Unilateral Condylar Fractures Research Articles

A New Method in Dealing With Children's Condylar Fracture by Botulinum Toxin A Injection in Lateral Pterygoid Muscle.

Condylar is one of the most vulnerable sites to be traumatized in pediatric mandible fracture, while temporomandibular joint ankylosis might be the most severe complication of condylar fracture in children. There exists a long-time controversy on the treatment of condylar fractures in children. Considering the risk of facial nerve injury and a certain probability of absorption or even ankylosis after open reduction and internal fixation (ORIF) of condylar fractures, a series of nonsurgical approaches are preferred in cases without severe malocclusion or shortening of the ramus. Our treatment plan was carried out through combining procedures of Botulinum toxin A injection in lateral pterygoid muscle with ORIF of para symphyseal fracture; subsequently, a conservative way of the occlusal splint with elastic traction was performed. Three patients of bilateral or unilateral condylar fractures, aged between 2y and 6y, were involved in this treatment. After more than 1 year's follow-up, the occlusion was satisfactory in all patients. Condylar remodeling was approximately complete in 3 months, and no unwanted complications were observed. We may expect this method to offer a new idea when dealing with children's condylar fracture.

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.

Effect of Different Treatment Modalities for Condylar Fractures in Childhood on Mandibular Symmetry and Temporomandibular Joint Function: A Retrospective Study.

In a retrospective study of the effects of different treatment modalities of condylar fractures in childhood on mandibular symmetry and temporomandibular function, the cases selected for this article were adult patients who had sustained a condylar fracture in childhood. The aim was to investigate the effects of condylar fractures in children on the development and function of the mandible and their specific manifestations after the completion of mandibular development. According to the different treatment modalities, the patients were divided into the conservative treatment group and the open surgical treatment group, and the effects of the 2 treatment modalities on the patients' condylar healing, the difference in growth ability, and the symmetry of the jaws were evaluated. The effects of different treatment modalities of children's condylar fracture on the growth, development, and function of the mandible were investigated using the Ai and Di, the grading of the imaging results, and the 3-dimensional CT fixation measurements from the aspects of both clinical examination and imaging examination. The 2 groups had condylar malalignment and condylar morphology abnormality, and there was one case of joint ankylosis in the surgical treatment group. There was a statistical difference in the evaluation of condylar reconstruction between the 2 groups, and the condylar reconstruction in the surgical treatment group was better than that in the conservative treatment, and there was a statistical difference between the condylar length, condylar width, condylar height, and depth of TMJ fossa between the healthy side and the affected side in the closed treatment group. There was a statistical difference in the height of the mandibular ascending branch between the healthy side and the affected side, and the unilateral condylar fracture was treated conservatively; the difference in the bony chin point deviation between the 2 groups was not statistically significant. In children, after conservative treatment of condylar fracture, the growth of condylar process is poor, and the condylar shape and position are not as good as surgical repositioning, but through the proliferation of temporomandibular joint fossa, it can make up for the insufficient height of condylar process, which has no effect on the symmetry of the mandible, and the surgical treatment can achieve good anatomical repositioning, which has a greater effect on the symmetry of the mandible than the conservative treatment.

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.

Conservative Management of Dislocated Pediatric Unilateral Condylar Fracture Using Orthodontic Treatment and Guiding Elastics

Conservative Management of Dislocated Pediatric Unilateral Condylar Fracture Using Orthodontic Treatment and Guiding Elastics

Correlating assessment between clinical features and morphologies on CT scan of mandibular condyle fracture

