To Assess the Effect of Trauma on the Temporomandibular Joint in Postoperative Cases of Zygomaticomaxillary Complex Fractures.

Abstract

The study aims to assess the incidence and features of temporomandibular joint(TMJ) dysfunction in post-surgical treatment of unilateral zygomaticomaxillary complex(ZMC) fractures.The objectives are:To assess severity of TMJ dysfunction in postoperative cases of ZMC fractures.To create awareness of the same among clinicians. Patients presenting with zygomaticomaxillary complex fractures were evaluated prospectively. Evaluation of TMJ dysfunction was done by different parameters via questionnaire, clinical and radiographic examination preoperatively and a follow-up period of 1week, 3months and 6months. The parameters were, clicking of joint, pain on opening /closing, pain on biting, deviation of mandible, pain in the preauricular region, ringing sound and mouth opening. Statistical analysis was done by the Friedman test and Post Hoc analysis. On presentation, 69.1% patients diagnosed with ZMC fractures presented with symptoms related to TMJ dysfunction. Post-surgery 1week majority findings persisted, with 21 patients complained of pain on opening or closing and 2 patients with a persistent opening click. These symptoms, however, decreased over the 3month and 6month follow up period. 5 patients presented with decreased mouth opening which was attributed to lack of adequate physiotherapy. Patients presented with mild symptoms of TMJ dysfunction until 6months post-surgery, however these symptoms weren't significant as the pain score assessed was found to decrease in the following post-operative periods. And the symptoms present were'nt exclusive to conclude a TMJ dysfunction. Early treatment and a close follow up are key to prevent progression of symptoms.