Mandibular Condylar Fractures Research Articles

Open Reduction and Internal Fixation of Mandibular Condyle Fractures Using AUTOFIX 2.0® Cannulated Compression Screw System: A Technical Innovation with Intraoperative CT-Scan

Condylar process fractures remain a matter of ongoing controversy in maxillofacial surgery because of variety of opinions and proposed treatment modalities offered in the literature. The trend is toward open reduction and internal fixation (ORIF) whenever there is displacement or dislocation combined with unstable occlusal conditions. The fundamental treatment goals are anatomical fixation and early return to function. However, ORIF of a fractured condyle carries significant risks, including facial nerve damage, and presents challenges in reducing and stabilizing the fractured segment in an area of limited access. We present here an innovative technique for ORIF of condylar head fractures. It consists in fracture reduction and stabilization with two Kirschner wires followed by osteosynthesis with two cannulated headless compression screws using the AUTOFIX 2.0® system (Stryker, Kalamazoo, USA). This new technique, combined with intraoperative CT scan, ensures satisfactory reduction and stabilization of the dislocated joint segment, thereby restoring the condyle to its physiologically normal position.

Open surgical approach to fractures of the mandibular condyle: surgical technique and associated complications.

This study evaluates anatomical reduction and rigid internal fixation of mandibular condyle fractures using the preauricular retroparotid approach. It also discusses advantages, deficiencies, and associated complications of the technique. This retrospective study reviewed the medical records of a total of 52 mandibular condyle fractures from 42 patients who were treated with open surgery using the preauricular retroparotid approach between January 2019 and January 2024. Preoperative and postoperative assessments included measurements of mouth opening (maximum interincisal distance), vertical mandibular movement, and facial paralysis. Moreover, the Vancouver Scar Scale (VSS) was used to evaluate scar quality at the surgical site. Descriptive statistics were used to summarize patient demographics, preoperative findings, and postoperative outcomes. Anterior open bite was the most common finding, detected in 83% of the patients before surgery. The mean mouth opening of the patients increased significantly from 29 ± 4.94 mm to 37.76 ± 2.12 mm. Vertical mandibular movement exceeding 4 cm was a finding in more than half (52.3%) of the patients. The mean VSS score, indicating scar quality, was 1.64 ± 0.70, suggesting overall good cosmetic outcomes. Plate breakage in two patients was noted as a complication during follow-up. Several surgical techniques have been described for mandibular condyle fractures, each with its own benefits and limitations.

Recent evaluation and analysis of the clinical effect of two closed treatment methods in children with intracapsular condyle fracture

Objective: To summarize and analyze clinical characteristics of pediatric mandibular condylar fractures and the long-term therapeutic effects of closed treatment. Methods: A retrospective study was conducted for pediatric condylar fracture in the Department of Oral and Maxillofacial Surgery of Peking University School and Hospital of Stomatology from October 2015 to October 2019, including 33 males (67.3%) and 16 females (32.7%), with an average age of (8.3±2.1) years old. According to the treatment methods, the children were divided into two groups: group A was a removable occlusal splint accompanied with functional exercise, group B was a pure functional exercise. Forty-nine cases (76 sides) children with intracapsular condylar fracture were included in this study. Twenty-three cases in group A and 26 cases in group B. The maximum month opening increased from (20.0±6.2) mm to (46.0±5.3) mm 6 months after closed treatment. Subjective evaluation, special examination, qualitative analysis and quantitative analysis of imaging were used to evaluate the condylar remodeling and functional recovery of temporomandibular joint in two groups of children after closed treatment of intracapsular condyle fracture. Results: There was no significant difference in subjective evaluation, maximum opening examination, mouth open-type, mandibular protrusion, lateral movement and qualitative analysis of imaging at the six-month follow-up after injury. Quantitative imaging measurements showed that the condylar anteroposterior diameter and condylar height in Group B were significantly higher than those in Group A after 1 year of injury. Conclusions: Closed treatment for pediatric condylar fractures can achieve satisfactory results. After 6 months of injury, the children in the two groups could recover the temporomandibular joint function and promote the condylar adaptative remodeling.