Background: Among mandibular fractures, condyle fractures are common injuries which directly affect the occlusal function and aesthetics of the patients. Accurate diagnosis based on clinical and radiographic features helps to choose the appropriate treatment. This study aims to evaluate clinical features, morphologies on CT Scan of mandibular condyle fractures and analyze the relationship between these characteristics. Materials and methods: A cross-sectional study on 30 patients with mandibular condyle fractures were conducted at Department of ENT - Ophthalmology - Odonto Stomatology in the Hospital of Hue University of Medicine and Pharmacy, from December 2021 to June 2023. Results: The male:female ratio was about 2:1, the main cause of fractures was traffic accidents (73.4%). The common clinical symptoms were malocclusion (96.7%) with occlusal interferences on posterior teeth and limited mouth opening (83.3%). On CT Scan, condylar neck fractures were the most common position (58.8%). There was a relationship between the side of deviated mouth opening and the affected sides (p &lt; 0.05). In cases of unilateral condyle fractures, there was a relation between the side of premature contact on posterior teeth and the affected sides (p &lt; 0.05). Conclusions: Fractures of condylar neck was the most common fractures in the mandibular condyle, which resulted in malocclusion, interferences on posterior teeth, limited and deviated mouth opening. There was a relationship between deviated mouth opening and premature contacts on posterior teeth with the fractured side. Key words: Mandibular condyle fracture, clinical features, CT Scan.

Anatomical position of the mandibular condyle after open versus closed treatment of unilateral fractures: A three-dimensional analysis

This study aimed to compare open and closed treatment for unilateral mandibular condyle neck and base fractures by final three-dimensional (3D) condylar position at 6 months follow-up. 3D position was associated with mandibular functioning and pain. A total of 21 patients received open (n = 11) or closed (n = 10) treatment. 3D positions were assessed on cone-beam computed tomography scans. Volume differences, root mean square, translations, and rotations were obtained related to the pursued anatomical position and compared between treatment groups by the Mann-Whitney U test. The 3D position parameters were associated with the maximum interincisal opening (MIO), mixing ability test (MAT), Mandibular Function Impairment Questionnaire (MFIQ), and pain based on Spearman correlation coefficients (rs). Translation in the medial-lateral direction was smaller after open treatment (P = 0.014). 3D position was not associated with the MAT; however, worse position was associated with a smaller MIO. A larger pitch rotation was associated with a worse MFIQ (rs = 0.499, P = 0.025). Volume reduction of the affected condyle was associated with more pain (rs = −0.503, P = 0.020). In conclusion, after unilateral condylar fractures, worse 3D position is associated with a smaller mouth opening and worse patient-reported outcomes. This is independent of the chosen treatment, despite a better anatomical reduction after open treatment.

Contact stress distribution after unilateral condylar fracture with angulation of the fractured part: A finite element model study

After a fracture of the condyle, the head of the condyle is often pulled inwards, which causes the fractured part to angulate medially. This change can cause a disbalance in the masticatory system. The disbalance could lead to contact stress differences within the temporomandibular joints (TMJs) which might induce remodelling within the TMJ to restore the balance. The contact stress in the fractured condyle during open and closing movements is expected to decrease, while the contact stress in the non-fractured condyle will increase. In a clinical situation this is hard to investigate. Therefore, a finite element model (FEM) was used. In the FEM a fractured right condyle with an angulation was induced, which was placed at different degrees, varying from 5° to 50° in steps of 5°. This study shows only minor differences in amount of contact stress between the fractured and the non-fractured condyle. The amount of contact stress in the condyles does not increase with a higher degree of angulation. However, with larger angulations, the contact stress within the fractured condyle is more centralized. Clinically, this more centralized area could be associated with complaints, such as pain. In conclusion, due to the more centralized contact stress in the fractured condyle, one would expect some minor remodelling on the fractured side with more angulation.

Changes in load distribution after unilateral condylar fracture: A finite element model study

ObjectivePremature dental contact on the fractured side and a contralateral open bite are signs of a unilaterally fractured condyle of the temporomandibular joint (TMJ). The lateral pterygoid muscle pulls the condyle inwards, causing angulation of the fractured part and shortening of the ramus. This imbalance after fracture might change the load in both TMJs and consequently induce remodeling. The present study aimed to calculate this change in load. It is hypothesized to decrease on the fractured side and increase on the non-fractured side. DesignFor these calculations, a finite element model (FEM) was used. In the FEM, shortening of the ramus varied from 2 mm to 16 mm; angulation, from 6.25° to 50°. ResultsAfter fracture, load on the non-fractured side increased, but only at maximal mouth opening (MMO). Simultaneously, load on the fractured side decreased, at both timepoints, i.e., MMO and closed mouth. When comparing all simulations at those time points, i.e., from 2 mm and 6.25° to 16 mm and 50°, the load in the fractured condyle declines steadily. However, for both timepoints, a threshold stands out around 6 mm shortening and 18.75° angulation: visualization of the fractured condyle showed, apart from load on the condylar head, a second point of load more medial in the TMJ which was most evident in the 6 mm – 18.75° simulation. ConclusionsThese findings could implicate that the balance between both TMJs is more difficult to restore after a fracture with more than 6 mm shortening and more than 18.75° angulation.

