• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.2
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• pp.164-170
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• 2005

The purpose of this study was to compare a sample of patients who had condylar fractures treated with open reduction using different plating techniques, to evaluate which plating technique is useful for stable fixation for fractures of the mandibular condyle and to evaluate effectiveness of resorbable miniplate. There were 60 patients (41 males, 19 females) whose condylar fractures were treated with open reduction. Rigid fixation was performed with a single miniplate, double miniplate ot one miniplate & one microplate and single resorbable plate. All patients remained intermaxillary fixation for 1 week postoperatively. Active physiotherapy was started after 2 weeks postoperatively. Radiographic evaluation (plate fracture, plate bending, screw loosening, displacement of condyle etc.) was performed at pre-operative, immediate, 2 weeks, 1 month, 3 months, 6 months after surgery. Clinical evaluation included degree of mouth opening, occlusion, mandibular lateral excursion, infection and facial nerve paralysis. In radiographic evaluation, displacement of fractured condylar segment associated with plate bending or screw loosening were showed 6 cases and 3 cases for single miniplate system and resorbable miniplate system. There was no patients who have this problem on double miniplate system. The results revealed that the application of two miniplates were more recommendable than single miniplates. When we select resorbable miniplate system, we should consider the type of fractures, post-operative treatment protocol and surgical technique.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.6
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• pp.269-274
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• 2018

Objectives: The incidence and patterns of mandibular fractures vary by country and population age. This retrospective study evaluated the etiologies and patterns of mandibular fractures in children. Materials and Methods: The clinical records of 89 children (45 males and 44 females) aged 0 to 12 years who presented with mandibular fractures from July 2012 to June 2016 were retrospectively reviewed. The sex, patient age, site of fracture, etiology of trauma, and monthly variations of the fractures were recorded. Descriptive statistics, the z-test and chi-square test were used for statistical analysis and the P-value was set at <0.05. Results: Eighty-nine children (male-to-female ratio 1.02:1) sustained 131 mandibular fractures. Within the study sample, the 6 to 9 year age group most frequently experienced fractures (47.3%). Falls and road traffic accidents (RTA) were the two most common etiological factors that accounted for 44.9% and 24.7% of cases. The condylar fracture was the most common anatomical location (38.9%) followed by the angle (20.6%), parasymphysis (18.3%), body (15.3%), and symphysis (5.3%). A single fracture (51.7%) was more common than multiple fractures (48.3%). The month-wise distribution of mandibular fractures was fairly constant. Conclusion: The condylar region was the most common anatomic site for fractures; in addition, a fall and RTA were the major etiological factors for mandibular fractures. A single fracture was observed in 51.7% of patients while multiple fracture lines accounted for 48.3% of cases.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.372-380
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• 2005

Condylar process of mandible, has the specialized anatomic structure compared with any other body structure, acts directly in connection with mastication and speech and so on. In general, mandibular condyle fractures have been managed by two methods as open and closed reduction. But, there are no reasonable consensus about the proper management of this injury. This study was designed for analysis of the prognosis of two methods of treatment, open and closed reduction, with positional change of fractured condyle and complications within 6 months post-intermaxillary fixation period. We conducted a retrospective analysis of 154 patients whose unilateral mandibular condyle fractures were treated by open or closed reduction in our department. The horizontal, sagittal, and coronal change of the condyle was examined using modified Towne's and panoramic radiographs before intermaxillary fixation(IMF), immediately after IMF, and at 6 months after IMF. Patients, whose mandibular condyle fractures were treated by closed reduction, had significantly shorter ramus height on the side of injury(P<0.05). But, fractured condylar fragments were displaced insignificantly with aspect to sagittal and coronal plane(P>0.05). The level of the fracture influenced the ramus length and the degree of coronal change in the closed reduction group(P<0.05). There was no significant correlation among the level of the fracture, treatment methods and complications(P>0.05). From the results obtained in this study, fractured mandibular condyles, were treated by closed reduction, had a tendency that continuous condylar displacement was occurred with aspect to horozontal and coronal plane in treatment period including intermaxillary fixation. And then there was a correlation between the level of the fracture and the position change in close reduction group statistically. These result suggested that care must be taken in basing treatment decisions on the degree of displacement of the condyle and in treating the mandibular condyle fractures for a long time.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.3
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• pp.135-139
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• 2014

