Masticatory dysfunction with rigid and nonrigid osteosynthesis of sagittal split osteotomies.

T emporomandibular joint and masticatory muscle dysfunction prior to and following bilateral sagittal split osteotomy (BSSO) of the mandible is not well documented. The effect, if any, that the type of internal fixation used has on dysfunctional symptoms is unclear. Several authors have concluded that the TMJ does not appear to be affected following a BSSO with wire osteosynthesis. 1-S However, Freihofer and Petresevic? noted that 16 of 38 patients experienced TMJ clicking after a BSSO advancement of the mandible with wire osteosynthesis. One patient reported pain in one joint, which radiographically displayed signs of arthrosis. Schendel and Epker,’ in a multi-institutional study, documented TMJ noise in 12 of 7 1 patients and TMJ pain in one after BSSO advancement. They concluded that there was no increased