Gerlach and
Schawarz,
2012 1717 Gerlach KL, Schwarz A. Bite forces in patients after treatment of mandibular angle fractures with miniplate osteosynthesis according to Champy. J. Oral Maxillofac. Surg. 2002;31:345-348.
|
To assess the maximum bite force in patients with mandibular angle fractures that were surgically treated |
Twenty men and two women with mandibular angle fractures aged 27 to 38 years
Age and gendermatched controls |
Electrical method used to measure the bite force (transducer positioned in the region of the incisors, canines, and molars)
Longitudinal monitoring of
patients (once a week for 6
weeks) |
The bite force of the patients significantly decreased in the first week after surgery compared with that in the control group and became equivalent to that in the control group after 6 weeks. |
Murakami
et al., 2009
18 |
To analyze the mandibular movement and the occlusal condition of patients who underwent conservative treatment for unilateral condylar fractures |
Fourteen men and four women were divided in two groups:
Twelve underwent maxillomandibular fixation + physical therapy
Six underwent physical therapy alone
Average age, 38 years
Control group |
The participants were evaluated 3 and 6 months after treatment initiation.
Evaluated parameters: mandibular movement |
After 6 months, the maximum mouth opening was normal in the patient groups, although the range was lower than that in the control group Recovery of lateralization and protrusion movements was observed.
Mandibular deviation was observed on mouth opening, although the values were lower than those before treatment.
After 6 months of treatment, a decrease in the bite force and level of asymmetry in the occlusal contact area was observed. |
| Kondoh et al., 2004 1919 Kondoh T, Hamada Y, Kamei K, Kobayakawa M, Horie A, Iino M, Kobayashi K, Seto K.Comparative study of intra-articular irrigation and conticosteroid injection versus closed reduction with intermaxillary fixation for the management of mandibular condyle fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:651-6.
|
To compare closed reduction + intermaxillary fixation + intra-articular irrigation (corticosteroid) and closed reduction + intermaxillary fixation without intra-articular
irrigation for unilateral condylar fractures |
Twenty-six patients with unilateral condylar fracture were divided in two groups:
Fourteen underwent conservative treatment + intra-articular irrigation
Twelve underwent conservative treatment only
Average age, 25 years |
Evaluated parameters: radiological findings, jaw function, and pain in the TMJ |
Three months after injury, the maximum mouth opening was significantly greater in the intraarticular irrigation group
TMJ pain gradually decreased over the course of treatment in the irrigation group, while in the other group, pain decreased only 6 months after treatment.
The conservative treatment protocol modified with intra-articular irrigation was found to be minimally invasive and safe for the treatment of unilateral condylar fractures. |
| Niezen et al., 2010 2020 Niezen ET, Bos RR, Bont LG, Stegenga B. Complaints related to mandibular function impairment after closed treatment of fractures of the mandibular condyle. J. Oral Maxillofac. Surg. 2010;39:660-665.
|
To analyze the relationship between impaired jaw function after closed treatment of mandibular condylar fractures. |
Seventy-three men and
41 women
Average age, 28 years |
Physical examination: articular sounds; pain during mandibular movement; measurements of maximum mouth
opening, lateralization, and protrusion; and evaluation of the dentition and occlusion Questionnaire: impairment of mandible function |
Pain, abnormal occlusion, decreased mouth opening, abnormal values of lateralization, and advanced age were found to be predictors of jaw function impairment in patients who undergo closed treatment of mandibular condylar fractures.
|
| Thorén et al., 2001 2121 Thore´n T, Hallikainen D, Iizuka T, Lindqvist C. Condylar process fractures in children: a follow-up study of fractures with total dislocation of the condyle from the glenoid fossa. J Oral Maxillofac Surg. 2001;768-73.
|
To investigate the incidence of functional impairment and radiological findings related to the TMJ in children with condylar fractures that were not surgically treated |
A total of 138 children with unior bilateral condylar fractures |
Questionnaire on TMJ function
Radiological examination Clinical examination: palpation and TMJ auscultation; investigation and measurement of midline deviations during mouth opening; and measurement of the maximum mouth opening, lateralization, and protrusion
Monitoring period: from 4.8 to 16.4 years |
Totally, 56% patients exhibited some form of symptoms and
72% showed signs of objective TMJ dysfunction.
It was found that conservative treatment may be indicated for patients below 15 years old.
|
Hlawitschka et al., 2005
22 |
To evaluate and compare the results of open and closed treatments for intracapsular fractures |
Forty-three patients were divided into two groups: 1) Fourteen (15 fractures) with an average age of 31 years were treated by open reduction with internal fixation
2) Twenty-nine (34 fractures) with an average age of 28 years were treated by closed reduction |
Clinical examination
Radiological examination
Axiography |
Patients treated by internal fixation showed better radiological outcomes
Both groups showed signs of persistent dysfunction, although lesser impairment was observed in the group treated with internal fixation
Axiography revealed significant limitations in condylar movements in both groups, although TMJ irregularities were significantly less frequent in the open treatment group.
