Department of Orthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
Eur J Orthod. 2012 Apr;34(2):147-51. doi: 10.1093/ejo/cjq154. Epub 2011 Feb 25.
Early fracture of the mandibular condyles may be related to an asymmetric morphologic occlusion. The aim of the study was to investigate the morphologic occlusal symmetry of non-surgically treated children after condylar fractures. The original study group consisted of 55 subjects (31 males and 24 females) who suffered temporomandibular joint condylar fractures at a young age and were treated conservatively, with physiotherapy only. Thirty-two of the respondents who were injured at a mean age of 6.5 years (range 9 months-12 years) comprised the study group. Their occlusion was re-examined intra-orally as well as on study models, at the mean age of 10.5 years (range 2.8-20.7 years). Of these, 21 suffered unilateral and 11 bilateral condylar fractures. The control group comprised a random population of 705 school children. The chi-square test was used for statistical comparison. The general distribution of occlusal patterns (Angle) differed significantly in the study group and in the controls. From the asymmetric occlusal features, only the lower midline deviation was found to be slightly more prevalent in the injured group, with almost perfect coincidence of the side of the fracture and the direction of the lower midline deviation. No significant differences were found in the distribution of posterior crossbite, anterior crossbite, and Class II subdivision in the two groups. Among children who experienced condylar fractures, a higher prevalence of malocclusion was diagnosed; the most prominent asymmetric trait was lower midline deviation coinciding with the side of the unilateral fractured condyle.
早期下颌骨髁突骨折可能与不对称的形态咬合有关。本研究旨在探讨未经手术治疗的儿童髁突骨折后的形态咬合对称性。原始研究组包括 55 名患者(31 名男性和 24 名女性),他们年轻时患有颞下颌关节髁突骨折,仅接受物理治疗进行保守治疗。32 名在平均年龄为 6.5 岁(9 个月至 12 岁)时受伤的受访者构成了研究组。在平均年龄为 10.5 岁(2.8-20.7 岁)时,通过口腔内检查和模型检查重新检查了他们的咬合情况。其中,21 人患有单侧髁突骨折,11 人患有双侧髁突骨折。对照组由 705 名学校儿童的随机人群组成。使用卡方检验进行统计比较。研究组和对照组的咬合模式(Angle)总体分布差异显著。在不对称的咬合特征中,只有下颌中线偏差在受伤组中略为常见,且与骨折侧和下颌中线偏差方向几乎完全一致。两组之间的后牙反颌、前牙反颌和 II 类亚类的分布无显著差异。在经历髁突骨折的儿童中,诊断出更高的错颌发生率;最突出的不对称特征是与单侧骨折髁突侧一致的下颌中线偏差。