Silvennoinen U, Iizuka T, Oikarinen K, Lindqvist C
IV Department of Surgery, Helsinki University Central Hospital, Finland.
J Oral Maxillofac Surg. 1994 Aug;52(8):793-9. doi: 10.1016/0278-2391(94)90219-4.
An attempt was made to identify types of condylar fractures that, despite active nonsurgical treatment, lead to unsatisfactory clinical results.
Ninety-two dentate adult patients with unilateral condylar fractures were studied clinically and radiologically. On the basis of the information collected, problematic cases were identified. These consisted of patients with persistent occlusal change and/or marked deviation of the mandible on mouth opening after removal of maxillomandibular fixation or during follow-up. Radiologic analyses were performed using panoramic and Towne's views, and the results of problematic and nonproblematic cases were compared.
Using clinical parameters, two problem groups were found. In patients with persistent malocclusion, ramus height was significantly reduced, irrespective of degree or direction of angulation between the fragments. Deviation of the jaw on mouth opening, but no occlusal disturbances, occurred in those with dislocated condyles.
Problematic condylar fractures can often be identified preoperatively by means of simple radiographic measurements and these cases should probably be treated surgically.
