Genetic stretching factors in masseter muscle after orthognathic surgery

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Wiebke Breuel - , TUD Dresden University of Technology (Author)
  • Micaela Krause - , Orthodontic Clinic (Author)
  • Matthias Schneider - , Department of Oral and Maxillofacial Surgery (Author)
  • Winfried Harzer - , Orthodontic Clinic (Author)

Abstract

Up to 30% of patients relapse after orthognathic operations, and one reason might be incomplete neuromuscular adaptation of the masticatory muscles. Displacement of the mandible in sagittal or vertical directions, or both, leads to stretching or compression of these muscles. The aim of this study was to analyse stretching factors in 35 patients with retrognathism or prognathism of the mandible (Classes II and III). Tissue samples were taken from both sides of the masseter muscle (anterior and posterior) both before and 6 months after operation. Developmental myosin heavy chains MYH3 and MYH8, the fast and slow MYH 1, 2, and 7, and cyclo-oxygenase (COX) 2, forkhead transcription factor (FOX)O3a, calcineurin, and nuclear factor of activated T cells (NFAT)1c (stretching and regeneration-specific), were analysed by real time polymerase chain reaction (PCR). Correlations of Class II and III with sagittal and vertical cephalometric measurements ANB and ML-NL-angle were examined, and the results showed significant differences in amounts of MYH8 (p < 0.05), MYH1 (p < 0.05), and FOXO3a (p < 0.05) between the 2 groups. Regeneration factor COX2 is more dominant in Class II. Surgically, bite opening (ML/NL angle) correlated with stretching indicators FOXO3a, calcineurin, and NFAT1c only in Class II patients. This means that stretching of the masseter muscle caused by lengthening of the mandible and raising of the bite in Class II patients was more likely to lead to relapse (similar to that in patients with open bite) than in Class III patients. In conclusion, deep bite should be reduced more by incisor intrusion than by skeletal opening. The focus in these patients should be directed towards physiotherapeutic strengthening of the muscles of mastication, and more consideration should be given to change in the vertical dimension.

Details

Original languageEnglish
Pages (from-to)530-535
Number of pages6
JournalBritish Journal of Oral and Maxillofacial Surgery
Volume51
Issue number6
Publication statusPublished - Sept 2013
Peer-reviewedYes

External IDs

PubMed 23280152

Keywords

Keywords

  • Co-oxygenase, Craniofacial biology/genetics, Deep bite, Functional morphology, Mastication muscle, Maxillofacial surgery, Muscle stretching