Assessment of Various Complains after Non-Surgical Treatment of Condylar Fracture

Objective: To assess various complains of patients after non-surgical treatment of condylar fracture. Methodology: A cross-sectional study was performed from October 2021 to October 2022 at the Department of Oral and Maxillofacial Surgery, Nishtar Institute of Dentistry, Multan. The sample size collected was 34 patients using a consecutive non-probability sampling. Using pertinent clinical examination, the patient was assessed for disturbed occlusion, limited mouth opening, deviation of the mouth, pain, and clicking sound. The mean follow-up period was six months. Results: The male-to-female ratio was 1.8: 1, with male predominance. The leading cause of fracture was attributed to incidents involving road traffic accidents (RTAs) (n—26, 76.5%).Twenty-three patients had a positive post-opt complaint after treatment, from which the most complaints presented were with unilateral condylar fracture n=15. The most common complaint presented was TMJ Pain with limited mouth opening n=8(23.5%). Conclusion: Conservative care for unilateral mandibular condyle fractures is a safe treatment approach. However, it can cause a few post-treatment functional complaints, the most frequent of which is TMJ pain. To further evaluate the improvement in function and discomfort, more research and consistent long-term follow-ups are required. Keyword: Temporomandibular joint movement (TMJ), TMJ Pain, Maxillomandibular Fixation (MMF)

Study of Facial Nerve Function Following Retromandibular Open Reduction of Mandibular Condylar Fracture

At least 1/3rd (26–40%) of all mandibular fractures occur in the condylar region, making it one of the most common fracture sites. They can further lead to morphological &amp; functional damage when undetected or poorly managed. Condylar fractures that are misdiagnosed or improperly treated can cause substantial functional impairment, such as malocclusion, decreased mouth opening due to jaw deviation, and restricted lateral mandibular motions. Objectives: The aim of the study was to examine facial nerve function following retromandibular trans parotid ORIF for mandibular sub-condylar fractures. Methodology: After receiving the necessary ethical approval, 50 patients who presented with unilateral condylar fractures, sub condylar fractures (36), &amp; neck fractures (14) (Ellis classification)5 were chosen. All of the research participants, who underwent open reduction using a retromandibular technique, provided informed consent. Results: All 50 patients were assessed and no patients were excluded. The healing went well, and no one experienced significant scarring or hardware infection. 7 (14%) individuals experienced transient buccal branch weakness, while 2 (4%) experienced transient zygomatic branch dimness Keywords: Condylar fracture, Open reduction, Retromandibular approach, Anatomical reduction

The Comparison of Functional Outcomes in Patients With Unilateral or Bilateral Intracapsular Mandibular Condylar Fractures After Closed or Open Treatment: A 10-Year Retrospective Study.