This following case report describes the open reduction, internal fixation and the reconstruction of an extensive comminuted mandibular fracture with bilateral condylar fractures in a 19-year-old male patient with an intellectual disability and autistic disorder. He suffered fall trauma, resulting in shattered bony fragments of the alveolus and mandibular body between both mandibular rami, the fracture of both condyles and the avulsion or dislocation of every posterior tooth of the mandible. The patient underwent open reduction and internal fixation between both mandibular rami using a reconstruction plate, open reduction and internal fixation of the shattered fragments using miniplates and screws, and the closed reduction of the bilateral condylar fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.1
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• pp.31-39
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• 2001

The purpose of this study is to reveal the factors leading to the problem of unilateral condylar fractures and suggest a treatment guideline of treatment for good prognosis in surgical treatment. The factors can be age, sex, fracture site, degree of displacement, posterior occlusion loss, post-operative alteration of condylar head position, post-operative condylar head resorption, and maxillomandibular fixation period. One hundred and eleven patients with unilateral condylar fractures, who were treated by surgical method from 1990 Feb. to 2000 Feb., were studied. Minimum follow-up period was 6 months. The results were as follows ; 1. In the age group of $41{\sim}60$, females had significantly higher complication rate than males, therefore we must be careful about treatment of female in this age group 2. In level I fractures of the mandibular condyle, because there were abundant complications when the patients were treated with fragment removal, conservative treatment is recommended over the surgical approach. 3. There were no differences in the complication rate, in the level II, III fractures. but were severe complications in the cases of patients treated by Dr.Nam's method or fragment removal. Therefore, open reduction and internal fixation is recommended over Dr.Nam's method or fragment removal. 4. In level IV fractures, open reduction and internal fixation is recommended 5. Although there was a higher complication rate depending on the degree of deviation, there was no correlation between the degree of deviation and development of complications in each level of fracture 6. Because the complication rate was higher in cases of condylar resorption, vertical dimension loss, and alteration of condylar head position, we must make an effort to prevent such complications during treatment

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.2
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• pp.167-180
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• 1997

79 surgically managed mandibular condylar fracture patients included the 25 patients treated with Dr, Nam's method were analysed the postoperative resluts in Oral and Maxillofcial Surgery, School of Dentistry, Wonkwang University since 1993 to 1995. Mean patient's age is 32.5 years (range, 8 to 65 years), and follow-up periods were a minimum of 3 months to 28 months. 19% condylar fractures were associated with mostly symphysis portion. According to the patient's age, severity of condylar fractures, clinical signs and symptoms, radiographic findings, treatmenet plans had been performed. Rigid fixation have performed greatly, and then fragment removal of fractured mesial pole of proximal segment of the condylar and little cases of reshaping and eminoplasty and lag screw have been applied. Two cases of the both condylar resorption and deviated condyle posteriorly in Dr. Nam's method. None of infection or necrosis signs of treated condyle surgically. In my opinion, whenever possible, displaced condylar fracture can be managed surgically with rigid fixation, but not Dr. Nam's method. Usually if perform the surgical management of condylar fractures you should maintain maxillomandibular fixation for 2 weeks, or more and has to follow-up functional mandibular exercise should be kept continuously.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.453-458
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• 2004

