[Orthodontic treatment of adults--luxury or necessity?].
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Biomedical subjects
Publications and source records attributed to M Sostmann.
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86 patients with dentofacial anomalies were examined to evaluate signs and symptoms of the stomatognathic system after orthognathic surgery. Clinical signs and symptoms were graded according to the anamnestic and clinical dysfunction index of Helkimo. Restriction of mouth opening in 37 patients influenced the anamnestic dysfunction index mainly to higher postoperative levels although the occurrence of symptoms as pain and tmj sounds decreased. No relationship between tmj pain-dysfunction and type of dysgnathia, surgical approach, molar support before and after surgery, age and sex was noted. It is concluded that surgical correction of dentofacial anomalies has a possible benefitialeffect on certain symptoms as tmj pain, but relief or impairment of clinical signs cannot be predicted preoperatively.
256 individuals with inflammatory rheumatic diseases and 117 individuals of two control groups returned their questionnaires in a survey of subjective symptoms of the masticatory system. Subjective symptoms of the temporomandibular joint (tmj) were reported by 41% of the patients with rheumatoid arthritis, 29% of the patients with psoriatic arthritis, 20% of the patients with ankylosing spondylitis and 23% of the patients with other rheumatic diseases (such as Reiter's syndrome). Statistically significant differences (p less than 0.05) regarding the occurrence of "difficulties in opening the mouth wide" and "crepitus from the tmj" were found between the various types of rheumatic arthritis. In 40 patients with rheumatic diseases and tmj-symptoms the tmj was examined clinically, by orthopantomography and lateral tomography. Radiographic abnormalities were found in 68% of the patients and classified by a new radiographic index, according to the index of Steinbrocker. There were no indications for a relationship between a loss of posterior support and extensive radiographic changes of the tmj. The most common objective symptoms were pain on chewing, crepitus in the tmj and tenderness to palpation of the masticatory muscles and neck.