Please use this identifier to cite or link to this item: https://repositorio.ufu.br/handle/123456789/48042
ORCID:  http://orcid.org/0000-0002-3732-715X
Document type: Trabalho de Conclusão de Residência
Access type: Acesso Embargado
Embargo Date: 2028-01-07
Title: Orthognathic surgery and temporomandibular disarrangement: a critical review of a complex relationship and two cases report
Alternate title (s): TMJ Disarrangement and Orthognathic Surgery
Author: Souza, Lívia Medeiros
Peres, Larissa Gonçalves Cunha
Barbosa, Darceny Zanetta
First Advisor: Lima, Felipe Gomes Gonçalves Peres
Summary: Objective: The relationship between orthognathic surgery (OS) and temporomandibular disorders (TMD) remains one of the most complex and debated topics in oral and maxillofacial surgery. This critical review aims to synthesize current evidence regarding the bidirectional relationship between these entities: specifically, how surgical repositioning of the maxillomandibular complex modulates temporomandibular Joint (TMJ) function, and conversely, how the baseline structural integrity of the TMJ dictates the long-term stability of the surgical outcome. Findings indicate that patients with severe skeletal malocclusions exhibit a significantly higher prevalence of preoperative TMD signs and symptoms compared to normognathic controls. The literature concerning the effect of OS on TMD is conflicting; while most patients experience improvement or no change in TMD symptoms post-operatively, a subset experiences worsening symptoms or new-onset TMD. The response is highly variable and often depends on whether the underlying TMD is myogenic or arthrogenic. Crucially, pre-existing joint pathology, such as active condylar resorption or unstable internal derangement, significantly compromises the skeletal stability of OS outcomes, particularly in procedures involving bimaxillary advancement with counterclockwise rotation. Management strategies range from staged approaches, prioritizing joint stabilization before skeletal correction, to simultaneous combined TMJ and orthognathic procedures. Conclusion: OS should not be viewed reliably as a "cure" for TMD, though functional improvements often occur. Conversely, ignoring TMJ pathology can lead to disastrous surgical relapse. A comprehensive evaluation of the TMJ condition using advanced imaging prior to OS is mandatory to select the appropriate treatment sequence and manage patient expectations realistically.
Keywords: Orthognathic Surgery
Temporomandibular Joint Disorders
Dentofacial Deformity
Malocclusion
Joint Stability
Mandibular Condyle
Area (s) of CNPq: CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA::CIRURGIA BUCO-MAXILO-FACIAL
Language: eng
Country: Brasil
Publisher: Universidade Federal de Uberlândia
Quote: SOUZA, Lívia Medeiros, et. al. Orthognathic surgery and temporomandibular disarrangement: a critical review of a complex relationship and two cases report. 2026. 22 f. Trabalho de Conclusão de Residência (Residência em Odontologia) - Universidade Federal de Uberlândia, Uberlândia, 2026.
URI: https://repositorio.ufu.br/handle/123456789/48042
Date of defense: 7-Jan-2026
Appears in Collections:COREMU - TCR - RESIDÊNCIA UNIPROFISSIONAL EM SAÚDE - ODONTOLOGIA

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