## 4 Discussion  
The impact of temporomandibular disorders (TMD) on overall quality of life is substantial, causing significant functional limitations, such as difficulties in eating, speaking, or sleeping [18]. The chronic pain associated with TMD can also lead to psychological issues including depression, anxiety, and social isolation [22]. In addition to the physical and emotional toll, TMD imposes a significant economic burden due to medical expenses, loss of productivity, and reduced quality of life [23]. This impact on individuals and society underscores the need for effective management and therapeutic strategies. Consequently, a crucial treatment goal is to preserve or improve joint health in any dental intervention. Previous studies [18; 20; 24; 25; 26; 27; 28; 29] have reported conflicting results regarding the effect of orthognathic surgery on TMD, and research on the optimal surgical approach for TMD remains limited [24; 25; 26]. Moreover, the existing literature lacks systematic reviews that comprehensively assess the impact of different orthognathic interventions and surgical modalities on TMD [18]. There is also no consensus in the literature regarding the role of orthognathic surgery in reducing or eliminating TMD symptoms. Some studies have associated orthognathic surgery with the onset of TMD, but its impact on signs and symptoms remains debatable [18]. Some authors argue that patients with joint disorders before surgery may experience significant worsening of symptoms afterward [27], while others highlight a 10-12% risk of increased joint symptoms following surgery [20; 28]. Studies examining the variation of TMD in patients undergoing orthognathic surgery for open bite correction have found that TMD did not significantly change after the intervention [29]. [PERSON] et al. [30] argue that individuals who already have temporomandibular joint (TM) dysfunction before treatment are more likely to experience worsening conditions after orthognathic surgery, particularly following mandibular advancement. In the sample we analyzed, no patient showed significant deterioration in joint health; rather, overall symptoms decreased or remained unchanged. Specifically, the number of patients with joint clicks decreased, as did the presence of TMJ pain, pain in masticatory and cervical muscles, headaches, and parafunctions such as clenching and bruxism. The only parameter that remained unchanged was episodes of joint locking: three patients experienced this before surgery, and three patients reported a single episode after surgery. The collected data were statistically analyzed using the McNemar Test to assess whether our treatment influenced the outcomes. For statistical purposes, values reported as \"decreased\" were considered as \"absent\", indicating that the treatment trend was correct. From the statistical analysis, we can conclude that the changes observed are significantly associated with the treatment performed, except for the Locking variable. The maximum mouth opening values before and after the intervention decreased: the average initial value was 51.46 mm, while the final value was 46.82 mm. The statistical analysis also confirms a significant association between the data variation and the intervention. Despite the decrease observed in the follow-up, the value remains well within the physiological range of mouth opening, typically greater than 35-40 mm [31]. This decrease can be attributed to the fact that maximum mouth opening is measured as the distance between the upper and lower incisal edges: correcting an open bite naturally reduces this measurement. It would be interesting to assess these data over a longer period to determine if the reduction in opening is lasting or if it is due to the new muscular arrangement resulting from the treatment. The collected data indicate that not only did the majority of examined patients not experience worsening of temporomandibular disorders (TMD), but also that most benefited from orthognathic surgery in terms of joint health and function.