• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권1호
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• pp.82-88
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• 2005

Treatment methods of mandibular condylar fracture were conservative and surgical method. Surgical method of mandibular high condylar fracture was very difficult because approach and internal fixation of small size fracture fragment were difficult. So there is a tendency to select conservative method over surgical method for guiding a stable occlusion and avoiding TMJ disorder and growth disturbance, minimizing pain and deviation during function. But, in case of mandibular high condylar fracture patient who has no biting teeth on posterior teeth area, guiding a stable occlusion and conservative functional treatment were very difficult. In this case, patient was 62years old male. He had fracture of mandibular symphysis, right mandibular body, left mandibular high condyle. We treated the patient for mandibular symphysis and right mandibular body fracture area with surgical method. But left mandibular high condylar fracture area was difficult to treat with surgical method. So we selected a conservative functional method on left mandibular high condylar fracture area. We intended recovery of vertical dimension and stable occlusion with implantation of immediate provisional implant on maxillar and mandibular posterior teeth area, and temporary crown. And then patient did mandibular functional movement and his mandibular function was recoverd.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권5호
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• pp.267-276
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• 2022

Objectives: Recently a modified high-submandibular approach (HSMA) has been introduced for treatment of condylar fracture. This approach involves an incision line close to the mandibular angle and transmasseteric transection, leading to a low incidence of facial palsy and allowing good visualization of the condyle area, especially the condylar neck and subcondyle positions. This study reports several cases managed with this modified HSMA technique for treating condylar fractures. Materials and Methods: Six cases of condylar fractures treated with modified HSMA technique were reviewed. Results: Three unilateral subcondylar fracture, 1 bilateral subcondylar fracture, 1 unilateral condylar neck fracture, 1 unlateral simultaneous condylar neck and subcondylar fracture cases were reviewed. All the cases were successfully treated without any major complication. Conclusion: Reduction, fixation, and osteosynthesis of condylar fractures via the modified HSMA technique enabled effective and stable treatment outcomes. Therefore, the described approach can be used especially for subcondylar and condylar neck fractures with minimal complications.

• 대한두개안면성형외과학회지
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• 제10권2호
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• pp.131-134
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• 2009

저자들은 보편적으로 보존치료가 불가능 하여 관혈적 정복술이 필요한 하악의 관절돌기골절 증례에서 당뇨, 고혈압의 병력, 고령으로 인한 절개 및 박리, 전신마취 시간증가로 발생할 수 있는 합병증을 줄이기 위해 우선적으로 시행한 형광투시하의 비관혈적 도수정복만으로 정확한 정복에 성공할 수 있었고 이후 골 유합까지 유지하여 만족스런 결과를 얻었기에 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제19권2호
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• pp.144-150
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• 2002

영남대학교 의과대학 부속병원 치과학교실에서는 악기능 장치를 이용하여 비관혈적 정복술을 시행한 하악 과두 골절 1례에서 양호한 치료 경과를 보였기에 문헌 고찰과 함께 보고하는 바이다. 추후 본 증례에 기초한 다수 증례의 연구가 필요할 것으로 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권5호
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• pp.488-492
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• 2010

This review evaluates the literature on the relationship between mandibular condylar process fracture and temporomadibular joint (TMJ). The topic of condylar fracture generated more discussion and controversy than any other field of maxillofacial trauma associated with TMJ. Disturbance of occlusal function, devia-tion of mandible, internal derangements of TMJ, and ankylosis of the joint with resultant inability to move the jaw are sequelae of condylar process fracture. Thus it is necessary to understand how the masticatory system adapts to the structural alterations that accompany fractures of the mandibular condyle. Treatment of condylar process fracture include two methods ; closed treatment and open treatment. If one chooses totreat closed, one must understand that adaptations in the musculature, skeleton, and dentition will be necessary. Open treatment of condylar process fractures probably requires fewer adaptations within the masticatory system to provide a favorable functional outcome. However, one must weigh the risk of open surgery against the possible improvement in outcome. The risks are not just surgical risk, but biological risk as well, such as disruption of the blood supply to the condyle. This review presents relevant aspects of change of TMJ associated with condylar process fracture.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.448-456
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• 2011