The treatment strategies for mandibular condylar head fractures, also known as intracapsular condylar fractures (ICFs), have not been concluded. We humbly present our treatment outcomes and share our experience in our department. The aim of this study was to compare the functional outcomes between closed reduction (CR) and open reduction and internal fixation (ORIF) for management of unilateral or bilateral ICFs. This 10-year retrospective cohort study included 71 patients with 102 ICFs who were treated in our department from May 2007 to August 2017. Nine patients mixed with extracapsular fractures were excluded; thus, 62 patients with 93 ICFs were included. All patients received treatment by the senior surgeon in Chang Gung Memorial Hospital, Linkou Branch, Taiwan. The patient's basic data, fracture morphologies, associated injuries, managements, complications, and maximal mouth opening (MMO) measurement at 1, 3, 6, and 12 months postoperative were reviewed for analysis. Among the 93 fractures, 31 (50%) were bilateral and 31 were unilateral (50%). Based on He's classification, 45 (48%) had type A fracture, 13 (14%) had type B, 5 (5%) had type C, 20 (22%) had type M, and 10 (11%) had no displacement. Maximal mouth opening of 37 mm in unilateral cases after 6 months was significantly higher than the 33-mm MMO in bilateral cases. In addition, the MMO in the ORIF group was significantly higher than that of the CR group in 3 months postoperative. Univariate (odds ratio, 4.92; P = 0.01) and multivariate (odds ratio, 4.76; P = 0.027) analyses revealed CR as an independent risk factor for trismus development compared with ORIF. Malocclusion was observed in 5 patients in both CR and ORIF groups. In addition, 1 patient developed temporomandibular joint osteoarthritis in the CR group. No surgical-related temporary or permanent facial nerve palsy was observed. Open reduction and internal fixation for condylar head fracture provided better recovery in MMO than CR, and the MMO recovery was less in bilateral condylar head fracture than unilateral condylar head fracture. Open reduction and internal fixation in ICFs have a lower risk for trismus development and should be the treatment of choice in selected cases.

Volumetric outcomes of treatment for unilateral condylar fractures: A pilot study

BackgroundThree-dimensional (3D) imaging allows assessment of changes in condylar volume and morphology. The association between the morphology of the condyle and post-treatment functional impairment is still unclear. PurposeTo analyse the volume of both condyles after a unilateral condylar fracture and to evaluate the relationship between condylar volume and mandibular function. MethodsA pilot study was performed in which data from a recently published cross-sectional study were used. In a previously published cross-sectional study a cone beam computed tomography scan was acquired of patients with a unilateral condyle fracture. These scans were analysed, and the condylar volumes were measured and related to the outcomes of the Mandibular Functional Impairment Questionnaire and the Mixing Ability Test. ResultsPatients with larger condyles have a better recovery regarding function than patient with smaller condyles, independent of the received treatment. This study showed a significant positive correlation between masticatory function and the post-treatment volume of the fractured condyle. Men tended to have larger condyle volumes than women and seem to have a better outcome in function. A larger condyle volume was associated with an increase of the mouth opening. ConclusionGiven that the volume of the condyle is associated with the function of the temporomandibular joint, imaging may be helpful to stratify the pathophysiological adaptation mechanisms and to improve our ability to plan individualized treatment.

Etiology of chin laceration and their possible association with underlying mandibular fractures- A retrospective study

The recognition of the associated mandibular fracture plays a vital role, if unrecognised may lead to complications such as Temporomandibular joint dysfunction, chronic pain and malocclusion. These complications may not be elicited at the time of injury, but many years later. Therefore, it is important to identify the presence of associated mandibular fractures while understanding the cause of injury followed by clinical examination.Our study reviews the factors (etiology, gender, and age) that determines the various patterns of chin laceration and the incidence of associated mandibular fractures.: A retrospective study was conducted among 55 patients who reported to the Casualty/ Emergency room with chin laceration between July 2018 and July 2019. Data on age, gender, etiology, and associated fractures were noted. Patients with facial laceration other than the chin region were excluded from the study. : Out of 55 patients, it was found that chin laceration was common in males in the age group of 20-40 years. 69.1% of it is due to the RTA, followed by fall from height, and assault. 27.8% of chin lacerations were associated with unilateral condylar fracture, and 20.4% were associated with symphysis fracture followed by parasymphysis, body, angle, and ramus fracture.Chin laceration acts as an important diagnostic clue for the underlying mandibular fracture and various complications that might occur with/after the fracture.

