Condylar position changes and prognosis in patients with unilateral mandibular condylar fracture treated non-surgically

Abstract

Background: Non-surgical method is a treatment option for mandibular condylar fracture; however, it is questionable whether bone fragments are adequately reduced and remodeled. The purpose of this study was to identify three-dimensional positional changes in the mandibular condyles in patients treated non-surgically, analyze factors influencing the extent of positional changes, and evaluate clinical prognosis. Methods: This retrospective study included 31 patients with unilateral mandibular condylar fractures treated non-surgically at the Ajou University Dental Hospital between 2005 and 2023. Computed tomography was performed at the time of the fracture (T0) and > 6 months after non-surgical treatment (T1). The extent of recovery of the highest point of the condyle head was measured in three-dimensional x-, y-, and z-axes. At the last follow-up > 6 months after remodeling (T1), the prognosis was evaluated by clinical examination of mouth opening limitation, malocclusion, deviation on opening, temporomandibular joint disorder (TMD), and facial asymmetry. Results: Position differences were statistically significant between T0 and T1 (paired Student’s t-test, P < 0.05), and between the x-, y-, and z-axes (Welch’s ANOVA, P < 0.05). The degree of positional recovery in the superior and lateral directions showed a statistically significant negative correlation with age (Pearson’s correlation analysis, P < 0.05). The average amount of recovery between two age groups of over and under 19 years old was statistically significant (independent t-test, P < 0.05). Complications included TMD (6.4%), malocclusion (3.2%) and facial asymmetry (3.2%). Conclusion: After non-surgical treatment, the condyle head of the fractured mandible recovered significantly laterally and superiorly in under 19-year-olds. The functional prognosis was favorable in all age groups. Non-surgical treatment can be an applicable treatment option for patients with mandibular condylar fractures.