Advertisement

Clinical Oral Investigations

, Volume 23, Issue 9, pp 3437–3444 | Cite as

Early and long-term changes in the muscles of the mandible following orthognathic surgery

  • Alina Coclici
  • Mihaela HedeşiuEmail author
  • Simion Bran
  • Mihaela Băciuţ
  • Cristian Dinu
  • Horatiu Rotaru
  • Raluca Roman
Review
  • 31 Downloads

Abstract

Objectives

The aim of the present study is to evaluate the early and long-term postoperative dimensional changes of the muscles of the mandible in patients with orthognathic surgery for class II and class III malocclusions by using ultrasonography (US).

Material and methods

Twenty-six patients who underwent bimaxillary orthognathic surgery for class II or class III malocclusions (14 and 12 patients, respectively) were ultrasonographically examined. The length, width, and cross-sectional area of the masseter and suprahyoid muscles were measured at three different time points: T0 (preoperatively), T1 (early postoperatively at 1 month after the surgery), and T2 (late postoperatively at 9 months). A repeated measures ANOVA was used to calculate statistically significant dimensional changes of the mandibular muscles.

Results

Statistically significant dimensional changes were found postoperatively in class II malocclusion patients only. The digastric muscle showed higher values for the length and lower values for the width (p < .05) at T1. The geniohyoid muscles were higher in length at T1 and lower in cross-sectional area (CSA) (p < .05) at T2. A decreased measured length and an increased measured width were found in case of the mylohyoid muscle (p < .05) at T2. The early and long-term postoperative dimensional changes of the masseter muscle were not statistically significant.

Conclusions

The mandibular muscles showed a variable adaptive response to the orthognathic surgery. US should be considered for the long-term follow-up of muscular dimensional changes in class II malocclusion patients.

Clinical relevance

From a clinical perspective, US is a reliable, non-invasive, and widely available method, which allows monitoring the postoperative muscular changes occurring in class II malocclusion patients.

Keywords

Orthognathic surgery Masseter muscle Suprahyoid muscles Ultrasonography 

Notes

Funding

This work was supported by the Department of Oral & Maxillofacial Surgery, University of Medicine and Pharmacy, Cluj Napoca, Romania.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study (approval number 126/18.03.2017).