It was found that in cases of complex reconstruction of the mandibular condyle, open reduction and internal fixation improve the prognosis of bone anatomy and recovery of soft tissues when combined with therapeutic exercises after surgery. |
| Kaplan et al, 2001 2323 Kaplan BA, Hoard MA, Park SS. Immediate mobilization following fixation of mandible fractures: a prospective, randomized study. Laryngoscope. 2001;111(9):1520-4.
|
To compare the results of open reduction and internal fixation between patients with displaced mandibular fractures who underwent immediate mobilization and those who did not. |
Twenty-nine patients older than 16 years who underwent open reduc-
tion and internal fixation were divided into two groups:
1) Sixteen underwent immediate mobilization 2) Thirteen underwent maxillomandibular fixation for 2 weeks |
Evaluation time points: six weeks and 3 and 6 months after surgery.
Evaluated parameters: pain, fracture healing, occlusal condition, trismus, inferior alveolar nerve condition, weight loss, and wound infection
Evaluated by a blinded surgeon |
There was no significant difference between groups in any of the evaluated parameters assessed at the different time points. |
| Rutges et al., 2006 2424 Rutges JP, Kruizinga EH, Rosenberg A, Koole R. Functional results after conservative treatment of fractures of the mandibular condyle. Br J Oral Maxillofac Surg. 2007 Jan;45(1):30-4.
|
To investigate the functional outcome of patients who undergo conservative treatment of condylar fractures |
Twenty-eight patients (25 men and three women) with condylar fractures
Average age: 30 years
. Average time of fracture:
3 years. |
Anamnesis
Clinical examination: functionality was scored using the Helkimo index.
Radiological examination |
The clinical dysfunction index revealed serious symptoms in 11% patients, moderate symptoms in 39%, mild symptoms in 39%, and the absence of symptoms in 11%. In addition, there were severe alterations in occlusion in 21% patients, moderate alterations in 61%, and the absence of alterations in 11%.
Anamnesis revealed the absence of symptoms in 89% patients.
According to the established criteria, the conservative treatment of condylar fractures was satisfactory only in 46% patients. |
| Throckmorton et al., 2003 2525 Throckmorton GS, Ellis E 3rd, Hayasaki H. Jaw kinematics during mastication after unilateral fractures of the mandibular condylar process. Am J Orthod Dentofacial Orthop. 2003;124(6):695-707.
|
To compare masticatory movements between patients with treated unilateral condylar fractures and healthy controls
To establish the time required for the restoration of normal masticatory movements |
Eighty-one men with condylar fractures aged 16 to 70 years
Control group: Fifteen men aged 22 to 23 years
|
Recording of mandibular movements and computational analysis of chewing
Evaluation time: six weeks, 6 months and 1 and 2 years after treatment
Treatments: open or closed reduction + physical therapy (elastics and guided jaw mobilization)
|
The total duration of chewing cycles and the phases of mouth opening and jaw closing were significantly lesser in the control group than in the treated patients, regardless of the chewing side, type of treatment, and evaluation time
It was found that unilateral condylar fractures can alter the chewing cycle in adults for several years, particularly on the opposite side of the fracture. |
| Gerbino et al., 2009 2626 Gerbino G, Boffano P, Tosco P, Berrone S. Long-term clinical and radiological outcomes for the surgical treatment of mandibular condylar fractures. J Oral Maxillofac Surg. 2009;67:1009-14.
|
To evaluate the efficacy and safety of a therapeutic method
To analyze long-term clinical and radiological findings of patients who undergo open reduction and internal fixation of the condyle (extraoral approach) |
Thirty-three men and 17 women with unior bilateral condylar fractures Average age: 30 years |
Treatment: retromandibular access, preauricular + elastics for 7 days + elastics for more than 7 days only at night + intake of soft diet for 30 days + functional exercises from the 15th day + intensification of functional therapy after 30 days + persistence of training until 6 months after surgery
Evaluation: radiological and clinical examinations
Evaluation time points: before and after treatment. |
A total of 12% patients exhibited facial muscle paralysis, which was permanent in 4%
Clinical and radiological evaluation revealed satisfactory recovery of facial symmetry and excellent recovery of facial function. Few patients complained of symptoms related to TMJ. Condylar remodeling was extensive in 8% patients, mild or moderate in 47%, and absent in 45%. A statistically significant correlation was observed between condylar remodeling and impairment in mouth opening
Surgical treatment associated with postoperative functional therapy was found to promote the recovery of occlusion, function, and facial symmetry. |
| Sforza et al., 2009 2727 Sforza C, Tartaglia GM, Lovecchio N, Ugolini A, Monteverdi R, Gianni AB. Mandibular movements at maximum mouth opening and EMG activity of masticatory and neck muscles in patients rehabilitated after a mandibular condyle fracture. J Craniomaxillofac Surg. 2009 Sep;37(6):327-33.
|
To quantitatively assess rotational and translational jaw movements during maximum mouth
opening in patients who were success-
fully rehabilitated after condylar fractures
|
Eight men and one woman with condylar fractures
Average age: 34 years Control group: healthy adult individuals matched to the patient group |
All patients received functional therapy for approximately 40 days after surgery.
