Temporomandibular disorders in patients with mandibular fractures: a preliminary comparative case-control study...

The status of temporomandibular disorders (TMD) in subjects with previously treated mandibular fracture was evaluated in two centres: South Australia (SA) and Oman (O). TMD status was evaluated using Mandibular Function Impairment Questionnaire (MFIQ), Helkimo index for clinical dysfunction (HI), RDC/TMD and Wilkes' classification. Data were retrieved for adult patients treated for mandibular fracture over 3 years from January 2004 to December 2006. Thirty-six subjects participated from SA and 23 from O. Their results were compared with matched controls. The incidence of TMD symptoms in SA injured and control groups was higher compared with the O groups. There was statistically significant difference on all evaluation indices for SA injured subjects compared with controls (MFIQ/P 0.04, HI/P 0.0015, RDC/TMD/P 0.05, Wilkes classification/P 0.03). These TMD symptoms were clinically insignificant for most subjects and all were internal derangement of the temporomandibular joint (TMJ). There was no significant difference in all evaluation indices for O injured subjects compared with controls. For SA injured subjects who reported clinically significant TMD symptoms, assault and bilateral mandibular fractures were predominant features. The study shows that most mandibular injuries fully recover and the associated TMJ trauma usually has low clinical significance in the long term.