The influence of the condylar fracture treatment method on mandible dynamics

Abstract

Background. Among commonly adopted condylar fracture treatment methods, there is the open reduction and closed reduction method. For the purpose of evaluating the therapeutic effect of a given method and the functional state of the temporomandibular joints, it is possible nowadays to conduct an instrumental analysis with the use of modern devices such as the axiograph. Objectives. The study was aimed at a long-term assessment of the function of the stomatognathic system, in particular assessment of the range of the condylar path in the temporomandibular joints, depending on the method of condylar fracture treatment (open or closed). Material and methods. The study involved 60 patients in total (mean age in the study group was 33.3 years), including 24 women (40%), who were divided into 2 groups. The 1st group included 40 patients in whom condylar fractures were surgically managed. The other group consisted of 20 patients in whom the closed reduction method of treatment was applied. Patients were qualified for surgery under general anesthesia or for treatment by means of standard splints and maxillomandibular fixation. After 6 months following the conclusion of treatment, each patient was scheduled for a follow-up appointment, during which an axiographic examination aimed at the registration of the condylar path in the temporomandibular joints was performed. The values registered were subject to a statistical analysis and compared between the groups. Results. A significant difference (F = 5.36; p = 0.0241) in the length of the condylar path in the sagittal plane was observed, depending on the method of condylar fracture treatment. In the case of open reduction, the values were higher than in the case of closed reduction. Conclusions. Miniplate osteosynthesis disturbs the mandibular dynamic pattern to a lesser degree but the technique should constantly be improved in order to limit the traumatization of sensitive periarticular structures.