Evaluated parameters: free mouth opening evaluated by three-dimensions analysis and division of movement into rotational and translational components and SEMS findings for the masseter, anterior temporal, and sternocleidomastoid muscles during maximum dental intercuspation
Moment: between the 6th and 36th month of treatment
(average of 18 months) |
Patients presented with a significantly lower range of mouth opening compared with controls, with a greater decrease in the vertical displacement component.
Percentage of rotational movements was significantly higher in patients (82%) than in controls (77%).
During maximum dental intercuspation, patients showed higher asymmetry and significant higher torque and contraction values for the sternocleidomastoid muscle.
Total recovery of opening movements could be achieved, although the rotational and translational components of this movement were altered. |
| Throckmortonet al, 2004 2828 Throckmorton GS, Ellis III E, Hayasaki H. Masticatory motion after surgical or nonsurgical treatment for unilateral fractures of the mandibular condylar process. J Oral Maxillofac Surg. 2004;62:127-38.
|
To compare mandibular movements during chewing between
patients with unilateral condylar fractures treated with open procedures and those treated with closed procedures |
Eighty-one patients with unilateral condylar fractures treated with open (n = 37) or closed (n = 44) procedures
Average age: 16 to 70 years |
All patients were instructed to follow the same physical therapy protocol (elastics and exercises for mandibular movement).
Evaluation: mandibular movements during mastication and computational analysis of the same
Evaluation time: 6 weeks, 6 months, and 1 and 2 years after fracture
Evaluated parameters: chewing cycle duration and maximum mandibular excursion during the chewing cycle, with three-dimensional
analysis of the latter move-
ment |
There was no significant difference between groups in the duration of the chewing cycle and the maximum mandibular excursion.
Surgical correction of unilateral condylar fractures was found to have little effect on mandibular movements the chewing pattern. |
| Jensen et al., 2006 2929 Jensen T, Jensen J, Norbolt SE, Dabt M, Lenk-Hansen L, Svensson P. Open reduction and rigid internal fixation of mandibular condilar fractures by an intraoral approach: a long-term follow-up sudy of 15 patients. J Oral Maxillofac Surg. 2006;64(12):1771-9.
|
To evaluate the longterm outcomes of open reduction and internal fixation for condylar fractures
using the intraoral approach |
Nine men and six women
Average age: 42 years
A total of 24 condylar fractures |
Evaluation time points: before
and after surgery (average of 23 months)
Evaluation: clinical examination, radiological examination, assessment of the psychological status, measurement of maximum bite force in maximal occlusion, pain thresholds in TMJ and chewing muscles measured using a pressure algometer
|
Two patients were diagnosed with impaired TMJ movements
Fracture healing was considered satisfactory in 12 joints
Mini-plate fracture occurred in three patients and severe bone resorption of the condyle in one.
Minor occlusal adjustments were necessary in six patients.
No significant difference was found in the maximum bite force and maximum pain threshold between the fractured side and the normal side in patients with unilateral fractures and between the operated side and nonoperated side in patients with bilateral fractures.
Open reduction and rigid internal fixation of condylar fractures using the intraoral approach requires expertise and was found to be associated with a high risk of postoperative complications. |
| Caldas et al., 2008 3030 Caldas IM, Magalhães T, Afonso A, Matos E. Orofacial damage resulting from road accidents. Dent Traumatol. 2008;24(4):410-5
|
To monitor the growth of children with subcondylar fractures |
Eighteen children
Average age at trauma:
7.7 years
A total of 21 fractures |
Treatment: intermaxillary fixation for 12 to 17 days, liquid diet for 15 days after fixation, and functional treatment (mouth opening exercises)
Follow-up: three to 6 years, with an average of 4.7 years
Evaluation: palpation and auscultation of TMJs, evaluation of the interincisal distance, and measurement of the maximum lateral excursion of the jaw
|
The maximum interincisal distance during mouth opening varied from 34 to 43 mm (slight deviation to the side of fracture in four patients)
The average lateralization to the side of fracture was 8.4 mm, while that to the contralateral side was 7.8 mm
Conservative treatment of condylar fractures in growing individuals was found to result in satisfactory functional outcomes and condylar remodeling. Functional treatment after intermaxillary fixation for 12 to 17 days proved to be acceptable. |
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