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[Evaluation of mandibular movement after condylar fracture]
1Dept. de Cirurgia, Prótese e Traumatologia Maxilo-Faciais, Universidade de São Paulo, Faculdade de Odontologia, CEP 05508-900, São Paulo, SP, Brasil. ocrivellojr@yahoo.fr
Background:
The purpose of this work was to compare results of two treatments for fracture of the mandibular condyle: functional therapy and intermaxillary block.
Material And Methods:
Forty patients were assessed: 32 unilateral fractures and 8 bilateral fractures. Half of the patients were given functional treatment and half had intermaxillary fixation for 40 days. Mouth opening amplitude, protrusion/retraction, and lateral movements were measured at inclusion, day 15, 30 and 180 for patients in the first group and at inclusion and on day 180 for the blocked patients.
Results:
Movement amplitude at the end of treatment was always greater in patients given functional treatment. This difference was found for all types of movement. And was even more marked in patients with bilateral fractures. Occlusion was restored in all patients given intermaxillary fixation, but 2 patients in the functional treatment group had an occlusal impairment due to insufficient compliance with the treatment protocol.
Discussion:
Functional treatment is more adapted than intermaxillary fixation for fractures of the mandibular condyle, particularly for bilateral fractures. Careful surveillance is nevertheless required to avoid malocclusion. An endobuccal device may be helpful in selected cases.