Humans ; Mandibular Fractures/etiology* ; Retrospective Studies

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

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

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 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

OBJECTIVETo determine the causes and incidence of facial injuries by an epidemiologic retrospective study.

METHODSA total of 3 958 patients with facial injuries treated at Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University from 1955 to 2001 were investigated. Data regarding age, gender, cause of injury, pattern of fracture and associated systemic injuries were reviewed.

RESULTSThe male to female ratio of the patients with facial injury was 4.27:1 and 33.4% of patients were aged between 21 and 30 years. The most common cause of injury was traffic accident (30.6%), followed by falls (21.4%) and collision (15.8%). A total of 794 patients (20.1%) showed only soft tissue injuries. 1 100 patients (27.8%) had multiple fractures in facial bones and 2,064 patients (52.1%) had single fracture. The mandibular fracture was most frequently seen, followed by the maxilla and the zygoma. The most common site of mandible fracture was the body (31.2%), followed by the symphysis (22.7%), the condylar (20.5%) and the angle (13.7%). Accompanied injuries to brain and skull happened in 916 patients (23.1%).

CONCLUSIONSBone fractures were more common in hospitalized patients with facial injuries. The numbers and sites of fracture were related to the causes of injuries and anatomic structure of the bone. The brain and skull injuries, the most often and seriously accompanied injuries, would not be neglected.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Brain Injuries ; etiology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mandibular Fractures ; complications ; epidemiology ; etiology ; Maxillofacial Injuries ; complications ; epidemiology ; etiology ; Middle Aged ; Retrospective Studies ; Sex Factors ; Young Adult

OBJECTIVE: To analyze age-related mandible stress distribution due to midline force. METHODS: Mandibles of children, adults, and elderly individuals were scanned by spiral CT to establish three-dimension imaging models with mesh elements by MIMICS software and HYPERMESH software. The mandible stress distribution was analyzed using ANSIS software. RESULTS: There was no significant difference in mandible stress distribution in various age groups with the greatest stress distribution (Von Mises) present at the mandible angle. Although there was stress present at the mandible neck in adults, no such mandible neck stress was found in children and elderly individuals. CONCLUSION Mandible stress distribution is closely related to the incidence of fracture in various age groups, i.e., more stress and more fracture.
Adolescent ; Adult ; Age Factors ; Biomechanical Phenomena ; Child ; Finite Element Analysis ; Humans ; Image Processing, Computer-Assisted ; Incidence ; Mandible/physiology* ; Mandibular Fractures/etiology* ; Middle Aged ; Models, Anatomic ; Stress, Mechanical ; Tomography, X-Ray Computed/methods* ; Young Adult