipment, but the stability when combined with orthognathic surgery is unknown. The purpose of this study was to evaluate the stability of temporomandibular joint (TMJ) disc repositioning by open suturing in patients with hypoplastic condyles when combined with orthographic surgery.

Patients with ADD and jaw deformity from 2017 to 2021 were included. Disc repositioning by either open suturing or mini-screw anchor were performed simultaneously with orthognathic surgery. MRI and CT images before and after operation and at least 6 months follow-ups were taken to evaluate and compare the TMJ disc and jaw stability. ProPlan CMF 1.4 software was used to measure the position of the jaw, condyle and its surface bone changes.

Seventeen patients with 20 hypoplastic condyles were included in the study. Among them, 12 joints had disc repositioning by open suturing and 8 by mini-screw anchor. After an average follow-up of 18.1 months, both the TMJ disc and jaw position were stable in the 2 groups except 2 discs moved anteriorly in each group. The overall condylar bone resorption was 8.3% in the open suturing group and 12.5% in the mini-screw anchor group.

Disc repositioning by open suturing can achieve both TMJ and jaw stability for hypoplastic condyles when combined with orthognathic surgery.

• Anterior disc displacement
• Disc repositioning
• Jaw deformity
• Orthognathic surgery
• Temporomandibular joint

Background: Idiopathic condylar resorption (ICR) is an aggressive degenerative disease of the temporomandibular joint that is most frequently observed in teenage girls. However, no specific cause of ICR has been identified. To explore the specific causes of the onset and progression of ICR, we performed a survey-based study on ICR in orthodontic patients and described its subjective symptoms, clinical signs, and condylar morphological features. Methods: A total of 1735 participants were recruited from 2193 orthodontic patients. For each participant, subjective symptoms and clinical signs of temporomandibular disorders (TMDs) were evaluated through clinical examination and a questionnaire. Furthermore, three-dimensional computed tomography (CT) was performed to diagnose ICR. Results: Among the 1735 patients evaluated, ICR was present in two male and ten female patients. All 12 patients had maxillary protrusion and an anterior open bite. Four patients with ICR underwent orthodontic treatment. Based on CT findings, patients with ICR had significantly different condylar sizes and shapes from patients with TMDs alone. Conclusions: The coexistence of intrinsic and extrinsic factors, such as sex-hormone imbalance and a history of orthodontic treatment, might lead to the onset of ICR. We suggest that growing patients suspected of having ICR should undergo CT evaluation because CT findings may precede clinical symptoms and signs.

• condylar displacement
• orthognathic surgery

• Humans
• Mandibular Condyle/surgery
• Orthognathic Surgery
• Orthognathic Surgical Procedures/adverse effects
• Postoperative Period

• Craniofacial microsomia
• Distraction osteogenesis
• Hemifacial microsomia
• Mandibular distraction
• Midface distraction
• Midface hypoplasia
• Treacher Collins syndrome
• Upper airway obstruction

The purpose of this study was to evaluate the stability on dental and skeletal aspect after surgical advancement and counterclockwise rotation for the correction of the mandibular deficiency in patients with high mandibular plane angle (MPA).

We analyzed the records of patients who had undergone surgical treatment for dentofacial deformities with mandibular deficiency and high MPA. Clinical and radiological data were taken 1 month before surgery (T0), 6 weeks after surgery (T1) and 1 year after surgery (T2). Cephalometric values of the MPA were recorded and compared. The cephalometric changes in the different time periods were defined as follows: A: postsurgical changes (T0–T1), B: one-year changes (T1–T2), and C: short term changes (T0–T2).

Twenty-seven patients had prominent mandibular deficiency with an MPA of over 35° (high angle). The mean age of patients at surgery was 29.7 years. Seven patients had a single jaw procedure, 20 patients had bilateral sagittal split osteotomy (BSSO) combined with a Le Fort I osteotomy, and 14 patients had additional genioplasty. MPA values differed significantly between the time periods (p < 0.05) with an observed relapse of the angle. However, satisfactory clinical improvement was achieved in the dental and skeletal presentation. The overjet improvement was evident from 8.815 ± 2.085 mm (T0) to 3.426 ± 1.253 mm (T2).

