Journal List > J Korean Assoc Oral Maxillofac Surg > v.37(6) > 1032501

J Korean Assoc Oral Maxillofac Surg. 2011 Dec;37(6):448-456. Korean.
Published online December 27, 2011.  https://doi.org/10.5125/jkaoms.2011.37.6.448
Copyright © 2011 by The Korean Association of Oral and Maxillofacial Surgeons
The study of the effect of mandibular growth and function in pediatric unilateral condyle fractures
Jin-Kyu Sang and Jae-Hoon Lee
Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Choenan, Korea.

Corresponding author: Jae-Hoon Lee. Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, 29, Anseo-dong, Cheonan, 330-714, Korea. TEL: +82-41-550-1991-3, FAX: +82-41-551-8988, Email: lee201@dankook.ac.kr
Received June 09, 2011; Revised August 31, 2011; Accepted October 12, 2011.

Abstract

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).

Keywords: Child; Mandibular fractures; Mandibular condyle; Growth disorders; Temporomandibular joint disorders

Figures


Fig. 1
Ramal height analysis. (A: superior point of condyle, D: gonial angle, RL: ramal line, ML: mandibular plane)
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Fig. 2
Frontal cephalometric analysis (evaluation of asymmetry). (Co: condylon, Ag: gonial angle, Me: menton, MSR: mid-sagittal reference line at crista galli, Cg: crista galli)
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Fig. 3
Condylar fracture types according to modified Spiessel & Schroll classification. A. Undisplaced extracapsular fracture (I). B. Displaced extracapsular fracture with contact between the fragments (II). C. Displaced extracapsular fracture without contact between the fragments (III). D. Severely displaced intracapsular fracture with contact between the fragments (IV). E. Severely displaced intracapsular fracture without contact between the fragments (V). F. Undisplaced intracapsular fracture (condylar head fracture) (VI).
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Tables


Table 1
Patients with respect age, sex and type of condylar fracture
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Table 2
Patients classification according to age and types of fracture displacement (N=18)
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Table 3
Etiology of mandibular fractures
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Table 4
Clinical evaluation of temporomandibular joint (TMJ) dysfunction classified with age groups
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Table 5
Statistical analysis of functional disturbance according to age groups
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Table 6
Clinical evaluation of growth disturbance classified with age groups
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Table 7
Statistical analysis of growth disturbance according to age groups
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Table 8
Clinical evaluation of temporomandibular joint (TMJ) dysfunction classified with fracture types
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Table 9
Clinical evaluation of growth disturbance classified with fracture types
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Table 10
Statistical analysis of functional disturbance and growth disturbance according to fracture types between the undisplaced group and the displaced group
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Table 11
Statistical analysis of functional disturbance and growth disturbance according to fracture types between the group of poor condyle-fossa relationship and the others
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Table 12
Statistical analysis of functional disturbance and growth disturbance according to fracture types between the high-level fracture group and the low-level fracture group
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Table 13
Statistical analysis of functional disturbance and growth disturbance according to fracture types between the fragment-contact group and the noncontact group
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