Temporomandibular disk position after orthognathic surgery: A systematic review

Abstract

Orthognathic surgery corrects dentofacial deformities by repositioning maxillary and mandibular bones. This review examined whether orthognathic surgery changes temporomandibular (TM) disk position. Databases searched on November 30, 2023 included Web of Science, PubMed, Scopus, Embase, Cochrane, and Google Scholar. Inclusion criteria were studies of orthognathic surgery in individuals with maxillomandibular deformities reporting on TM disk position. Risk of bias was assessed using Cochrane Risk of Bias 2 and Newcastle-Ottawa scales. From 948 retrieved articles, 31 were included. Bilateral sagittal split osteotomy (BSSO) was the most common mandibular osteotomy technique and largely maintained disk position post-operatively. Intraoral vertical ramus osteotomy (IVRO) appeared to improve disk position, though studied less extensively. Overall, surgery had conflicting effects on disk position; quantitative methods showed little change. Limitations were small sample sizes and lack of standardization in assessing disk position. In conclusion, orthognathic surgery does not consistently alter TM disk position, though IVRO may confer some benefit. Larger, standardized studies are needed to better understand effects on TM joint status.