Retrospective clinical study of mandible fractures

BackgroundAs society becomes more complex, the incidence of mandibular fractures is increasing. This study aimed to analyze the incidence and type and identify etiological factors of mandibular fractures to use them in future treatments.Material and methodsData were collected from 224 patients who visited the department of oral and maxillofacial surgery at the Kyung Hee Medical Center dental hospital during a 6-year period (2016 to 2021). A logistic regression model was used for data analysis.ResultsIn a total of 224 patients, 362 fractures were appeared. The average age of the patients was 34.1 years, with the highest incidence in the 20s. And the ratio between male and female was 4.09:1. Symphysis fractures were the most prevalent of all patients (52.7%), followed by unilateral condyle (37.1%), angle (36.2%), bilateral condyle (9.4%), body (8%), and coronoid (2.2%). The most common cause of fracture was daily-life activity (57.6%), followed by violence (30.4%), traffic accidents (8.5%), and syncope (3.6%). Patients with symphysis fracture were at low risk (OR < 1) of angle, body, and unilateral condyle fractures. Similarly, patients with unilateral fracture were at low risk (OR < 1) of symphysis, angle, body, and others site fractures. In contrast, patient with bilateral condyle fracture were at high risk (OR > 1) of coronoid fractures. And younger patients were high risk of mandibular angle fractures.ConclusionThrough this study, it was confirmed that etiological factors of mandibular fractures were like those of previous studies.

Modified high-submandibular appraoch for open reduction and internal fixation of condylar fracture: case series report.

Recently a modified high-submandibular approach (HSMA) has been introduced for treatment of condylar fracture. This approach involves an incision line close to the mandibular angle and transmasseteric transection, leading to a low incidence of facial palsy and allowing good visualization of the condyle area, especially the condylar neck and subcondyle positions. This study reports several cases managed with this modified HSMA technique for treating condylar fractures. Six cases of condylar fractures treated with modified HSMA technique were reviewed. Three unilateral subcondylar fracture, 1 bilateral subcondylar fracture, 1 unilateral condylar neck fracture, 1 unlateral simultaneous condylar neck and subcondylar fracture cases were reviewed. All the cases were successfully treated without any major complication. Reduction, fixation, and osteosynthesis of condylar fractures via the modified HSMA technique enabled effective and stable treatment outcomes. Therefore, the described approach can be used especially for subcondylar and condylar neck fractures with minimal complications.

The Treatment Perspective of Pediatric Condyle Fractures and Long-Term Outcomes.

In our study, the characteristics, treatment approach and long-term outcomes of condyle fractures treated in the pediatric plastic surgery and reconstruction unit in the last 10 years were evaluated. This study consisted of two retrospective and prospective sections with the participation of pediatric patients with condylar fractures who were treated in the Plastic, Reconstructive and Aesthetic Surgery clinic of a university hospital in the last 10 years. In the retrospective section, data were obtained from the electronic patient records and patient files regarding the treatment applied, as well as the characteristics of the patient and condyle fractures. In the perspective section, patients were invited to the clinic and the effectiveness of the treatment was evaluated. Statistical analyses were performed with SPSS (Statistical Package for Social Sciences) for IBM 25 package program. It was determined that 55.8% of the pediatric patients had accompanying facial fractures, and 72.4% had unilateral condyle fractures. It was determined that 59.5% of the pediatric patients underwent intermaxillary fixation (IMF). Physical complications were seen in 6.75% in the long term after treatment. Falling from height and traffic accidents, which are the most important factors in the occurrence of condyle fractures, should be eliminated by increasing parental attention and awareness. Surgical treatment should be considered in the treatment of pediatric condyle fractures, especially if there are accompanying facial and mandible bone fractures.

Evaluation and Prediction of Healing Morphology After Closed Reduction for Unilateral Mandibular Condyle Fractures.