Counterclockwise surgical advancement of the mandible to correct mandibular deficiency in patients with a high mandibular plane angle showed an overall acceptable stability during one-year follow-up.

• Computed tomography (CT)
• Condyle
• Disc position
• Sagittal split ramus osteotomy

• Female
• Humans
• Malocclusion, Angle Class III/diagnostic imaging
• Malocclusion, Angle Class III/surgery
• Mandible/diagnostic imaging
• Mandible/surgery
• Mandibular Condyle/diagnostic imaging
• Mandibular Condyle/surgery
• Orthognathic Surgery
• Osteotomy, Sagittal Split Ramus
• Temporomandibular Joint/diagnostic imaging
• Temporomandibular Joint/surgery
• Tomography, X-Ray Computed

• Anterior disc displacement
• Genioplasty
• TMJ anchorage Surgery

Bilateral sagittal split osteotomy (BSSO) is commonly considered as the surgical technique of election for the treatment of skeletal class II with mandibular hypoplasia. After orthognathic surgery, condylar resorption can occur as a surgical relapse, which may affect the temporomandibular joint. Objective: This study aimed to summarise published systematic review that assess if orthognathic surgery with mandibular advancement performed on skeletal class II patients results in condylar form alteration.

A literature search was performed using the electronic databases PubMed, Web of Science, Cochrane Library, Embase along with several sources of grey literature. Selection Criteria: Inclusion criteria were systematic reviews published until December 2019, of skeletal class II patients aged more than 18 years old that underwent BSSO with mandibular advancement surgery. Data collection: The electronic search identified 37 publications. Four publications fulfilled the inclusion criteria and were included in this meta-analysis. Qualitative assessment of the selected studies was performed using the Assessment of Multiple Systematic Reviews – AMSTAR 2 checklist.

Four systematic reviews were included in this review. Despite its low incidence all studies reported condylar resorption. However, there were methodological limitations in all assessed articles.

The alteration of the condylar form may be a consequence of BSSO with mandibular advancement surgery. Additional high quality prospective research assisted by 3D-imaging technology is needed to allow more definite conclusions.

Key words:Evidence-based orthodontics, TMJ, Class II, mandibular advancement, malocclusion, Angle class II.

• Disc displacement
• Finite element
• Mandibular advancement
• Osteotomy
• Stress

• Bone Plates
• Mandible/diagnostic imaging
• Mandible/surgery
• Mandibular Advancement
• Osteotomy
• Temporomandibular Joint/diagnostic imaging

• Adult
• Cephalometry
• Female
• Humans
• Malocclusion
• Maxilla
• Micrognathism
• Open Bite
• Orthodontics, Corrective

The purpose of this study was to confirm the 5-year efficiency of temporomandibular joint (TMJ) anchorage, using clinical evaluation and magnetic resonance imaging (MRI). We also studied the influence of disc length and position on efficiency and postoperative condylar height. Sixty-one patients (76 joints) undergoing TMJ disc anchorage were followed up for >5 years. Visual analogue scale (VAS) score and maximum mouth-opening pre-and postsurgery were analysed and patient satisfaction recorded. Disc length, condyle height and disc position pre- and postsurgery were measured using MRI. Patients were ranked as A, B or C degree according to postoperative disc condyle position. Mean follow-up time was 71.34 months. Maximum mouth-opening improved by 14.34 ± 5.87 mm, and VAS score decreased by 33.44 ± 20.56 (P < 0.05). Clinical evaluation efficiency was 84.21%; patient satisfaction rate was 85.53%. On follow-up MRI, 68 joints were judged A or B degree (89.67%). Disc length was 7.96 ± 1.38 mm, 7.10 ± 1.41 mm and 5.75 ± 1.16 mm in A, B and C groups, respectively. In patients evaluated as C, condylar height decreased by 0.43 ± 1.36 mm, while increasing by 0.67 ± 1.88 mm and 0.51 ± 1.09 mm in A and B groups, respectively (all P < 0.05). We concluded that anchorage surgery improves mouth-opening and eliminates pain, longer disc length is related to better postoperative disc position, and significant condylar reconstruction occurs after disc repositioning. MRI confirmed that TMJ disc anchorage is reliable 5 years postsurgery.