Deferoxamine Accelerates Mandibular Condylar Neck Fracture Early Bone Healing by Promoting Type H VesselProliferation.

Condylar fractures (CFs) are a common type of maxillofacial trauma, especially in adolescents. Conservative treatment of CF avoids the possible complications of surgical intervention, but prolongs the patient's suffering because of the requirement for extended intermaxillary fixation. Therefore, the development of a new strategy to accelerate the rate of fracture healing to shorten the period of conservative treatment is of great clinical importance. To investigate the potential of deferoxamine (DFO) in promoting the healing process of CF in adolescent mice. Thirty-two 4-week-old male C57BL/6J mice were randomly assigned to four groups: vehicle + sham group, vehicle + CF group, DFO + sham group and DFO + CF group. After constructing the mandibular CF model, mandibular tissue samples were collected respectively at 1, 2 and 4 weeks postoperatively. Radiographic and histomorphometric analyses were employed to assess bone tissue healing and vascular formation. Deferoxamine was observed to promote the early bone healing of fracture, both radiologically and histomorphometrically. Furthermore, this enhancement of condylar neck fracture healing was attributed to the upregulation of the hypoxia-inducible factor-1α (HIF-1α) signalling pathway while facilitating the formation of type H vessels. In addition, DFO did not produce significant effects on the condylar neck between vehicle + sham and DFO + sham group. The application of the HIF-1α inducer DFO can enhance type H vessels expansion thereby accelerating condylar neck fracture healing.

Assessment of the trapezoidal miniplate with posterior extension for open management of condylar fractures: Can it be used instead of straight miniplates?

AbstractObjectiveThis study comparatively measures and evaluates the strength of five plating techniques for mandibular condylar fracture fixation when linear loading is applied.Materials and MethodsThe investigators designed and implemented a cross‐sectional in vitro study. The sample was composed of 60 polyurethane mandibles for the mechanical tests. For the photoelastic test, 10 photoelastic mandibles were used. The predictor variable is the plating technique, and it was categorized as groups G2P‐2.0: two 4‐hole 2.0 mm straight plates, G1TP‐2.0: 4‐hole 2.0 mm trapezoidal plate; G1TPPE‐2.0: 4‐hole 2.0 mm trapezoidal plate with posterior extension; G1TP‐1.5: 4‐hole 1.5 mm trapezoidal plate and G1TPPE‐1.5: 4‐hole 1.5 mm trapezoidal plate with posterior extension. The outcome variable is the strength of the plating techniques that was evaluated with the loading test: peak/ending load and peak/ending displacement measures collected. The photoelastic test was used to detect tension distribution throughout the structure helping to understand the material's behaviour. Values of the loading test were analysed using SAS (SAS Institute, Cary, NC, EUA). A p <0.5 (p = 0.05) was considered significant and means were compared using the Tukey test.ResultsThe results indicated that the fixation with two plates presented a higher resistance in the anteroposterior direction and fixation with a trapezoidal plate with posterior extension is more resistant towards mediolateral. The photoelastic analysis showed that the strain lines were best distributed when trapezoidal plates were used.ConclusionAccording to the results, the posterior extension of the trapezoidal plates increased the strength of the fixation system, and the use of trapezoidal plates with or without posterior extension was favourable to a more balanced stress distribution. However, clinical studies must be done to confirm the biomechanical findings.

