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This narrative review evaluates the literature on the management of mandibular condyle fractures in growing patients. It aims to illustrate some fundamental biological principles and to offer a series of considerations applicable to clinical practice. The discussion is based on 116 papers published in PubMed and two relevant textbooks. Condylar fractures may be overlooked, especially in pre-scholar children, where compliance is usually reduced. However, these injuries can have disabling sequelae such as ankyloses, facial deformities, malocclusion, and chronic pain in some patients if not diagnosed and managed correctly. Due to their significance, mandibular condyle fractures in children are a subject of considerable clinical interest. As of today, there is consensus about their treatment. Four management options are available: expectative (analgesia, soft food and follow-up), functional protocols (guiding elastics, orthodontic appliances and exercises), maxillomandibular fixation (MMF), and open reduction and internal fixation (ORIF). Nondisplaced and minimally displaced fractures should be treated expectantly; severely displaced non-comminuted fractures can be safely operated on if the expertise is available, even in patients with deciduous dentition. Moderately displaced fractures can be managed with functional protocols or operatively, depending on the background and know-how of the specialist. Functional protocols can achieve good outcomes, especially in patients with deciduous dentition. MMF should be foregone in children due to its many drawbacks.
This narrative review evaluates the literature on the management of mandibular condyle fractures in growing patients. It aims to illustrate some fundamental biological principles and to offer a series of considerations applicable to clinical practice. The discussion is based on 116 papers published in PubMed and two relevant textbooks. Condylar fractures may be overlooked, especially in pre-scholar children, where compliance is usually reduced. However, these injuries can have disabling sequelae such as ankyloses, facial deformities, malocclusion, and chronic pain in some patients if not diagnosed and managed correctly. Due to their significance, mandibular condyle fractures in children are a subject of considerable clinical interest. As of today, there is consensus about their treatment. Four management options are available: expectative (analgesia, soft food and follow-up), functional protocols (guiding elastics, orthodontic appliances and exercises), maxillomandibular fixation (MMF), and open reduction and internal fixation (ORIF). Nondisplaced and minimally displaced fractures should be treated expectantly; severely displaced non-comminuted fractures can be safely operated on if the expertise is available, even in patients with deciduous dentition. Moderately displaced fractures can be managed with functional protocols or operatively, depending on the background and know-how of the specialist. Functional protocols can achieve good outcomes, especially in patients with deciduous dentition. MMF should be foregone in children due to its many drawbacks.
Background/Objectives: Pediatric facial fractures present unique challenges due to the anatomical, physiological, and developmental differences in children’s facial structures. The growing facial bones in children complicate diagnosis and treatment. This review explores the advancements and complexities in managing pediatric facial fractures, focusing on innovations in diagnosis, treatment strategies, and multidisciplinary care. Methods: A narrative review was conducted, synthesizing data from English-language articles published between 2001 and 2024. Relevant studies were identified through databases such as PubMed, Scopus, Lilacs, Embase, and SciELO using keywords related to pediatric facial fractures. This narrative review focuses on anatomical challenges, advancements in diagnostic techniques, treatment approaches, and the role of interdisciplinary teams in management. Results: Key findings highlight advancements in imaging technologies, including three-dimensional computed tomography (3D CT) and magnetic resonance imaging (MRI), which have improved fracture diagnosis and preoperative planning. Minimally invasive techniques and bioresorbable implants have revolutionized treatment, reducing trauma and enhancing recovery. The integration of multidisciplinary teams, including pediatricians, psychologists, and speech therapists, has become crucial in addressing both the physical and emotional needs of patients. Emerging technologies such as 3D printing and computer-assisted navigation are shaping future treatment approaches. Conclusions: The management of pediatric facial fractures has significantly advanced due to innovations in imaging, surgical techniques, and the growing importance of interdisciplinary care. Despite these improvements, long-term follow-up remains critical to monitor potential complications. Ongoing research and collaboration are essential to refine treatment strategies and improve long-term outcomes for pediatric patients with facial trauma.
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