Re-establishment of occlusion after unilateral condylar fracture

Yookyung Kim; Sung-Ho Park; Byoung-Duck Roh

doi:10.5395/rde.2012.37.2.110

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Kim, Park, and Roh: Re-establishment of occlusion after unilateral condylar fracture

Case Report

Restorative Dentistry & Endodontics

Restorative Dentistry & Endodontics 2012; 37(2): 110-113.

Published online: 18 May 2012

DOI: https://doi.org/10.5395/rde.2012.37.2.110

Re-establishment of occlusion after unilateral condylar fracture

Yookyung Kim, DDS, Sung-Ho Park, DDS, MSD, PhD, Byoung-Duck Roh, DDS, MSD, PhD

Resident

Professor

Department of Conservative Dentistry, Yonsei University College of Dentistry, Seoul, Korea.

Correspondence to Byoung-duck Roh, DDS, MSD, PhD. Professor, Department of Conservative Dentistry, Yonsei University College of Dentistry, Seoul, Korea, 50 Yonsei-ro, Seodaemun-gu, Seoul, Korea 120-752. TEL, +82-2-2228-8701; FAX, +82-2-313-7575; operatys16@yuhs.ac

Received 28 December 2011 Revised 1 February 2012 Accepted 3 February 2012

©Copyights 2012. The Korean Academy of Conservative Dentistry.

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Complications resulting from condylar fracture include occlusal disturbance due to loss of leverage from temporomandibular joint (TMJ). In general, closed reduction with active physical training has been performed, and under favorable circumstances, adaptation occurs in attempt to restore the articulation. The patient in this case report had unilateral condylar fracture accompanied with multiple teeth injuries, but he was left without any dental treatment for 1 mon which led to unrestorable occlusal collapse. Fortunately, delayed surgical repositioning of dislocated maxillary anterior teeth followed by consistent long-term physical training has been proved successful. Normal occlusion and satisfactory remodeling of condyle were obtained on 10 mon follow-up.

Keywords: Condylar fracture, Delayed reduction, Dental injury, Occlusion, Physical training

Figures and Tables

Figure 1

Preoperative panoramic view. Diagnosed as mandibular fracture, bilateral parasymphysis and left condyle. Multiple teeth injury with dislocation is also noticeable on upper anterior area.

Figure 2

Panoramic view after open reduction of mandible, parasymphysis. Arch bar fixation was done without any dental treatments.

Figure 3

Initial photograph. Upper anterior teeth are dislocated, including severe intrusion on #12. Patient complained premature contact of dislocated anterior teeth, and no posterior teeth were in contact.

Figure 4

Cast analysis. (a) Initial occlusion; (b) Reduction of anterior contacts; (c) Dramatic changes showing complete seating on both sides.

Figure 5

Surgical repositioning under flap operation.

Figure 6

Occlusal view, before and after physical training (Black dots indicate CO stop).

(a) 3 month; (b) 10 month after trauma.

CO, centric occlusion.

Figure 7

Panoramic view on 10 month follow up. Left condyle reveals successful bone remodeling.

Figure 8

Clinical image on 10 month follow up.

Notes

No potential conflict of interest relevant to this article was reported.

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