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Informationen aus Orthodontie & Kieferorthopädie 2021; 53(04): 291-294
DOI: 10.1055/a-1653-3779
Übersichtsartikel

Orthognathe Chirurgie und CMD – was ist erwiesen?

Orthognathic Surgery and CMD – What is the Evidence?
Andreas Kolk
1   Klinik für Mund-Kiefer-Gesichtschirurgie, Medizinische Universität Innsbruck, Österreich
,
Benjamin Walch
1   Klinik für Mund-Kiefer-Gesichtschirurgie, Medizinische Universität Innsbruck, Österreich
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Zusammenfassung

Kraniomandibuläre Dysfunktionen (CMD) und deren Stellenwert für die orthognathe Chirurgie (OGC) wurden in den letzten Jahren kontrovers diskutiert. Das durch vielfältige Symptome gekennzeichnete Bild einer CMD hat funktionelle und psychogene Einflüsse und beeinträchtigt die Lebensqualität der Betroffenen. Ätiologie und Pathophysiologie der CMD sind nur teilweise verstanden; die Fluktuation der CMD-Symptome mit On- und Off-Phasen erschwert die Analyse unter Studienbedingungen. Ob OGC eine CMD verbessert oder gar verschlechtert ist die Kardinalfrage, die sich stellt und auf die dieser Übersichtsartikel eine Antwort geben soll. Obwohl zahlreiche Studien zu diesem Themenbereich vorliegen, ist die Beantwortung der Frage des Kausalzusammenhanges zwischen CMD und OGC nicht eindeutig möglich. Der überwiegende Teil der Studien unterstützt die Annahme, dass eine CMD durch OGC eher verbessert wird. Relativ einig ist man sich auch dabei, dass eine vor OGC bestehende CMD präoperativ beseitigt bzw. zumindest deutlich gemildert werden muss, da es sonst zu einer Symptomverstärkung kommen kann. Zusätzlich werden Risikofaktoren beleuchtet, die eine OGC-bedingte CMD begünstigen können.

Abstract

Craniomandibular dysfunctions (CMD) and their significance for orthognathic surgery (OGC) have been controversially discussed in recent years. Characterized by multiple symptoms, CMD has functional and psychogenic influences and compromises the quality of life of affected individuals. The etiology and pathophysiology of CMD are only partially understood; the fluctuation of CMD symptoms with on and off phases complicates analysis under study conditions. Whether OGC improves or even worsens CMD is the cardinal question that arises and to which this review article aims to provide an answer. Although numerous studies are available on this topic, the answer to the question of the causal relationship between CMD and OGC is not clear-cut. The majority of studies support the assumption that CMD tends to be improved by OGC. There is also relative agreement that CMD existing prior to OGC must be eliminated or at least significantly alleviated preoperatively, otherwise symptoms may be increased. In addition, risk factors are highlighted that may promote OGC-related CMD.

Schlüsselwörter

Orthognathe Chirurgie - Craniomandibuläre Dysfunktion - Kiefergelenk - Risikofaktoren

Key words

orthognathic surgery - craniomandibular dysfunction - temporomandibular joint - risk factors


Publication History

Article published online:
08 December 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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