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Condylar Fracture and tmj

Ephraim R Rikhotso, Muhammad A Bobat
Traumatic dislocation of the mandibular condyle into the middle cranial fossa is an extremely rare complication of maxillofacial injury. The rarity of this injury has led researchers to propose a set of anatomic features that might explain this injury. These features include a small rounded condylar head, hyper-pneumatization of the temporal bone, a thin roof over the glenoid fossa, and missing posterior teeth. The greatest risk factor for this injury is a blow to the chin when the mouth is open without fracture of the condyle (and therefore no dissipation of the forces)...
July 30, 2016: Journal of Oral and Maxillofacial Surgery
Leila Khojastepour, Shirin Kolahi, Nazi Panahi, Abdolaziz Haghnegahdar
OBJECTIVES: Differential diagnosis of bifid mandibular condyle (BMC) is important, since it may play a role in temporomandibular joint (TMJ) dysfunctions and joint symptoms. In addition, radiographic appearance of BMC may mimic tumors and/or fractures. The aim of this study was to evaluate the prevalence and orientation of BMC based on cone beam computed tomography (CBCT) scans. MATERIALS AND METHODS: This cross-sectional study was performed on CBCT scans of paranasal sinuses of 425 patients...
December 2015: Journal of Dentistry of Tehran University of Medical Sciences
Sudheesh K M, Rajendra Desai, Siva Bharani K Sn, Subhalakshmi S
There are no clearly defined guidelines for when an open or closed treatment is indicated for treatment of mandibular condylar fractures. The aim of the study is to analyze the mandibular function after nonsurgical treatment of unilateral subcondylar fractures, in a prospective study. A prospective study was conducted on 30 patients with unilateral mandibular subcondylar fracture undergoing nonsurgical treatment. Clinical and radiographic examinations were done prior to treatment and at 12-month follow-up. Pain, perceived occlusion, mouth opening, protrusion, and horizontal movements of the mandible were evaluated by clinical examination...
September 2016: Craniomaxillofacial Trauma & Reconstruction
Bong Chul Kim, Yoon Chang Lee, Hyung Seok Cha, Sang-Hwy Lee
BACKGROUND: This study aimed to evaluate the structural changes of temporomandibular joint immediately after condylar fractures with magnetic resonance imaging (MRI). METHOD: We evaluated 34 subjects of condylar fractures with MRI. The position, shape, and signal intensity of the condyle, disc, and retrodiscal tissue were analyzed with MR images. RESULTS: Immediately after trauma, the disc was displaced with the fractured segment in almost all cases...
December 2016: Maxillofacial Plastic and Reconstructive Surgery
S M Balaji
BACKGROUND: There are several treatment approaches for mandibular condyle fractures. Type of fracture, clinical experience, and preference of the operating surgeon dictate the approach. Given this highly varied outcome, this manuscript intends to document the treatment experience of 75 patients with extracapsular condyle fractures using author's modification of the traditional endaural approach in the region. MATERIALS AND METHODS: A retrospective chart review was performed on patients with mandibular condylar fractures who visited the author's center between 2004 and 2014...
May 2016: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
Y Nabil
A prospective cohort study was performed to investigate concurrent and delayed temporomandibular joint (TMJ) injuries following different types of mandibular fracture using magnetic resonance imaging (MRI). One hundred adult male patients with a recent history of mandibular fracture were included. The patients were divided into five groups according to the site of fracture. The patients underwent MRI within 10 days of the primary injury. The same clinical, radiographic, and MRI examinations were performed 5 years later...
May 26, 2016: International Journal of Oral and Maxillofacial Surgery
Tian-Ge Deng, Chang-Kui Liu, Ping Liu, Lin-Lin Zhang, Li-Geng Wu, Hong-Zhi Zhou, Yu-Xiang Ding, Kai-Jin Hu
BACKGROUND: The pathogenesis of traumatic TMJ ankylosis remains unclear. This study aimed to verify the role of the lateral pterygoid muscle in the pathogenesis of traumatic temporomandibular joint (TMJ) bony ankylosis. METHODS: Eight 6-month-old male sheep were used in this study. Bilateral TMJ osteotomies were performed to induce sagittal fractures of the mandibular condyle. The lateral one-fourth segment of the disc was removed to establish a model of TMJ bony ankylosis...