Two versus three magnesium screws for osteosynthesis of mandibular condylar head fractures: a finite element analysis

ObjectivesPrevious finite element analyses (FEA) have shown promising results for using two titanium screws in treating mandibular condylar head fractures but limited mechanical stability of a two-screw osteosynthesis with magnesium screws. Given the potential benefits of magnesium screws in terms of biocompatibility and resorption, this study aimed to compare two- and three-screw osteosynthesis solutions for a right condylar head fracture (AO CMF type p) with magnesium screws with a FEA.Materials and methodsA previously validated finite element model simulating a 350 N bite on the contralateral molars was used to analyze von Mises stress within the screws, fragment deformation, and fracture displacement. All screws were modeled with uniform geometric specifications mirroring the design of Medartis MODUS® Mandible Hexadrive cortical screws.ResultsThe three-screw configuration demonstrated lower values for all three parameters compared to the two-screw scenario. There was a 30% reduction in maximum von Mises stress for the top screw and a 46% reduction for the bottom screw.ConclusionsFracture treatment with three magnesium screws could be a valuable and sufficiently stable alternative to the established treatment with titanium screws. Further studies on screw geometry could help improve material stability under mechanical loading, enhancing the performance of magnesium screws in clinical applications.Clinical relevanceThe use of magnesium screws for osteosynthesis of mandibular condylar head fractures offers the benefit of reducing the need for second surgery for hardware removal. Clinical data is needed to determine whether the advantages of resorbable screw materials outweigh potential drawbacks in condylar head fracture treatment.

Management of Mandibular Condyle Fractures in Pediatric Patients: A Multicentric Retrospective Study with 180 Children and Adolescents.

Background: Mandibular condyle fractures in pediatric patients can lead to crippling sequelae such as ankylosis, pain and facial deformity if not managed properly. However, there is no consensus on the best approach for treating these fractures in children. Objective: This study aimed to describe the management of mandibular condyle fractures in growing patients across 14 maxillofacial departments worldwide. Methods: A retrospective multicenter study was conducted on children and adolescents aged 0 to 16 who had at least one mandibular condyle fracture. This study included patients who underwent expectant, closed, or open management and were treated over an 11-year period. Results: 180 patients had at least one mandibular condyle fracture, and 37 had a second condylar fracture. One hundred sixteen patients (65%) were males, and 64 (35%) were females (ratio 1.8:1). An expectant strategy was chosen in 51 (28%) patients, a closed treatment-stand-alone maxillomandibular fixation (MMF)-in 47 (26%), and open reduction and internal fixation (ORIF) was performed in 82 (46%) patients. The management varied significantly between the different departments (p < 0.0001). Significant differences were also identified between the fracture type (non-displaced, displaced or comminuted) and the management of the 180 patients with a single condylar fracture. Out of 50 non-displaced fractures, only 3 (6%) had ORIF, 25 (50%) had expectant management, and 22 (44%) had MMF. Out of 129 displaced fractures, 79 (62%) had ORIF, 25 (19%) had a soft diet, and 25 (19%) had MMF. Conclusions: Expectative management, MMF, and ORIF were all effective in treating pediatric mandibular condyle fractures, with a low incidence of complications and asymmetry.

Non-Invasive Management of Mandibular Condyle Fracture with Ramus Shortening Using Low Intensity Pulsed Ultrasound and Hypomochlion Splint

Non-Invasive Management of Mandibular Condyle Fracture with Ramus Shortening Using Low Intensity Pulsed Ultrasound and Hypomochlion Splint

Single versus Double Plate Fixation in Condylar Neck Fractures: Clinical Results and Biomechanics Simulation.

The open reduction of mandibular condyle neck fractures is difficult due to the limited surgical field and complex facial nerve structures. The most effective fixation method for narrow fractured segments is debated as standard double four-hole plate fixation is often not feasible. This research compared bone stability and force resistance between single-long-plate and double-short-plate fixations using clinical outcomes, a Sawbones mandible model, and finite element analysis. In patients with condyle neck fractures, nine were fixed with single-long-plate and twelve with double-short-plate fixations, with no significant differences in malocclusion and facial palsy rates. In compression tests with a Sawbones model, displacements in the posterior part were similar in both fixation groups. In contrast, the anterior part had significantly higher displacements in the single-long-plate group. Finite element analysis showed higher displacements in both anterior and posterior parts in the single-plate group compared to the double-short-plate group. Maximum stresses were at the second screw hole in single-long-plate fixation and the turning point of the upper plate at the condyle neck in double-short-plate fixation. Double-short-plate fixations demonstrated better stability and force resistance than single-long-plate fixations.