This study aims to establish a new staging system of temporomandibular joint (TMJ) anterior disc displacement (ADD) and evaluate its role in guiding the treatment plan. A consecutive sample of 522 juvenile patients (780 joints) diagnosed as ADD based on magnetic resonance imaging (MRI) was included and analyzed. 674 joints received TMJ treatments according to our staging system, while 106 joints rejected any treatment; only for follow-up. The outcomes were judged according to our success criteria. The prognosis of our staging system was also evaluated in comparison to Wilkes classification. Kaplan–Meier survival analysis showed that significant stratifications of the ameliorative rate were found at all subgroups within any two stages in our staging system, except for subgroups between stages 0 and 1, stages 2 and 3, and stages 3 and 4. After analyzing the interactions between different candidate prognostic factors in a Cox model, the relative risks of deterioration of ADD included treatment methods (HR = 42.94, P < 0.0001), disease course (HR = 0.98, P = 0.0019), stages of ADD (HR = 3.81, 9.62, 12.14, P = 0.016, 0.000,0.000 respectively for stage 2, stage 3 and stage 4) and the interaction between ADD stages and treatment methods. The C index of this model was 0.87. The new staging system of TMJ ADD appears reliable, and benefits to making treatment planning and predicting the prognosis.

• Adolescent internal condylar resorption (AICR)
• Mitek anchor
• disc repositioning
• high occlusal plane angle
• mandibular condylar resorption
• mandibular condyle
• orthognathic surgery
• temporomandibular joint (TMJ)

• AICR
• Adolescent internal condylar resorption
• Mitek anchor
• condylar resorption
• counterclockwise rotation
• mandibular condyle
• maxillofacial surgery
• temporomandibular joint

• BSSO
• Case control
• Meta analysis
• Orthognathic surgery
• TMD

• cone beam computed tomography
• mandibular condyle
• orthognathic surgery

• Environmental intolerance
• IIHWOP
• Idiopathic intracranial hypertension
• Maxillomandibular advancement
• Multiple chemical sensitivity
• Obstructive sleep apnea
• Pseudotumor cerebri
• Upper airway resistance syndrome

• Magnetic resonance imaging
• Mandibular setback
• Sagittal split ramus osteotomy
• Temporomandibular joint

The aim of this study was to better understand how surgical repositioning and stabilization of anteriorly displaced articular discs using the Mitek mini-anchor technique affects condylar growth in growing patients with adolescent internal condylar resorption (AICR).

Twenty-two adolescent patients diagnosed with AICR and anterior temporomandibular disc displacement were compared to untreated control subjects without AICR matched for age, sex, and Angle classification. Pre-surgical (T1 and T2) and post-surgical (T3 and T4) mandibular tracings were superimposed on natural stable structures to evaluate the horizontal, vertical, and total changes in the position of condylion.

The treated group showed an overall decrease in condylar height pre-surgically and statistically significant changes in condylar growth direction between the pre- and post-surgical observation periods. Pre-surgically, the treated group showed significantly more posterior condylar growth than the control group; they also showed inferior condylar growth, while the controls showed superior growth. Controls and patients in the treated group showed no significant differences in condylar growth post-surgically.

Adolescent patients diagnosed with AICR and anterior disc displacement treated with mandibular ramus and maxillary osteotomies, along with Mitek anchors to reposition internally deranged discs, showed post-surgical normalization of condylar growth.