Asim Muhammad Adil, Ibrahim Muhammad Wasim, Javed Muhammad Umer, Zahra Rubbab, Qayyum Muhammad Umar
Rawal Institute of Health Sciences Islamabad, Pakistan.
CMH Institute of Medical Sciences Multan, Pakistan.
J Ayub Med Coll Abbottabad. 2019 Jan-Mar;31(1):67-71.
Although mandibular condylar fractures are among the most common fractures of maxillofacial region, the ideal method for treatment of these fractures is still a controversy. The objective of this study was to compare functional outcomes of open vs closed treatment of unilateral mandibular condylar fractures.
This study was carried out at Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi. All patients, included in our study, were randomly put in open and closed treatment groups. Patients were assessed for maximal mouth opening, deviation of mandible on opening and occlusal status six months postoperatively. Maximal mouth opening was assessed by maximal interincisal distance, deviation of mandible on opening by calculating the midline discrepancy during mouth opening and occlusion was assessed by clinical examination according the modified criteria described by Singh V et al. Independent samples t-test was used to compare means of variables in open and closed treatment groups.
After six months of follow up the mean mouth opening was 36.39±4.72 mm in open treatment group while it was 33.74±4.72 mm in closed treatment group and difference was statistically significant. While deviation of mandible on opening was found to be 0.48±0.99 mm in open treatment group and 1.09±1.60 mm in closed treatment group. The mean occlusal disturbance was found to be 1.17±0.38 in closed treatment group while it was 1.10±0.30 in open treatment group..
Open treatment of unilateral mandibular condylar fractures results in better functional outcomes particularly in terms of mobility of mandible (mouth opening).
尽管下颌髁突骨折是颌面部最常见的骨折之一,但这些骨折的理想治疗方法仍存在争议。本研究的目的是比较单侧下颌髁突骨折开放治疗与闭合治疗的功能结果。
本研究在拉瓦尔品第武装部队牙科学院口腔颌面外科进行。纳入本研究的所有患者被随机分为开放治疗组和闭合治疗组。术后六个月对患者进行最大开口度、开口时下颌偏斜和咬合状况评估。最大开口度通过最大切牙间距离评估,开口时下颌偏斜通过计算开口时中线差异评估,咬合通过根据Singh V等人描述的改良标准进行临床检查评估。采用独立样本t检验比较开放治疗组和闭合治疗组变量的均值。
随访六个月后,开放治疗组的平均开口度为36.39±4.72mm,而闭合治疗组为33.74±4.72mm,差异具有统计学意义。开放治疗组开口时下颌偏斜为0.48±0.99mm,闭合治疗组为1.09±1.60mm。闭合治疗组平均咬合紊乱为1.17±0.38,开放治疗组为1.10±0.30。
单侧下颌髁突骨折的开放治疗能带来更好的功能结果,尤其是在下颌活动度(开口度)方面。