Magnetic resonance imaging evaluation of articular disk position after orthognathic surgery with or without concomitant disk repositioning: a retrospective study

Objective: The aim of this study was to compare the outcomes of 2 surgical treatment options: one for correction of class II malocclusion skeletal deformity and one for pre-existing temporomandibular joint (TMJ) disorders requiring orthognathic surgery (OS) for correction of dentofacial deformity. Study Design: This retrospective study evaluated patients who underwent OS with maxillomandibular advancement (MMA) with or without concomitant TMJ surgery for articular disk repositioning (ADR). Patients were divided into 2 groups: group I (MMA) was treated with OS only (18 patients); and group II (MMA-ADR) was treated with OS and concomitant ADR (19 patients). The sample consisted of 74 TMJs (mean patient age 29.86 years). Results: In group I, 38.5% of the disks that were originally in normal position became displaced after OS, and 33.3% of displaced disks with reduction became nonreducing after OS. In group II, 78.9% of disks exhibited normal position in the final evaluation, and 97.3% of patients showed improved disk position after surgery. There was significant symptom improvement in all patients in group II, but no significant improvement in group I. Conclusions: OS with ADR appears to produce stable and beneficial results in improving symptoms in patients with displaced disk and TMJ pain.