The Helkimo-Index as an instrument of clinical functional analysis in orthognathic surgery

Beside functional and aesthetic aspect in orthognathic surgery pain has not a negligible influence on patients' satisfaction after osteotomies in maxillofacial region. The aim of the present study was to evaluate the influence of craniomandibular disorder on patients' satisfaction after osteotomies.Craniomandibular disorder (CMD) were examined by using the Helkimo-Index (D0-DIII) in a group of patients (n=123; f=78, m=43) after osteotomies. The average follow-up time was 47 months (9-141 months). The performed osteotomies were as follows: 67 bilateral sagittal split osteotomies, 11 LeFort-I osteotomies, 11 bimaxillary osteotomies, 13 segment-osteotomies and 4 isolated genioplasties.In 29.3% (n=36) of the patients no symptom of CMD were found. Mild dysfunction (DI) were seen in 56,8% (n=69), whereas 10.6% (n=13) showed moderate (DII) and 3.3% (n=4) severe (DIII) dysfunction. A statistic relation between the kind of osteotomy and severity of dysfunktion after Helkimo were not found. No influence on patients' satisfaction was statistically evaluated.The use of the Helkimo-Index seems to be an effective and reliable method to evaluate also cranio-mandibular disorders (CMD) after orthognathic surgery. Keywords: intraoral bone defect, cyst, SCHULTE-coagulum, reconstruction