Determinants in the management of mandibular condyle fractures

Condylar fractures has generated more controversy than other maxillofacial fractures because they relate to the complex anatomy and function of the ATM, and because at present no scientific evidence to support the best therapeutic option.

Purpose: Objective of this study was to analyze the behavior of variables that determine the choice of the treatment and the outcome in condylar fractures.

Materials and methods: A retrospective analysis of 153 mandibular fractures in the last 5 years, 34 were selected to present condylar fracture; patients underwent a clinic-radiologic investigation focusing on function, evolution, fracture remodeling and facial morphology. We analyzed the influence of the principal variables (level of fracture, displacement, deviation and dislocation, treatment, etiology, pain, occlusion, dentition, mandibular movement, mouth opening, ramus mandibular height, unilateral or bilateral fracture and presence maxillofacial fractures) before and after treatment.

Results: The main cause of condylar fracture is traffic accidents; the most common fracture was condylar neck. The functional improvement obtained by open methods was greater than that obtained by closed treatment. Surgical management allowed different surgical approaches depended of the analysis of the variables. The therapeutic decision was taken to evaluate each variable and the most important were the level and position of the fracture.

Conclusion: Criteria Zide and Kent still retain an important therapeutic regimen. Comprehensive study of determinants such as: pain, occlusion, movement, opening, dentition, ramus mandibular height, presence of unilateral or bilateral fracture, level and position of the fracture and presence of other maxillofacial fractures definitively determine the best treatment.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Determinants in the management of mandibular condyle fractures
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