Edition V15N01 | Year 2016 | Editorial TMD and Orofacial Pain | Pages 18 to 23
During orthognathic surgery, whenever the mandible moves forward and is secured in its new position, adjacent tissues are stretched and tend to move the distal segment back to its former position. The amount of mandibular forward movement and the degree of maxillomandibular counterclockwise rotation, in addition to the stiffness of the fixture technique contribute to increase the load acting over the temporomandibular joint (TMJ), thus interfering in its final position and integrity. The response to such a load is usually adaptive, and includes physiological condylar bone and temporal fossa remodeling, which might or might not be associated with transient processes of arthralgia and functional impairment. There might occasionally be more significant destruction of the condylar cartilage and underlying subchondral bone, thus exceeding the limits of adaptive tolerance and speeding up the development of skeletal and occlusal changes, a phenomenon also known as post-surgical condylar resorption (PSCR).