Re-establishment of occlusion after unilateral condylar fracture

Article information

Restor Dent Endod. 2012;37(2):110-113

Publication date (electronic) : 2012 May 18

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

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

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 2011 December 28; Revised 2012 February 01; Accepted 2012 February 03.

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

Notes

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

References

1. Medina AC. Functional appliance treatment for bilateral condylar fracture in a pediatric patient. Pediatr Dent 2009. 31432–437.

2. Ellis E, Throckmorton GS. Treatment of mandibular condylar process fractures: biological considerations. J Oral Maxillofac Surg 2005. 63115–134.

3. Talwar RM, Ellis E 3rd, Throckmorton GS. Adaptations of the masticatory system after bilateral fractures of the mandibular condylar process. J Oral Maxillofac Surg 1998. 56430–439.

4. Villarreal PM, Monje F, Junquera LM, Mateo J, Morillo AJ, González C. Mandibular condyle fractures: determinants of treatment and outcome. J Oral Maxillofac Surg 2004. 62155–163.

5. Andreasen JO, Andreasen FM, Skeie A, Hjørting-Hansen E, Schwartz O. Effect of treatment delay upon pulp and periodontal healing of traumatic dental injuries - a review article. Dent Traumatol 2002. 18116–128.

6. Miyashin M, Kato J, Takagi Y. Tissue reactions after experimental luxation injuries in immature rat teeth. Endod Dent Traumatol 1991. 726–35.

7. Trombelli L, Farina R, Marzola A, Bozzi L, Liljenberg B, Lindhe J. Modeling and remodeling of human extraction sockets. J Clin Periodontol 2008. 35630–639.

8. Murakami K, Yamamoto K, Sugiura T, Yamanaka Y, Kirita T. Changes in mandibular movement and occlusal condition after conservative treatment for condylar fractures. J Oral Maxillofac Surg 2009. 6783–91.

Article information Continued

©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.

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.