[Changes in the condyle path following fractures with dislocation of the maxilla]

In spite of rigid internal fixation with miniplates after midfacial fractures, dislocation of the previously mobilized fragment in the dorsal direction is conceivable. Thus, the mandible would be forced into a dorsal position over the occlusion. As a result, changes of the condyle paths, such as limitations or deviations from the normal, would be possible. Six patients, who had sustained midfacial fractures with mobilization or dislocation of the maxilla, were followed up. The condyle paths were recorded at the earliest time possible after rigid internal fixation and after removal of the miniplates. We used the electronic computer-assisted registration system (ECRS), which allows three-dimensional registration without occlusal interferences. The patterns of the TMJ movements were not impaired, arguing against the dorsal transposition of the maxilla. The extent of the movements during the first postoperative weeks, however, was significantly reduced in some cases, even if intermaxillary fixation was not carried out. In our opinion, this is due to the periarticular infiltration and a varying elasticity of the articular capsule in different directions.