J Korean Assoc Oral Maxillofac Surg.  2011 Dec;37(6):448-456. 10.5125/jkaoms.2011.37.6.448.

The study of the effect of mandibular growth and function in pediatric unilateral condyle fractures

• Sang JK
• Lee JH

• KMID: 2136980
• DOI: http://doi.org/10.5125/jkaoms.2011.37.6.448

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).

Keyword

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

MeSH Terms

Accounting
Child
Displacement (Psychology)
Facial Asymmetry
Growth Disorders
Humans
Incidence
Male
Mandible
Mandibular Condyle
Mandibular Fractures
Mouth
Temporomandibular Joint Disorders

Figure

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  Fig. 1. Ramal height analysis. (A: superior point of condyle, D: gonial angle, RL: ramal line, ML: mandibular plane) Jin-Kyu Sang et al: The study of the effect of mandibular growth and function in pediatric unilateral condyle fractures. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 2. Frontal cephalometric analysis (evaluation of asymmetry). (Co: condylon, Ag: gonial angle, Me: menton, MSR: midsagittal reference line at crista galli, Cg: crista galli) Jin-Kyu Sang et al: The study of the effect of mandibular growth and function in pediatric unilateral condyle fractures. J Korean Assoc Oral Maxillofac Surg 2011

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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). Jin-Kyu Sang et al: The study of the effect of mandibular growth and function in pediatric unilateral condyle fractures. J Korean Assoc Oral Maxillofac Surg 2011

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