Facial nerve and temporomandibular joint functional evaluation after subcondylar fractures Osteosynthesis by rhomboid-plate versus conventional miniplates

Abstract

Aim : This study was conducted to assess the function of temporomandibular joint (TMJ) and the facial nerve after subcondylar fractures Osteosynthesis by three-dimensional 3D-rhomboid plate compared with conventional double miniplates. Patient and methods: 20 patients suffering from unilateral displaced subcondylar fractures were divided randomly into two equal groups. Group, I was reduced and fixed by two miniplates while Group II was reduced and fixed by 3D-rhomboid plate. All patients were diagnosed according to Temporomandibular Dysfunction Diagnostic Research Criteria and classified according to the Helkimo Index. Facial nerve affection was assessed by Hause Brackmann facial nerve grading system. Radiographic evaluation was done using multi-slice CT and Orthopantomogram via condylar morphology scale (CMS) assessment. Postoperative occlusion and masticatory muscles were also assessed. All data collected and statistically analyzed. Results: Results showed non statistically significant difference between groups, regarding mandibular mobility and occlusion status however, TMJ, muscular pain, facial nerve affection, and CMS parameters showed comparable values between both groups in favor of Rhomboid plate group. Conclusion: From the results from the current study we can conclude that 3D-rhomboid plate had good functional TMJ and facial nerve outcomes in comparable to standard two miniplates in management of high subcondylar fracture. .