COMPLICATIONS OF CONSERVATIVE AND SURGICAL TREATMENT OF FRACTURES OF THE MANDIBULAR CONDYLAR PROCESS (LITERATURE REVIEW)

One of the most pressing problems in modern maxillofacial surgery is the treatment and rehabilitation of patients with fractures of the condylar process of the mandible. According to various statistical data, the incidence of fractures at this site is 19-37%, and these fractures are the most controversial in terms of diagnosis and treatment. In recent years, there has been an increase in severe forms of mandibular condyle fractures: bilateral, combined, intra-articular, leading to serious complications that affect the functioning of the temporomandibular joint. The data obtained indicated the need for a detailed study of this pathology in order to make a qualitative diagnosis and improve the available treatment methods. The aim of the study – to analyse and summarise current data from the scientific literature on possible complications in the treatment of the condylar process fractures of the mandible. Materials and methods. The bibliosemantic method was used to clarify the state of the problem, to study the analysis of the results of previous scientific research based on the literature sources and electronic resources. Results and discussion. The management of patients with mandibular condylar fractures is widely discussed in the literature due to their high prevalence, but there is still no consensus on the optimal management of patients with this pathology. To date, there are many studies that highlight certain complications of conservative and surgical treatment, but they are not generalised or systematised. Conclusions. Summarizing, we can conclude that complications occur during both conservative and surgical treatment of patients with mandibular condyle fractures. Complications are most often associated with incomplete diagnosis, incorrect choice of treatment method, and depend on the method of access and fixation in surgical treatment.

Influence of Method of Treatment of Mandibular Condylar Fractures on Range of Articular Path Measured by Cadiax Device.

Background/Objectives: The aim of this study was to evaluate the function of the treated temporomandibular joint based on the analysis of the image of the articular path using the Cadiax device depending on the choice of treatment method for unilateral condylar fracture of the mandible. Methods: Sixty patients who were treated for condylar fractures of the mandible at the Maxil-lofacial Surgery Department in Katowice were qualified for the analysis of the range of movements of the mandibular heads using the Cadiax device. From the group of patients who suffered fractures of the mandible, including condylar processes, patients were finally qualified for the measurement of the articular path of the injured and healthy joint according to strict criteria. Results: The condylar examination was performed in 20 patients who had conservative condylar fracture treatment and 40 patients who underwent various surgeries in the course of a single condylar fracture. The control group consisted of 20 patients whose mean values for the articular pathway measured for both sides were 12.73 and 12.69 and fell within the standard developed for healthy joints tested with the Cadiax device. Conclusions: We have achieved an almost ideal treatment for condylar fractures. We are also beginning to notice the need for rehabilitation of patients after this type of surgery.

Quantitative Assessment of Condylar Remodeling After Open Reduction and Internal Fixation in Mandibular Condylar Head Fractures.

Open reduction and internal fixation (OR/IF) and closed treatments are viable options, with OR/IF gaining popularity in mandibular condylar head fracture (CHF). Sufficient research is lacking on long-term condylar morphologic changes. This study quantitatively evaluated the morphologic changes in the condylar head in patients who underwent OR/IF for CHF without the removal of osteosynthesis material. A retrospective study analyzed patients who underwent OR/IF for CHF between November 2010 and August 2022. The transverse/lateral condyle width and condyle height were radiologically analyzed using panoramic and reverse Towne view x-ray images at immediate (T0), short-term (T1), and long-term (T2) postoperative periods. The study involved 29 patients with 32 surgically treated CHF. Long-term condyle height decreased significantly from 18.9±0.8mm at T0 to 18.1±0.8mm at T1 (P=0.042), and further to 17.3±0.7mm at T2 (P=0.034). Transverse width slightly reduced from 18.7±0.7mm at T0 to 17.9±0.8mm at T1 (P=0.001) but remained stable from T1 to T2 (17.6±1.0mm, P=0.756). Following surgery, maximal mouth opening averaged 39.5±6.1mm, with one case of chin deviation and three cases of joint pain. The condyle undergoes long-term shortening without altering its width. Nevertheless, patients experience favorable functional outcomes, including satisfactory mouth opening and occlusion. In addition, it is advisable not to remove the osteosynthesis material, as the remaining material causes minimal functional impairment and bone resorption.

