Correlation between Condylar Fracture Pattern after Parasymphyseal Impact and Condyle Morphological Features

Abstract

Background:The treatment of the condylar fractures is difficult. Factors that result in the fractures are complex. The objective of this morphometric study was to investigate the relationship between condylar fracture patterns and condylar morphological characteristics.Methods:We conducted a retrospective analysis of 107 patients admitted to the West China Hospital of Stomatology for bilateral condylar fractures caused by parasymphyseal impact. The patients were divided into five groups according to the type of condylar fracture. Ten parameters were evaluated on three-dimensional (3D) reconstruction mandible models through the Mimics 16.0 (Materialize Leuven, Belgium) anthropometry toolkit. Each parameter of the 3D models was analyzed using multivariate analysis. Multinomial logistic regression analyses were used to examine the relationships between the five groups.Results:The results showed that the differences of condylar head width (M1), condylar neck width (M3), the ratio of condylar head width to condylar anteroposterior diameter (M1/M2), the ratio of condylar head width to condylar neck width (M1/M3), the ratio of condylar height to ramus height (M8/M7), and mandibular angle (M10) were statistically significant (p < 0.05). Type A condylar head fractures were positively associated with M1 (compared to Type B: OR =1.627, 95% CI: 1.123, 2.359; compared to Type C: OR = 1.705, 95% CI: 1.170, 2.484) and M1/M2 (compared to Type B: OR =1.034, 95% CI: 0.879, 2.484). Type B condylar head fractures were negatively associated with M10 (compared to Type C: OR = 0.909, 95% CI: 0.821, 1.007). Condylar neck fractures were negatively associated with M3 (compared to condylar head: OR = 0.382, CI: 0.203, 0.720; compared to condylar base: OR = 0.436, 95% CI: 0.218, 0.874), and positively associated with M1/M3 (compared to condylar head: OR = 1.229, 95% CI: 1.063, 1.420 compared to condylar base: OR = 1.223, 95% CI: 1.034, 1.447). Condylar base fractures were positively associated with M10 (OR = 1.095, 95% CI: 1.008, 1.189) and negatively associated with M8/M7 (OR = 0.855, 95% CI: 0.763, 0.959) as compared with condylar head fractures.Conclusions:Condylar fracture pattern is associated with the anatomical features of the condyles when a fracture occurs from parasymphyseal impact.

Do the Presence of Mandibular Third Molar and the Occlusal Support Affect the Occurrence and the Mode of Mandibular Condylar Fractures?

“…In addition, this study did not investigate the morphology of the mandible the enrolled patients. With regard to mandibular condylar fractures, the morphology of the mandible was associated with fracture fracture 21) . Further studies on the relationship between occlusal support and the morphology possibly together with the boney quality of the mandible could be required to conclude these issues as discussed in the present study.…”

The Influence of the Mandibular Chin Angle on the Occurrence of Mandibular Condylar Fracture: A Retrospective Study

“…Internal factors such as bone mineral density, mandibular anatomy, and masticatory muscles can also affect the fracture pattern. According to Han et al, the morphological features of the mandibular chin region correlate with condylar fractures occurring due to an impact in the parasymphyseal area [ 5 ]. The distribution of stress in the mandibular ramus and body region varies due to an impact in the parasymphysis region and can result in a condylar fracture.…”

“…The distribution of stress in the mandibular ramus and body region varies due to an impact in the parasymphysis region and can result in a condylar fracture. A change in the ramus morphology may affect the transmission of forces [ 5 ]. Similarly, in the present study, the authors suggest changes in the chin morphology (symphyseal and parasympyseal region) affect forces transmitted to the condyles.…”

“…The mandibular fracture location strongly correlates with age, sex, dental trauma, and soft-tissue injury. The mandibular anatomy, bone mineral density, and masticatory muscles are internal factors that influence fracture patterns [ 5 ]. The magnitude and direction of the external forces acting on the mandible dictate the fracture pattern and the location of fractures [ 6 ].…”

“…e mandibular fracture location strongly correlates with age, sex, dental trauma, and soft-tissue injury. e mandibular anatomy, bone mineral density, and masticatory muscles are internal factors that influence fracture patterns [5].…”