How Does the Remodeling Capacity of Children Affect the Morphologic Changes of Fractured Mandibular Condylar Processes After Conservative Treatment?

PURPOSE: Our aim was to explore how the remodeling capacity of children's mandibular condyles affected the morphologic changes of fractured condyles after conservative treatment.

PATIENTS AND METHODS: A retrospective study was designed and performed in children and adult patients with mandibular condylar fractures. Computed tomographic imaging was reviewed for all patients to analyze the morphologic changes and risk factors for traumatic temporomandibular joint ankylosis.

RESULTS: From 2012 to 2017, 81 patients younger than 18 years and 10 adult patients accepted treatment in our department. There were 23 young patients (aged <18 years) with 41 fractured condyles and 10 adults with 14 fractured condyles who were managed with conservative treatment, and the morphologic changes were analyzed with the aid of Mimics 19.0 software (Materialise, Leuven, Belgium). The fractured condyles with intracapsular fractures completed the remodeling progress within 3 to 4 months, and condyles with neck or base fractures took more than 6 months. In contrast, we found no remodeling in adults. Of the 81 young patients, 3 had temporomandibular joint ankylosis. Each case was analyzed regarding the risk factors, morphologic changes, and remodeling features. Finally, the common points of these cases were summarized.

CONCLUSIONS: The shape of fractured condyles can be remodeled after conservative treatment in young patients instead of bony fusion between the fractured fragments compared with adult patients.