Condylar position changes and prognosis in patients with unilateral mandibular condylar fracture treated non-surgically

Jihye Lim; Woomin Jo; Hyelynn Jeon; Seung Il Song; Jeong Keun Lee

doi:10.1186/s40902-024-00454-5

Condylar position changes and prognosis in patients with unilateral mandibular condylar fracture treated non-surgically

Maxillofac Plast Reconstr Surg. 2024 Dec 27;46(1):42. doi: 10.1186/s40902-024-00454-5.

Authors

Jihye Lim¹, Woomin Jo¹, Hyelynn Jeon², Seung Il Song¹, Jeong Keun Lee³

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Republic of Korea.
² Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Republic of Korea.
³ Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Republic of Korea. arcady@ajou.ac.kr.

PMID: 39725784
DOI: 10.1186/s40902-024-00454-5

Abstract

Background: Non-surgical method is a treatment option for mandibular condylar fracture; however, it is questionable whether bone fragments are adequately reduced and remodeled. The purpose of this study was to identify three-dimensional positional changes in the mandibular condyles in patients treated non-surgically, analyze factors influencing the extent of positional changes, and evaluate clinical prognosis.

Methods: This retrospective study included 31 patients with unilateral mandibular condylar fractures treated non-surgically at the Ajou University Dental Hospital between 2005 and 2023. Computed tomography was performed at the time of the fracture (T ₀) and > 6 months after non-surgical treatment (T ₁). The extent of recovery of the highest point of the condyle head was measured in three-dimensional x-, y-, and z-axes. At the last follow-up > 6 months after remodeling (T ₁), the prognosis was evaluated by clinical examination of mouth opening limitation, malocclusion, deviation on opening, temporomandibular joint disorder (TMD), and facial asymmetry.

Results: Position differences were statistically significant between T₀ and T₁ (paired Student's t-test, P < 0.05), and between the x-, y-, and z-axes (Welch's ANOVA, P < 0.05). The degree of positional recovery in the superior and lateral directions showed a statistically significant negative correlation with age (Pearson's correlation analysis, P < 0.05). The average amount of recovery between two age groups of over and under 19 years old was statistically significant (independent t-test, P < 0.05). Complications included TMD (6.4%), malocclusion (3.2%) and facial asymmetry (3.2%).

Conclusion: After non-surgical treatment, the condyle head of the fractured mandible recovered significantly laterally and superiorly in under 19-year-olds. The functional prognosis was favorable in all age groups. Non-surgical treatment can be an applicable treatment option for patients with mandibular condylar fractures.

Keywords: Mandibular condylar fracture; Non-surgical treatment; Positional recovery; Prognosis.