Humans ; Mandibular Fractures/etiology* ; Retrospective Studies

Ankylosis ; etiology ; Humans ; Mandibular Condyle ; injuries ; Mandibular Fractures ; complications ; Temporomandibular Joint Disc ; injuries ; Temporomandibular Joint Disorders ; etiology

This article summarized the advances in treatment and research of temporomandibular joint surgery in the last 5 years which was presented in "The 2nd Condyle Fracture and Temporomandibular Joint Ankylosis Symposium". The content includes 5 parts: non-surgical treatment of children condyle fracture and long-term follow-up, the improvement of operative approach for condyle fracture and key techniques, the importance and the method for the simultanesous reduction of disc in condylar fracture treatment, the development of traumatic temporomandibular joint ankylosis similar to hypertrophic non-union and the improved safety and accuracy by applying digital surgery in joint surgery.
Ankylosis ; etiology ; Humans ; Mandibular Condyle ; injuries ; Mandibular Fractures ; complications ; therapy ; Temporomandibular Joint ; surgery ; Temporomandibular Joint Disorders ; etiology

OBJECTIVETo investigate the technique and clinical effect in the surgical reduction and screw fixation of sagittal condylar fractures.

METHODSOpen treatment was performed on 21 cases (23 condyles) with sagittal condylar fractures. The condylar fracture segment was reduced and fixed by screw (long screw or lag screw). The patients began the mandible movement exercise early after the operation, and follow-up was performed in the first half year after the operation.

RESULTSFavorable results were obtained in all cases. Slight malocclusion was observed in 3 cases accompanied with mandible fracture, but normal occlusion was almost reestablished after one week of intermaxillary traction. The CT examination indicated the ideal condition of reduction and fixation of these condylar fractures. During the follow-up, the mouth opening was normal, and mandible movement and function was satisfactory.

CONCLUSIONSThe technique of reduction and screw fixation in condyle sagittal fracture can obtain stable reduction and fixation.

Bone Screws ; Fracture Fixation, Internal ; methods ; Humans ; Malocclusion ; etiology ; physiopathology ; Mandible ; physiopathology ; Mandibular Condyle ; injuries ; Mandibular Fractures ; surgery

OBJECTIVETo investigate clinical features of disk displacement during the course of condylar fracture and to explore the techniques of disk reposition and suturation.

METHODS32 patients (10 females and 22 males) who had disk displacements with condylar fractures were followed up. Reduction and reposition of the dislocated disks simultaneously with fixation of fractures were performed. 7 patients underwent intermaxillary fixation with elastic bands for 1 to 2 weeks.

RESULTSThe occlusions were satisfactory in all cases but one for the reason of ramus height loss. No TMJ symptom was found when examined 3 months post operation.

CONCLUSIONSAnterior disk displacements were most occurred with high condylar process fractures. Surgical reposition and suturation of disk play an important role for the later TMJ-function.

Adolescent ; Adult ; Female ; Fracture Fixation, Internal ; Humans ; Joint Dislocations ; etiology ; surgery ; Male ; Mandibular Condyle ; injuries ; Mandibular Fractures ; complications ; surgery ; Middle Aged ; Temporomandibular Joint Disc ; pathology

OBJECTIVETo analysis the cause of malocclusion that was found in patients suffering from condylar neck and subcondylar fractures after perfectly anatomic reduction and rigid fixation.

METHODSThere were 23 cases of malocclusion in the patients of condylar neck and subcondylar fractures after anatomic reduction and rigid fixation during 1994 to 2001. The possible reasons were studied, and the treatment methods were proposed.

RESULTSBoth distortion and(or) fracture of miniplates and displacement anain of the condylar process after operation were not found in all 23 cases. There were 6 cases of open bite at the molar teeth of the fractured side, while the normal occlusions were showed in the nonfractured side. 11 cases showed that the whole mandibles were moved slightly to the nonfractured side. 4 cases showed that the mandible of fractured side moved slightly to the nonfractured side and the occlusion of nonfractured side were normal. 2 cases showed premature contact at the fractured molar teeth and the anterior teeth showed open bite. There were 5 cases of facial nerve damages, 2 cases wound infection, 2 cases TMJ chronic pain and 1 cases TMJ click and(or) murmur.

CONCLUSIONSAlthough the anatomical reduction and miniplate rigid fixation were operated on the condylar neck and subcondylar fractures, there were probably having the chance of showing malocclusion. The malocclusion was not caused by the fracture itself, but in the TMJ and/or muscular injury. Therefore, the malocclusion can be cured with intermaxillary elastic traction and functional exercise. Sometimes, the occlusal adjustment may be performed to resume the normal occlusion. In any case, operation is not needed.