Mandibular fracture is less common in children than in adults. However, children are more susceptible to ankylosis and developmental disorders, and don't respond as well to intermaxillary fixation compared to adults. On the other hand, bone fracture is healed more quickly in children and complications are scarce. Mandibular fracture in children is usually treated successfully with acrylic splint therapy with or without the use of eyelet wires and intermaxillary fixation. Severe complications that include ankylosis and developmental disorders may occur. The frequency and severity of such complications can be mitigated with a shorter duration of intermaxillary fixation and good post-operative care. Encouraging mandibular physical therapy by increasing patient motivation may be necessary in such cases where the patient's response is poor and the duration of intermaxillary fixation increases; when the patient is unable to undergo physical therapy, or when intermaxillary fixation is not necessary with the patient showing only minor symptoms such as trismus. In this case report, a 6 year-old girl with bilateral condylar fracture was treated with elastic in both the upper and lower jaws to allow mandibular physical therapy using a Benoist's appliance, which allows opening, lateral, and protrusive retrusive movements of the mandible. A 7-month follow-up showed beneficial therapeutic effects such as increased mandibular movement and prevention of condylar ankylosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.2
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• pp.171-179
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• 1995

The conservative treatment of the condylar fracture has been used for a long time because of its simplicity, good prognosis and less complication. Traditionally the conservative treatment has been carried out by maxillomandibular fixation using arch bar and wire. But a simplified technique of maxillomandibular fixation introduced here is a procedure that 4 bone screws are placed above the apecies of the maxillary and mandibular canines and then ipsilaterally placed maxillary and mandibular bone screws are linked by a loop of wire each other. This procedure has several advantages compared with the traditional maxillomandibular fixation method. 1) it provides simplicity for the operators. 2) it sustains maxillomandibular fixation more rigidly compared with arch bar technique. 3) it keeps stable maxillomandibular fixation in the region of the anterior teeth so that anterior open bite tendency can be remarkably minimized. 4) it does not injure the periodontal tissue because the teeth are not engaged and causes less discomfort to the patient. 5) it decreases the possibility of operator's AIDS infection through inadvertent skin puncture. 6) it is highly recommended for the patients whose teeth are available for maxillomandibular fixation. The two male patients were diagnosed as bilateral condylar and symphyseal fracture of the mandible. They restored stable occlusion and functional mandibular movement only by a simplified technique of maxillomandibular fixation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.1
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• pp.49-55
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• 2004

The management of mandibular condylar fractures in children has long been a matter of controversy. The fracture, if not treated appropriately, may result in complications such as disturbance of mandibular growth and temporomandibular joint ankylosis. They are usually treated nonsurgically, which has been proved to be satisfactory in the long term results. Nineteen children with 25 condylar fractures experienced during their growth period (age at trauma from 10 months to 12 years, mean 7.0 years) were studied. All patients were treated by arch bars and intermaxillary fixation for $7{\sim}14$ days. They have been evaluated with clinical and radiographic examination. The maximum mouth opening and lateral movement of the mandible were within normal limits. There was no malocclusion or ankylosis. Beginning of remodelling was evident at postoperative $1{\sim}3$ months. Remodelling of the condyle was good in 21, while partial adjustment occured in the other 4 condyles. These results suggest that the conservative treatment of condylar fractures in growing children results in good functional results and good remodelling of the condyle.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.13 no.1
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• pp.7-15
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• 1983

The purpose of this study was to investigate the radiographic images of the condylar head in clinically normal subjects and the TMJ patients using standardized projection technique. 45 subjects who have not clinical evidence of TMJ problems and 96 patients who have the clinical evidence of TMJ problems were evaluated, but the patients who had fracture, trauma and tumor on TMJ area were discluded in this study. For the evaluation of radiographic images, the author has observed the condylar head positions in closed mouth and 2.54㎝ open mouth position taken by the standardized transcranial oblique lateral projection technique. The results were as follows: 1. In closed mouth position, the crest of condylar head took relatively posterior position to the deepest point of the glenoid fossa in 8.9 % of the normals and in 26.6% of TMJ patients. 2. In 2.54㎝ open mouth position, condylar head took relatively posterior position to the articular eminence in 2.2% of TMJ patients and 39.6% of the normals. 3. In open mouth position, the horizontal distance from the deepest point of the glenoid fossa to the condyla head was 13.96㎜ in the normals and 10.68㎜ in TMJ patients. 4. The distance of true movement of condyalr head was 13.49㎜ in the normals and l0.27㎜ in TMJ patients. 5. The deviation of mandible in TMJ patients was slightly greater than that of the normals.