Clinical Outcome of Open Reduction and Internal Fixation of Mandibular Condyle Fracture: A Prospective Observational Study

Introduction: Condyle of mandible plays crucial role in functioning of jaw. Untimely and inadequate treatment leads to deformity of face along with range of complications. The purpose of this study was to assess outcomes of open reduction and internal fixation of mandibular condyle fractures in terms of mouth opening, facial nerve function and occlusion.Methods: This was a prospective observational study conducted at Chitwan Medical College. Thirty-two patients of mandibular condyle fracture were treated by open reduction and internal fixation via retromandibular approach and evaluated for mouth opening, facial nerve function, and occlusion on 2nd day, 10th day and 25th day postoperatively. All collected data were entered on SPSS version 21 and analyzed using descriptive statistical methods. The results were presented as graphs and tables.Results: Of 32 patients, 7 patients show abnormal occlusion while 25 patients show normal occlusion. A gradual improvement in mouth opening and facial nerve function was also seen on 25th day.Conclusion: Open reduction and internal fixation gives superior clinical outcomes in terms of mouth opening, facial nerve function and occlusion. It also allows good anatomical repositioning and early function.Keywords: Facial nerve function, Mouth opening, Occlusion, Open reduction internal fixation Layman summary: The mandible is largest and strongest bone of face. However, it is also most common facial bone that is fractured. Condyle of the mandible is highly prevalent site of mandibular fracture. The fracture of mandible is managed by open or closed reduction. Both of the methods have their own merits and demerits. In this study, we planned to assess the outcomes of open reduction and internal fixation of mandibular condyle fractures at a tertiary care center of Nepal. We found that ORIF has a good clinical outcome in mandibular fracture in terms of mouth opening, facial nerve function and occlusion.

Electromyographic Study of Facial Nerve Function Using Two Different Surgical Approaches in Low Condylar Fractures of the Mandible: A Randomized Controlled Clinical Trial