Adult ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Malocclusion ; etiology ; therapy ; Mandibular Condyle ; injuries ; Mandibular Fractures ; surgery ; Middle Aged ; Postoperative Complications ; Retrospective Studies

Atrophy ; Bone Transplantation ; methods ; Fracture Fixation, Internal ; Fracture Healing ; Fractures, Comminuted ; surgery ; Humans ; Mandible ; pathology ; Mandibular Fractures ; pathology ; surgery ; Surgical Wound Infection ; etiology

OBJECTIVETo investigate the relationship between fractured fragment and joint disc displacement after sagittal fracture of mandibular condyle (SFMC).

METHODSbased on CT examination, SFMC were classified into fissue, displacement and dislocation type. Based on oblique sagittal MRI examination, the displacement of joint disc was grouped into type A and type B. Abnormal superiorposterior attachment was classified into elongation and avulsion type.

RESULTSCT exmination were taken in 26 patients with 41 SFMC. There were 5 SFMC (12%) with fissue type, 18 SFMC (44%) with displacement type and 18 SFMC (44%) with dislocation type. Both CT and MRI examination were taken in 19 patients with 32 SFMC. There were 27 (84%) SFMC with disc displacement. Five SFMC with type fissue showed no signs of disc displacement. Among 15 SFMC with type displacement, there were 3 cases with type A disc displacement and 12 cases with type B disc displacement. All the dislocated SFMC (12 cases) were type B disc displacement. In term of superiorposterior attachment figures, 4 cases (4/5) of type fissue SFMC showed normal. 14 cases (14/15) of the displacement SFMC showed elongated and all cases with dislocated SFMC showed sign of avulsion. There were 20 cases (63%) showing superior joint effusion. There were 13 cases (13/15) with displaced SFMC and 6 cases with dislocated SFMC showing joint effusion. One case with fissue SFMC showed no sign of joint effusion.

CONCLUSIONSJoint effusion, disc displacement and abnormal superiorposterior attachment were related to the displacement of condyle which was involved with SFMC.

Adolescent ; Adult ; Child ; Female ; Humans ; Joint Dislocations ; etiology ; Magnetic Resonance Imaging ; Male ; Mandibular Condyle ; injuries ; Mandibular Fractures ; classification ; diagnosis ; diagnostic imaging ; Middle Aged ; Temporomandibular Joint Disc ; pathology ; Temporomandibular Joint Disorders ; diagnosis ; diagnostic imaging ; etiology ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo investigate the patterns of condylar fractures associated with temporomandibular joint ankylosis (TMJA) and treatment methods and results based on the different types of ankylosis.

METHODSForty-two joints of ankylosis in 31 patients with were categorized to four groups according to Sawhney's classification and undergone surgical treatment as follows: a joint release and disc reposition for Type I ankylosis, a dissection of bony block and disc reposition for Type II; a dissection of full-joint and employment of the temporal myofascial flap as interposition for Type III; a radically dissection of full joint followed by ramus distraction osteogenesis and genioplasty for Type IV. All of patients were followed up for 9 to 54 months with an average of 30 months. The range of mouth opening and temporomandibular joint (TMJ) function were assessed. Condylar fractures were retrospectively investigated on the patterns and the course of ankylosis development. Macroscopical visualization on the osseously ankylosed sites and disc displacement were analyzed in comparison with the radiological findings.

RESULTSCondylar sagittal and comminuted fractures were most susceptible to TMJA. Early fibrous ankylosis occurred usually at the 4th or 5th month post-traumatically with an average month opening of 18.3 mm. The articular discs were found displaced in all cases and early bony bridge formed at a limited area where there was no disc as cushion. During fellow-up, considerable improvement in mandibular movement was attained with a stable joint function and mouth opening range of over 30 mm except for two cases in which ankylosis relapsed.

CONCLUSIONSCondylar sagittal and comminuted fractures are most likely to cause ankylosis. Early surgical intervention could reduce the disc and avoid the later ankylosis.

Adolescent ; Adult ; Ankylosis ; classification ; etiology ; surgery ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Mandibular Condyle ; injuries ; surgery ; Mandibular Fractures ; complications ; surgery ; Middle Aged ; Temporomandibular Joint Disc ; injuries ; surgery ; Temporomandibular Joint Disorders ; classification ; etiology ; surgery ; Young Adult

Adult ; Humans ; Imaging, Three-Dimensional ; Jaw Fixation Techniques ; Joint Dislocations ; diagnostic imaging ; etiology ; surgery ; Male ; Mandible ; surgery ; Mandibular Condyle ; diagnostic imaging ; injuries ; surgery ; Mandibular Fractures ; complications ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed