Jaw kinematics during mastication after unilateral fractures of the mandibular condylar process

Abstract

This study compared the mandibular kinematics during mastication of patients treated for unilateral fractures of the mandibular condylar process with those of control subjects. We used a Sirognathograph (Siemens, Bensheim, Germany) to record the chewing cycles of 81 male patients with unilateral condylar process fractures while they chewed a constant bolus unilaterally on the same side as the fracture and on the opposite side. Recordings were made at 6 weeks, 6 months, 1 year, and 2 years after treatment. Similar chewing cycles were recorded for 15 male controls (Class I dental and Class I skeletal occlusion) without fractures of the condylar process. The chewing cycles of both groups were analyzed with a custom computer program, and the duration, excursive ranges, and 3-dimensional cycle shape were compared at each time interval with multilevel linear modeling statistics. Fracture patients had significantly slower chewing cycles, with significantly less maximum excursion toward the working side during the closing phase and significantly greater excursion toward the balancing side during the opening phase than the controls. The opening pathway of the incisors showed greater differences between patients and controls than the closing pathways. Differences in chewing cycle shape persisted for up to 2 years, especially when chewing was on the side opposite the fracture. Unilateral condylar process fractures produce long-lasting changes in chewing cycle duration and chewing cycle shape of adults.