Facial nerve (FN) dysfunction is a potential complication during open reduction of mandibular condylar fractures. The purpose of this study was to measure and compare the postoperative FN function following transparotid (TP) and transmasseteric anterior parotid (TMAP) operative approaches in open reduction and internal fixation of condylar fractures using electromyogram. A randomized controlled clinical trial was designed. The study was conducted in a single tertiary-care hospital in the inpatient setting. Patients aged above 18years with unilateral condylar fracture of the jaw or bilateral condylar fractures undergoing surgery on only 1 side were included. Patients were excluded if they had fractures of the head, bilateral condylar fractures with surgery planned on both sides, a previous history of surgery in the retromandibular area, existing lacerations to approach condyle, preoperative signs of FN weakness, or a history of parotid surgery. The predictor variable was the operative approach and the subjects were allocated randomly to TMAP and TP. The primary outcome variable was postoperative FN function in the surgical approach employed using the House-Brackmann scale and electromyography (EMG) to record any subtle weakness in nerve function. The FN function is recorded at 3 time intervals postoperatively 1week (T1), 1month (T2), and 3months (T3). The secondary outcomes studied were operating time and any other complications recorded. Age, sex, fracture pattern with classification of condylar fractures into condylar neck or base fractures according to Loukata etal.4 Any associated fracture of mandible describing the anatomical location viz symphysis and parasymphysis (anterior mandible), body, contralateral condyle or greater than 1 associated fracture were recorded. Similarly, the presence or absence of any associated midface fracture was also recorded to suggest that the study participants were homogenous in all aspects. Analytical statistics included χ2 test, t-test, and repeated measures ANOVA followed by post hoc test to compare EMG data (mean power and mean amplitude) between 2 operative approaches (TP vs TMAP) for facial muscles including frontalis, oculi, and buccinator at different time intervals (T0, T1, T2, T3). Patients within each group were also analyzed to check for nerve recovery occurring during the follow-up period. The level of significance was set at P<.05. The study sample was composed of 22 patients with a mean age of 32.82±11.21years in TMAP and 27.82±8.54years in the TP group respectively (P=.26); male predominance of 81.8 and 90.9% in TMAP and TP group respectively (P=.53) was noted. The FN deficit as assessed by the House-Brackmann scale clinically, was at 54% (T1), 36.4% (T2), and 9.1% (T3) for the TP group and 27% (T1),9% (T2), and 0% (T3) for TMAP group; however, the results were statistically insignificant (P=.31). In surface EMG evaluation, the mean power for the frontalis muscle was significantly higher in the TMAP approach at the T3 time (105.03±9.7 vs 89.56±10; 95% confidence interval -24.28 to -6.65 with P value=.002). TP approach was faster with a mean exposure time of 9.9minutes. The results show that both approaches give comparable long-term results with the TMAP group showing better frontalis muscle activity.

Effect of stainless-steel wire internal fixation on intracapsular condylar fracture.

The aim of the study was to investigate the clinical effect of stainless-steel wire fixation on the early mouth-opening movement of an intracapsular fracture involving the condylar process. In this study, patients who underwent mandibular condylar intracapsular fracture surgery in our hospital from 2012 to 2020 were selected as research subjects. A total of 44 patients received steel wire internal fixation treatment, 32 patients received titanium plate-and-nail rigid internal fixation, and 28 patients underwent conservative non-surgical treatment. For the patients in the stainless-steel wire group, the degree of mouth opening reached normal levels of 3.7 cm approximately 10 days after surgery. The recovery time for the patients in the titanium plate-and-nail rigid internal-fixation group was 21 days, while the patients in the conservative treatment group needed 60 days to recover. The treatment of fixation with a stainless-steel wire for intracapsular condylar fracture reduced the time taken to perform mouth-opening exercises and improved the recovery rate of patients.

Transoral endoscopic assisted reduction and internal fixation of mandibular condylar neck fractures with short condylar segment

This study aimed to assess the reliability and safety of transoral endoscopic-assisted reduction internal fixation (TERIF) for treating short-segment condylar neck fractures (CNF), including hardware removal.Patients with displaced CNF and short condylar segments treated using TERIF were included in the study. Clinical evaluation covered dental occlusion, range of mouth opening, deviation during mouth opening, protrusion, laterotrusion, pain, and chewing. Radiological evaluation was used to assess fracture displacement, angulation, head dislocation, postoperative reduction, fixation stability, and bone healing. The same technique was used to treat 15 patients with 18 CNF and short condylar segments. Hardware removal was performed for nine fractures in eight patients after fracture healing using the same approach.All patients regained satisfactory, pain-free mouth opening with no deviation and complete bone healing. Computed tomographic images displayed adequate reduction and stable fixation during the follow-up period for all patients. No temporary or permanent facial nerve impairment occurred in any of the patients.TERIF is a reliable and safe treatment for CNF with short condylar segments, even in the presence of head dislocation, medial override, and malunited fractures; hardware can be safely removed after healing using the same approach.