Although closed reduction is common for condylar fractures, bone fragments may heal improperly. This study aimed to investigate the healing morphology of unilateral condylar fractures. We retrospectively investigated 70 patients with unilateral condylar fractures. Clinico-statistical analyses were performed on the whole-condylar fracture, closed reduction, and observation/functional therapy groups. Among these patients, 52 patients aged older than 16 years underwent closed reduction. The extent of maximum mouth opening, the incidence of malocclusion, and the relationship between healing morphology and Arbeitsgemeinschaft für Osteosynthesefragen classification or trismus were analyzed in the closed reduction group. There were significant differences in age ( P= 0.008) and sex ( P =0.025) between the closed reduction and observation/functional therapy groups. However, there were no significant differences in trauma etiologies and concomitant fractures between the 2 groups. The average maximum mouth opening extent for unilateral fractures after closed reduction was 42.6±6.1mm. Only 1 case (2.1%) of post-treatment malocclusion was observed. In all the MacLennan classification of deviation or more, regardless of the classification, upper fractures (head and upper neck) tended to heal through a spherical ( P <0.001) morphology, whereas lower fractures (lower neck and subcondylar) tended to heal through an L-shaped and lateral fusion ( P <0.001). There was no significant difference in the incidence of trismus between the healing morphology of unchanged type and others ( P =0.690). Our results elucidated the etiology, dysfunction, and healing morphology classification of unilateral mandibular condyle fractures treated with closed reduction.

Clinical comparison between bilateral and unilateral mandibular condyle fractures combined with symphysis fractures – A retrospective study

ObjectiveEffective treatment strategies for a mandibular fracture, especially a condylar fracture, have yet to be established. The purpose of the present study was to examine characteristics and treatment management practices to compare between bilateral and unilateral condyle fractures combined with a symphysis fracture. MethodsThis retrospective study included 30 patients with a mandibular condyle fracture combined with a symphysis fracture. They were divided into the unilateral and bilateral condyle fracture groups. Variables noted included fracture etiology, fracture sites, treatment methods, and functional evaluations. ResultsIn patients with a mandibular condyle fracture combined with a symphysis fracture, the most common cause of injury was a fall. High condyle fractures accounted for the majority of bilateral fracture cases, with low condyle fractures seen in the majority of those with a unilateral fracture. Moreover, in the bilateral fracture group, in not only patients with a low condyle fracture but also those with a high condyle fracture, ORIF was performed on at least one side, with IR used for the other side, resulting in early postoperative recovery of range of mouth opening and reduction in temporomandibular joint pain. ConclusionThe results of the present study indicated that while the causes were common, condyle fracture sites differed between cases with a bilateral and those with a unilateral condyle fracture when combined with a symphysis fracture. The findings in the present study suggest that treatment with a combination of ORIF and IR may be better for obtaining good functional recovery in the bilateral fractures pattern.

Radiological Shortening of the Ramus: A Reliable Guide for Diagnosis of Unilateral Mandibular Condylar Fracture

Aim: The aim of this study was to assess and compare the radiological shortening of the ramal height on an Orthopantomogram (OPG) x-ray and Lateral Cephalogram for the diagnosis of a unilateral condylar fracture.&#x0D; Study Design: Comparative Study.&#x0D; Place and Duration of Study: Department of Oral &amp; Maxillofacial Surgery (OMFS), Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad over a period of 6 months.&#x0D; Methodology: The study included 100 patients coming to the OMFS department, 50 of them with unilateralcondylar fracture made up the patient group, and the other 50 for the extraction of lower wisdom tooth comprised the control group. Both groups were having the standardized OPGs alone with lateral cephalograms with them, age ranging from 18 and above of either gender. The following linear mandibular measurements were obtained in mm such as body length, ramal height and ramal shortening using both of the radiographs, respectively. Mean values of left and right sides of the OPG and the lateral cephalogram were calculated for both the parameters that is ramus height and body length. Comparison of the said parameters was also done, subsequently.The collected data was analyzed with the software SPSS 21.0 and Microsoft Excel.&#x0D; Results: A total of 100 patients had been assessed and compared on the basis of the radiological shortening of the ramal height on the OPG x-ray and Lateral Cephalogram. The obtained data showed that there was a decrease in the ramal height on OPG as well as Lateral Cephalogram of the fractured patients compared to the non-fractured side, but there was a decrease in the ramal height of patients in the control group as well without having any fracture.&#x0D; Conclusion: The shortening of ramal height measured on an OPG and Lateral Cephalogram cannot be relied upon to diagnose a unilateral condylar fracture.