Introduction: Condylar fractures are common in the maxillofacial region, comprising 29-40 percent of all mandibular fractures, accounting for about 20-62 percent). Previous studies reported that pediatric condylar fractures can cause disorders in facial growth and function, and the treatment methods have been controversial. Recently, conservative treatment has shown good results in skeletal growth and functional recovery but the conservative treatment of pediatric condylar fractures has shown unpredictable and undesirable results in some cases, such as facial asymmetry and temporomandibular joint disorder. This study examined the specific age groups and specific mandibular condylar fracture type in growing children treated conservatively in the past. Materials and Methods: Eighteen patients (10 men and 8 women) who received conservative treatment for unilateral condylar fractures in Dankook University Dental Hospital between 2000 to 2007 were followed up for a mean period of 7.2 years. Results: In the survey of 18 pediatric patients who received conservative treatment for condylar fractures, the incidence of temporomandibular dysfunction and growth disturbance was 45% and 35%, respectively. Conclusion: In all complications, the symptoms observed most frequently was mouth opening displacement of the mandible exceeding 2 mm. The other complications of functional and growth disturbance included facial asymmetry concentrated along specific condylar types. Complications including facial asymmetry and functional and growth disturbances showed an increasing tendency according to the specific fracture types. Functional and growth disturbances in the undisplaced condylar fracture type showed a lower incidence(P <0.05). Functional and growth disturbances differed according to the fracture type, which has poor relationship with articular fossa and condyle(P <0.05). Functional and growth disturbance in the cases of the high-level condylar fracture type showed a higher incidence(P <0.05). The functional and growth disturbances of the fracture types were similar in the fragment-contact and non-contact groups(P >0.05).

• Archives of Plastic Surgery
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• 제39권4호
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• pp.291-300
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• 2012

The incidence of condylar fractures is high,but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture.

• The Journal of Advanced Prosthodontics
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• 제3권1호
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• pp.51-55
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• 2011

BACKGROUND. Mandibular displacement is a common complication of condylar fracture. In the mandibular displacement due to condylar fracture, it is difficult to restore both esthetics and function without using orthognathic surgery. CASE DESCRIPTION. This clinical report described a full mouth rehabilitation in the patient with bilateral condylar fractures and displaced mandible using bilateral sagittal split ramus osteotomy (BSSRO) and simultaneous dental implant surgery. Mandibular position was determined by model surgery through the diagnostic wax up and restoration of fractured teeth. The precise amount of the mandibular shift can be obtained from the ideal intercuspation of remaining teeth. CLINICAL IMPLICATION. Mandibular displacement by both condylar fractures can be successfully treated by orthognathic surgery. Determination of occlusal plane and visualization from diagnostic wax up are mandatory for mandibular repositioning of model surgery. Stable occlusion and regular recall check up are needed for long-term outcome.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권1호
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• pp.30-36
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• 2014

There are many treatment options in management of mandibular condylar neck fractures. Closed reduction is the most conservative treatment; however, achievement of anatomic reduction is difficult, and there are some risks of mandibular functional impairment. Open anatomic reduction and internal fixation have some advantages; therefore, many oral and maxillofacial surgeons have attempted to achieve anatomic reduction through the open approach and extracorporeal reduction and fixation. However, when using this method, there is some risk of resorption of the fractured mandibular condylar head. Therefore, we designed a modified extracorporeal reduction technique, without detaching the lateral pterygoid muscle in order to maintain the blood supply to the fractured mandibular condylar head. We believe that this minor modification may minimize the risk of resorption of the fractured mandibular condylar head. In this article, we introduce this technique in detail, and report on two cases.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권6호
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• pp.535-544
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• 2005

The management of mandibular condyle fractures continues to be a subject of much debate. It is suggested that, if not properly managed, these fractures may give rise to serious problems, such as malocclusion, mouth opening limitation, temporomandibular joint disorders. Treatment planing of mandibular condyle fractures is very important. The aim of this present study was to evaluate the long-term results according to treatment methods in condylar fractures. Also, it was to evaluate results of treatment according to condylar fracture level. We conducted a retrospective analysis of 43 mandibular condyle fractures. 43 patients followed for average period of 9.00 years(mini. 7yr, max. 12yr). All patients underwent a clinical and radiologic evaluation focusing on mouth opening, mandibular movements, TMJ function, change of ramal height, condylar remodelling. If the level of fracture was positioned in high, especially in level II, mandibular movement disability and ramus length loss was more prominent. This results were similar to the cases of treatment of fragment removal. In high level fracture and fragment removal cases, It is thought that more intensive and long term management are needed than other treatment cases using different operation methods. Also, direct fixation by each approach showed good results in mandibular movement, ramal height change and condylar shape. Through this results, accurate reduction of the mandibular condyle fractures was a very important factor in postoperative prognosis.