A multicenter and epidemiological study of patterns and treatment strategies for mandibular condyle fractures

To evaluate retrospectively the epidemiological characteristics of the prevalence, type and treatment modalities of the condylar mandibular fractures. Data of all patients who underwent surgical or nonsurgical management for condyle mandibular fracture were collected. The study was conducted to assess the trauma etiology, age group, gender, treatment method, anatomic distribution of injury and complications by reviewing patients’ records. There were 139 patients with 171 mandibular condylar fractures. Among these patients, 85% were men, with an overall male-to-female ratio of 5.6:1. The highest occurrence of trauma was in the 21-30 years age group. The most frequently observed etiology was motorcycle traffic accidents and the subcondylar region was the most common location with 109 fractures. There was statistically significant difference between treatments (p &lt; 0,001). In the nonsurgical treatment group, the prevalence of complications was observed compared to the surgical group (p &lt; 0.001). The predominant complications were: mouth opening limitation, mandibular deviation, malocclusion, temporomandibular disorder, paresthesia and facial paralysis. Considering the limitations of this study, subcondylar fractures were the most frequent, especially in men aged 21-30 years, and the surgical treatment showed the fewest complications.

Two Miniplates Versus Three Dimensional Plate in Management of Mandibular Condylar Fractures: A Systematic Review and Meta-Analysis

Study Design Systematic Review and Meta-analysis. Objective This systematic review and meta-analysis aimed to compare the efficacy of 2 miniplates vs a three-dimensional plate in the management of mandibular condylar fractures. The primary objective was to assess key parameters, including intraoperative time, maximum mouth opening, complications, and functional outcomes, to determine potential differences between the 2 fixation methods. Methods A comprehensive literature search was conducted to identify relevant studies. Inclusion criteria were applied, and the selected studies underwent systematic review. The key parameters were extracted and subjected to meta-analysis to quantify and compare the outcomes associated with the use of 2 miniplates and three-dimensional plates. The methodologies of the included studies were critically evaluated to address potential biases and confounding factors. Results The meta-analysis results indicated that there were no statistically significant differences between the 2 fixation methods in terms of intraoperative time, maximum mouth opening, complications, and functional outcomes. However, concerns were raised regarding the high risk of bias, confounding factors, and considerable heterogeneity observed across the reviewed studies. Conclusions The findings suggest that both 2 miniplates and three-dimensional plates are viable options for the management of mandibular condylar fractures. Despite the lack of statistical significance in the observed differences, the study highlights the need for further prospective research with enhanced methodologies, standardized protocols, larger sample sizes, and reduced bias to refine our understanding and potentially influence clinical management protocols.

Three-Dimensional Analysis of Bone Remodeling After Closed Treatment for Mandibular Condylar Head Fracture.

Closed treatment of mandibular condylar fractures has been used for its indications based on the fracture site, fracture status, and patient age. Posttreatment mandibular condyle size is associated with mandibular function; however, a few studies have reported bone remodeling patterns and volume changes in the condyle and glenoid fossa after mandibular condylar head fractures (CHFs). Therefore, volumetric changes in the mandibular condyle and glenoid fossa were analyzed in the present study, and bone remodeling patterns were evaluated after mandibular CHFs. The present study included 16 condyles from 12 patients who received closed treatment for CHF. After reconstruction of a 3-dimensional skull model, including the mandible, using computed tomography data taken immediately after injury and 6 months after treatment, volume changes in the mandibular condyle and glenoid fossa were analyzed. The condylar volume increased by 0.32±0.66cm3 during the 6-month healing period without statistical significance (P=0.093). Regarding the glenoid fossa, the fossa showed a statistically significant volume increase of 0.41±0.59cm3 (P=0.021), and 12 glenoid fossae (75%) showed downward bone apposition; however, no change or only mild bone resorption was observed in 4 glenoid fossae (25%). The results of this study indicated that the volume changes in the mandibular condyle after closed treatment of a mandibular CHF are not significant, and the glenoid fossa adapts to the displaced mandibular condyle through downward growth accompanied by volume increase.

Posterior Border Osteosynthesis for Fractures of Mandibular Condyle: A Case Series with Finite Element Model Corroboration

Posterior Border Osteosynthesis for Fractures of Mandibular Condyle: A Case Series with Finite Element Model Corroboration