Three-dimensional finite element analysis of temporomandibular joints in patients with jaw deformity during unilateral molar clenching before and after orthognathic surgery

To analyze the effects of orthognathic surgery on stress distributions in the temporomandibular joint (TMJ) of patients with jaw deformity during unilateral molar clenching (UMC) by using three-dimensional (3D) finite element method. Nine patients with jaw deformity (preoperative group, 26.1 ± 5.6 years old) and 9 asymptomatic subjects (control group, 22.0 ± 6.0 years old) were selected. Furthermore, the patients with jaw deformity were also considered as the postoperative group after undergoing orthognathic surgery. Finite element models for the mandible, articular disc, and maxilla were developed through cone beam computed tomography. Contact was used to simulate the interaction of the articular disc, condyle, fossa, and upper and lower dentition. The muscle forces and boundary conditions corresponding to the UMC were applied on the models. The stresses on both TMJs of the control group were significantly different, whereas there was no significant difference on both sides for the preoperative group. All the stresses of the preoperative group were greater than those of the control and postoperative groups, except the minimum principal stress on the ipsilateral fossa. Orthognathic surgery is beneficial for alleviating the abnormal stress distributions on TMJ.