2016: BMC Oral Health
Maciej Sikora, Marcin Sielski, Agata Stąpor, Dariusz Chlubek
PURPOSE: The purpose of this study was to summarize the results of our own experience in the application of the Delta plate for surgical treatment of condylar fractures. MATERIAL AND METHODS: The research was carried out in 42 patients of the Department for Maxillofacial Surgery, Hospital of the Ministry of Interior in Kielce (Poland), who were surgically treated in the years 2013-2015 after a unilateral condylar fracture. To be qualified for surgery patients fulfilled at least two of the following criteria: (1) presence of occlusal disorders, (2) presence of displacement of fragments, (3) height decrease of the mandibular ramus of over 4 mm, or (4) dislocation of the temporomandibular joint...
July 2016: Journal of Cranio-maxillo-facial Surgery
Joshua P Weiss, Raja Sawhney
PURPOSE OF REVIEW: Fractures of the mandibular condyle have provided a lasting source of controversy in the field of facial trauma. Concerns regarding facial nerve injury as well as reasonable functional outcomes with closed management led to a reluctance to treat with an open operative intervention. This article reviews how incorporating new technologies and surgical methods have changed the treatment paradigm. RECENT FINDINGS: Multiple large studies and meta-analyses continue to demonstrate superior outcomes for condylar fractures when managed surgically...
August 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Yi Zhang
This article summarized the advances in treatment and research of temporomandibular joint surgery in the last 5 years which was presented in "The 2nd Condyle Fracture and Temporomandibular Joint Ankylosis Symposium". The content includes 5 parts: non-surgical treatment of children condyle fracture and long-term follow-up, the improvement of operative approach for condyle fracture and key techniques, the importance and the method for the simultanesous reduction of disc in condylar fracture treatment, the development of traumatic temporomandibular joint ankylosis similar to hypertrophic non-union and the improved safety and accuracy by applying digital surgery in joint surgery...
March 2016: Zhonghua Kou Qiang Yi Xue za Zhi, Zhonghua Kouqiang Yixue Zazhi, Chinese Journal of Stomatology
H Takano, T Takahashi, A Nakata, S Nogami, K Yusa, S Kuwajima, M Yamazaki, M Fukuda
The aim of this study was to investigate the bone resorption effect of the mediators delivered in joint cavity of patients with mandibular condyle fractures by detecting osteoclast markers using cellular biochemistry methods, and by analysing bone resorption activities via inducing osteoclast differentiation of the infiltrated cells from arthrocentesis. Sixteen joints in 10 patients with mandibular condyle fractures were evaluated. The control group consisted of synovial fluid (SF) samples from seven joints of four volunteers who had no clinical signs or symptoms involving the temporomandibular joint (TMJ) or disc displacement...
May 2016: Journal of Oral Rehabilitation
Hui Li, Gang Zhang, Junhui Cui, Weilong Liu, Dilnu Dilxat, Lei Liu
PURPOSE: The facial nerve remains at risk of injury with the preauricular approach; thus, preservation of the functional integrity of the facial nerve is considered an important factor in the success of temporomandibular joint surgery. The aim of this study was to prevent facial nerve injury using the supratemporalis approach in the treatment of intracapsular condylar fractures. MATERIALS AND METHODS: In this prospective cohort study, the population consisted of patients diagnosed with intracapsular condylar fractures who received surgical treatment from July 2005 to May 2014...
May 2016: Journal of Oral and Maxillofacial Surgery
X Y Quan, M Qin, Y F Kang, Y Zhang, Y M Zhao
OBJECTIVE: To evaluate the developmental and functional outcome of condylar fractures in children and adolescents after conservative treatment. METHODS: Eight children and adolescents with unilateral condylar fracture, aged 5-13 were included. A removable occlusal splint, the thickness of which was determined according to the age, the developmental stage of the dentition, the level of the fracture and the degree of dislocation, worn for 1-3 months, and the patients were asked to perform functional exercises...
