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Outcome of Management of Mandibular Sub condylar Fractures Based on Classification System Using Cone-Beam Computed
V Vidhya1, Shiney Dominic1, S Mohan1
1Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, Kerala 686008 India.
Journal of Maxillofacial and Oral Surgery
|May 1, 2023
Summary
This study on mandibular sub condylar fractures found closed reduction effective for mild (Class I) fractures. Open reduction is recommended for severe (Class III) fractures, with Class II requiring further evaluation.
Area of Science:
- Oral and Maxillofacial Surgery
- Radiology
- Traumatology
Background:
- Mandibular subcondylar fractures are common facial injuries.
- Accurate classification is crucial for effective treatment planning.
- Cone-beam computed tomography (CBCT) offers detailed 3D visualization.
Purpose of the Study:
- To determine optimal management strategies for mandibular subcondylar fractures.
- To correlate ramal height shortening and displacement with treatment outcomes.
- To evaluate the utility of CBCT in classifying these fractures.
Main Methods:
- Prospective study of 42 patients with unilateral subcondylar fractures.
- Classification into Class I, II, and III based on CBCT measurements (displacement, ramal height shortening).
- Treatment: Closed reduction (Class I), Open reduction with internal fixation (Class II & III). Functional outcomes assessed clinically at 2 weeks, 1, and 3 months.
Main Results:
- 20 Class I, 12 Class II, 10 Class III fractures identified.
- No significant functional outcome differences between Class I and II.
- Significant differences in outcomes between Class I and III; more pain in surgical Class II & III.
- Class I fractures showed significant difference in mouth opening compared to Class III.
Conclusions:
- CBCT is valuable for accurate subcondylar fracture classification.
- Closed reduction is suitable for mild (Class I) fractures.
- Surgical management is favored for severe (Class III) fractures.
- Further evaluation needed for optimal management of Class II fractures.
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