Do non-condylar mandibular fractures affect the temporomandibular joint? a prospective clinical and radiologic follow-up study

Non-condylar mandibular fractures may alter temporomandibular joint (TMJ) biomechanics despite the absence of direct condylar injury. This prospective study evaluated clinical and radiological TMJ changes following surgical management of non-condylar mandibular fractures.

Forty patients with parasymphysis, body, or angle fractures treated by open reduction and internal fixation were evaluated at postoperative day 15-16 and at 6 months. Temporomandibular dysfunction was assessed using the Helkimo Anamnestic Index (Ai) and Clinical Dysfunction Index (Di). Bilateral computed tomography (CT) and ultrasonography (USG) were used to assess joint space and structural changes.

At 6 months, 28 patients (70%) were free of subjective symptoms, whereas 32 patients (80%) demonstrated objective clinical dysfunction (Di ≥ I). Eight patients (20%) reported severe subjective symptoms, and 4 (10%) exhibited severe objective dysfunction. CT and USG showed no significant changes in joint space and no condylar erosions or osteophytes.

Temporomandibular dysfunction is common after surgical treatment of non-condylar mandibular fractures and may persist despite resolution of symptoms and absence of detectable osseous changes. Routine TMJ assessment during postoperative follow-up may help identify patients who require continued monitoring and management.