References

  1. 1.
    Upadhyaya C, Baliga M, Shetty P (2013) Soft tissue changes after orthognathic surgery: a study. Orthod J Nepal 1(1):47–51CrossRefGoogle Scholar
  2. 2.
    Ellis E, Carlson DS (1990) Neuromuscular adaptation after orthognathic surgery. Oral Maxillofac Surg Clin North Am 2:811–830Google Scholar
  3. 3.
    Gassamann CJ, Van Sickels JE, Thrash WJ (1990) Causes, location and timing of relapse following rigid fixation after mandibular advancement. J Oral Maxillofac Sum 48:450–454CrossRefGoogle Scholar
  4. 4.
    Rawford JGC, Stoelinga PJW, Blijdorp PA, Brouns JJA (1994) Stability after reoperation for progressive condylar resorption after orthognathic surgery: report of seven cases. J Oral Maxillofac Surg 52:460–466CrossRefGoogle Scholar
  5. 5.
    Merkx MAW, Van Damme PA (1994) Condylar resorption after orthognathic surgery. J Craniomaxillofac Surg 22:53–58CrossRefGoogle Scholar
  6. 6.
    Hannam AG, McMillan AS (1994) Internal organization in the human jaw muscles. Crit Rev Oral Biol Med 5(1):55–89CrossRefGoogle Scholar
  7. 7.
    Stålberg E, Eriksson PO, Antoni L, Thornell LE (1986) Electrophysiological study of size and fiber distribution of motor units in the human masseter and temporal muscles. Arch Oral Biol 31:521–527CrossRefGoogle Scholar
  8. 8.
    Eriksson PO, Thornell LE (1983) Histochemical and morphological muscle-fiber characteristics of the human masseter, the medial pterygoid and the temporal muscle. Arch Oral Biol 28:781–795CrossRefGoogle Scholar
  9. 9.
    Van Eijden TMGJ, Turkawski SJJ (2001) Morphology and physiology of masticatory muscle motor units. Crit Rev Oral Biol Med 12:76–91CrossRefGoogle Scholar
  10. 10.
    Grünheid T, Langenbach GE, Korfage JA, Zentner A, Van Eijden TM (2009) The adaptive response of jaw muscles to varying functional demands. Eur J Orthod 31(6):596–612CrossRefGoogle Scholar
  11. 11.
    Majourau A (1993) Effects of orthognathic surgery on masticatory muscle function. Masters Theses, University of ConnecticutGoogle Scholar
  12. 12.
    Pearson WG Jr, Langmore SE, Zumwalt AC (2011) Evaluating the structural properties of suprahyoid muscles and their potential for moving the hyoid. Dysphagia 26(4):345–351CrossRefGoogle Scholar
  13. 13.
    Poulton DR, Ware WH (1971) Surgical-orthodontic treatment of severe mandibular retrusion. Am J Orthod 59(3):244–265CrossRefGoogle Scholar
  14. 14.
    Carlson DS, Ellis E, Dechow PC (1987) Adaptation of the suprahyoid muscle complex to mandibular advancement surgery. Am J Orthod Dentofac Orthop 92:134–143CrossRefGoogle Scholar
  15. 15.
    Katsumata A, Fujishita M, Ariji Y, Ariji E, Langlais RP (2004) 3D CT evaluation of masseter muscle morphology after setback osteotomy for mandibular prognathism. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98:461–470CrossRefGoogle Scholar
  16. 16.
    Dicker G, Van Spronsen P, Van Schijndel R, van Ginkel F, Manoliu R, Boom H, Tuinzing DB (2007) Adaptation of jaw closing muscles after surgical mandibular advancement procedures in different vertical craniofacial types: a magnetic resonance imaging study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103(4):475–482CrossRefGoogle Scholar
  17. 17.
    Van Spronsen PH, Weijs WA, Valk J, Prahl-Andersen B, van Ginkel FC (1991) Relationships between jaw muscle cross-sections and craniofacial morphology in normal adults, studied with magnetic resonance imaging. Eur J Orthod 13(5):351–361CrossRefGoogle Scholar
  18. 18.
    Raadsheer MC, van Eijden TM, van Spronsen PH, van Ginkel FC, Kiliaridis S, Prahl-Andersen B (1994) A comparison of human masseter muscle thickness measured by ultrasonography and magnetic resonance imaging. Arch Oral Biol 39(12):1079–1084CrossRefGoogle Scholar
  19. 19.
    Serra MD, Duarte Gavião MB, dos Santos Uchôa MN (2008) The use of ultrasound in the investigation of the muscles of mastication. Ultrasound Med Biol 34(12):1875–1884CrossRefGoogle Scholar
  20. 20.
    Kremkau FW, Taylor KJ (1986) Artifacts in ultrasound imaging. J Ultrasound Med 5:227–237CrossRefGoogle Scholar
  21. 21.
    Reis Durão AP, Morosolli A, Brown J, Jacobs R (2017) Masseter muscle measurement performed by ultrasound: a systematic review. Dentomaxillofac Radiol, 46(6): 20170052Google Scholar
  22. 22.
    Lee DH, Yu HS (2012) Masseter muscle changes following orthognathic surgery: a long-term three-dimensional computed tomography follow-up. Angle Orthod 82(5):792–798CrossRefGoogle Scholar
  23. 23.
    Yellich GM, McNamara JA Jr, Ungerleider JC (1981) Muscular and mandibular adaptation after lengthening, detachment, and reattachment of the masseter muscle. J Oral Surg 39(9):656–665Google Scholar
  24. 24.
    Yamashita AL, Iwaki Filho L, Leite PCC, Navarro RL, Ramos AL, Previdelli ITS, Ribeiro MHDM, Iwaki LCV (2017) Three-dimensional analysis of the pharyngeal airway space and hyoid bone position after orthognathic surgery. J Craciomaxillofac Surg 45(9):1408–1414CrossRefGoogle Scholar
  25. 25.
    Emshoff R, Bertram S, Strobl H (1999) Ultrasonographic cross-sectional characteristics of muscles of the head and neck. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 87(1):93–106Google Scholar
  26. 26.
    Geers C, Nyssen-Behets C, Cosnard G, Lengele B (2005) The deep belly of the temporalis muscle: an anatomical, histological and MRI study. Surg Radiol Anat 27(3):184–191CrossRefGoogle Scholar
  27. 27.
    Toro-Ibacache V, Zapata MuÑoz V, O'higgins P (2015) The predictability from skull morphology of temporalis and masseter muscle cross-sectional areas in humans. Anat Rec (Hoboken) 298(7):1261–1270CrossRefGoogle Scholar
  28. 28.
    Rowlerson A, Gwénaël R, Yousif D, Close J, Maurage CA, Ferri J, Scioteg JJ (2005) Fiber-type differences in masseter muscle associated with different facial morphologies. Am J Orthod Dentofac Orthop 127(1):37–46CrossRefGoogle Scholar
  29. 29.
    Eriksson PO, Eriksson A, Ringqvist M, Thornell LE (1982) Histochemical fibre composition of the human digastric muscle. Arch Oral Biol 27(3):207–215CrossRefGoogle Scholar
  30. 30.
    Breuel W, Krause M, Schneider M, Harzer W (2013) Genetic stretching factors in masseter muscle after orthognathic surgery. Br J Oral Maxillofac Surg 51(6):530–535CrossRefGoogle Scholar
  31. 31.
    Poulton DR, Ware WH (1973) Surgical-orthodontic treatment of severe mandibular retrusion. II. Am J Orthod 63(3):237–255CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Oral RadiologyUniversity of Medicine and PharmacyCluj NapocaRomania
  2. 2.Department of Maxillofacial SurgeryUniversity of Medicine and PharmacyCluj NapocaRomania

Personalised recommendations