January 2016: Zhonghua Kou Qiang Yi Xue za Zhi, Zhonghua Kouqiang Yixue Zazhi, Chinese Journal of Stomatology
JiSi Zheng, ShanYong Zhang, Chi Yang, Ahmed Abdelrehem, DongMei He, HanHsuan Chiu
To evaluate the displacement of the disc of the temporomandibular joint (TMJ) in different types of condylar fracture we studied 160 patients (222 joints) from May 2009-June 2014. All patients had computed tomographic scans (CT) and magnetic resonance images (MRI) taken preoperatively, and 24 patients (32 joints) had MRI postoperatively. CT scans were reviewed to categorise the types of condylar fracture (intracapsular, condylar neck, and subcondylar), and intracapsular condylar fractures were further classified into subtypes A, B, C, and M...
January 2016: British Journal of Oral & Maxillofacial Surgery
Yavuz Yildirim, Eugene E Keller
Treatment of condylar fractures is variable and controversial. Treatment options for management of condylar fractures include surgical and nonsurgical methods, and if a nonsurgical method is as effective as a surgical method, the former is preferred. Although plain film radiographs and functional outcomes attained through nonsurgical treatment are well established in literature, evidence of the remodeling process through detailed, high-quality imaging is lacking. The purpose of this case series is to describe and illustrate two adults and one pediatric patient with significantly displaced condylar fractures treated nonsurgically with excellent clinical results...
December 2015: Craniomaxillofacial Trauma & Reconstruction
Maciej Sikora, Tomasz Olszowski, Marcin Sielski, Agata Stąpor, Joanna Janiszewska-Olszowska, Dariusz Chlubek
AIM: To assess the results of surgical treatment of condylar fractures using the transparotid approach. MATERIAL AND METHODS: The transparotid approach was used in 38 patients with unilateral condylar fracture. In four cases a single 2.0 plate was used, in the latter - 3D plates were used. All the patients were subjected to control clinical examination including: occlusion, facial nerve function, mandibular movements, pain presence, subjective assessment of the scar aesthetics and the presence of salivary fistula or salivary cyst on the first day following surgery and after 1, 3 and 6 months...
December 2015: Journal of Cranio-maxillo-facial Surgery
Shuo Chen, Yi Zhang, Jin-Gang An, Yang He
PURPOSE: Symphyseal and parasymphyseal fractures and bilateral condylar fractures represent a pattern that is quite challenging to manage. This study evaluated the treatment outcomes of a group of patients who underwent surgery using miniplate fixation for anterior mandibular fractures. MATERIALS AND METHODS: This retrospective case series study reviewed patients with bilateral condylar fractures and noncomminuted symphyseal and parasymphyseal fractures. The patients were surgically treated from 2008 to 2014 in the department of oral surgery...
February 2016: Journal of Oral and Maxillofacial Surgery
Richik Tripathi, Naresh Sharma, Amit Nandan Dwivedi, Sanjeev Kumar
PURPOSE: This study aimed to quantify articular soft tissue injury in condylar fractures based on magnetic resonance imaging (MRI) findings and investigate the impact of severity of articular soft tissue injury on the development of postoperative complications after functional reduction of a condylar fracture. PATIENTS AND METHODS: Fifty-four patients 18 to 60 years old with unilateral undisplaced, deviated, or displaced condylar fractures were included in this prospective study...
December 2015: Journal of Oral and Maxillofacial Surgery
Eugénio Martins, Joana-Cristina Silva, Carlos A Pires, Maria-João-Feio Ponces-Ramalhão, Jorge-Dias Lopes
INTRODUCTION: The joint space measurements of the temporomandibular joint have been used to determine the condyle position variation. Therefore, the aim of this study is to perform a systematic review and meta-analysis on the coronal joint spaces measurements of the temporomandibular joint. MATERIAL AND METHODS: An electronic database search was performed with the terms "condylar position"; "joint space"AND"TMJ". Inclusionary criteria included: tomographic 3D imaging of the TMJ, presentation of at least two joint space measurements on the coronal plane...
July 2015: Journal of Clinical and Experimental Dentistry
J H Kim, D H Nam
Most surgeons agree that closed treatment provides the best results for condylar fractures in children. Nevertheless, treatment of the paediatric mandibular condyle fracture that is severely displaced or dislocated is controversial. The purpose of this study was to investigate the long-term clinical and radiological outcomes following the treatment of displaced or dislocated condylar fractures in children using threaded Kirschner wire and external rubber traction. This procedure can strengthen the advantage of closed reduction and make up for the shortcomings of open reduction...
October 2015: International Journal of Oral and Maxillofacial Surgery
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