Long-term results of nonsurgical management of condylar fractures in children

Conservative orthodontic fixed appliance management of pediatric mandibular bilateral condylar fracture

“…[26][27][28] Disadvantages of arch bar intermaxillary fixation include an unacceptably high glove perforation rate associated with arch bar placement, risk of blood-borne pathogen infection in maxillofacial trauma, need for general anesthesia to place the arch bars, the effects of the arch bar on dental enamel and gingiva, increased discomfort, prolonged treatment, poor oral hygiene, and the likelihood of gingival injury. 6,28 The orthodontic bracketing that we used offers an acceptable and less threatening procedure to a pediatric patient and resulted in high patient comfort and acceptance. The use of elastics for fixation in this patient was not intermaxillary fixation in the strict sense of the word, since there was some functional activity and he could remove the elastics at least once a day.…”

“…6,7,[29][30][31] For example, Tavares and Allgayer 29 reported the use of a maxillary acrylic splint to raise the posterior occlusal plane in an intracapsular fracture of the mandibular condyle. An asymmetric bionator was constructed to reposition the mandible anteriorly and inferiorly to correct a mandibular shift and maintain ramal length in a patient with a displaced right condylar fracture.…”

“…5 Pediatric condylar fractures, if not properly managed, can easily lead to problems such as mandibular deficiency, facial asymmetry, and temporomandibular joint (TMJ) disorder on both the injured and the noninjured sides. 1,[6][7][8] The degree of displacement of the condyles is determined by the direction, degree, magnitude, and precise point of application of the force, the state of the dentition, and the occlusal position. 9 Most condylar fractures are caused by indirect forces transmitted to the condyle from a blow elsewhere, 10 and traffic accidents, including bicycle crashes, are the main causes of these fractures in children.…”

“…Because pediatric mandibular condylar fractures have a greater ability to remodel than do adult fractures, a conservative approach is often recommended. 6,7,20 Here, we present a conservative approach whereby orthodontic treatment was used as an adjunct in the reduction of a bilateral condylar fracture in a 10-yearold boy. A computed tomograpy scan, known for its diagnostic accuracy, sensitivity, and specificity, was taken.…”

Pathological changes after the surgical creation of a vertical intracapsular condylar fracture

“…They may be divided into condylar head, condylar neck and subcondylar region types according to the anatomic location of the fracture 11 . Other authors have classified condylar fractures as intracapsular, high condylar neck or low condylar neck 8 . There are three types of intracapsular fracture: type A, fractures pass through the medial condylar pole; type B, fractures pass through the lateral condylar pole with loss of vertical height of the mandibular ramus; and type M, multiple fragments or comminuted fractures 20 .…”