Conservative orthodontic fixed appliance management of pediatric mandibular bilateral condylar fracture

Xu, Yeqiong; Gong, Siew‐Ging; Zhu, Fangyong; Li, Ming; Xu, Bin

doi:10.1016/j.ajodo.2016.02.012

Cited by 15 publications

(28 citation statements)

References 30 publications

(43 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Good occlusion with masticatory function is conducive to remodeling 15,27 of imperfectly aligned fracture segments into satisfactory anatomic and functional positions within the limits of the functional matrix principle 28 . Andrew et al 6 discussed that during the mixed dentition stage, ORIF should be reserved for situations in which the occlusion is not improving because of a greater tolerability of imperfect alignment 6,13,15,20,27 when the treatment goals are achieved, similar to displaced subcondylar fractures in children less than 12 years of age 5,12‐14,17,26,29 …”

Section: Discussionmentioning

confidence: 99%

“…However, two significantly displaced fractures in this study were managed conservatively ‐ they showed step deformity at 4 weeks follow‐up and complete remodeling without any contour defects after 18 months. The exceptional remodeling potential of children has already been widely accepted for cases with displaced condylar fractures except for extreme dislocations 6,12,14,26 . Alpen 13 also reported a case of complete remodeling overcoming malunion deformities and criticized Posnick et al’s belief of “unpredictable remodeling potential of pediatric craniofacial skeleton resulting in malunion and contour deformities if fractures were not reduced and fixed anatomically” 13 .…”

Section: Discussionmentioning

confidence: 99%

“…Alpen 13 also reported a case of complete remodeling overcoming malunion deformities and criticized Posnick et al’s belief of “unpredictable remodeling potential of pediatric craniofacial skeleton resulting in malunion and contour deformities if fractures were not reduced and fixed anatomically” 13 . This MMF technique offers many advantages such as being painless, 37 quicker (30 to 60 minutes), 37‐39 cost‐effective, 37,39 an OPD service or reduced hospitalization time, less operator sensitive, high acceptability, superior oral hygiene, 37‐39 maintains continuity of the periosteal sleeve 15 , and reduced patient morbidity being a non‐surgical treatment 26,37‐39 . The durability of orthodontic appliances to sustain the fixation force has been known 15,23,26,37‐39 The resilient elastics have the tendency to provide guidance into maximum intercuspation position.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Conservative management of pediatric mandibular distal fractures—A retrospective study

Mittal

Yadav

Shekhawat

2020

Dental Traumatology

View full text Add to dashboard Cite

Background/Aim Pediatric mandibular distal fractures present unique treatment challenges which are usually managed with open reduction and internal fixation (ORIF) with the risk of developing tooth bud injuries. Conservative management through maxillomandibular fixation (MMF) with orthodontic bracket‐elastic as an out‐patient department (OPD) service has been used for these fractures presenting with derangement of occlusion. The aim of this study was to retrospectively analyze MMF with orthodontic bracket‐elastic as a treatment method and its outcome for management of pediatric mandibular distal fractures. Methodology Data of seventeen pediatric cases diagnosed with displaced mandibular distal fractures managed with MMF with orthodontic bracket‐elastic over a period of 5 years were analyzed. In this technique, two weeks of immobilization and one week for guiding elastics were used. Results The mean age of patients was 7.6 ± 1.6 years with a mean follow‐up of 24 months. All fractures healed uneventfully with satisfactory occlusion. The cases included 23.5% minimally displaced, and 64.7% moderately displaced and 11.8% significantly displaced fractures with step deformity with successful remodeling of the lower border contours over a duration of 18 months ± 1 month. The developing tooth buds in the fracture line showed no complications except for root dilacerations/malformation (n = 3). Conclusion MMF with orthodontic bracket‐elastic is a viable and conservative technique for the management of pediatric mandibular distal fractures which need to be verified through randomized trials for generalization of the results.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Conservative management of pediatric mandibular distal fractures—A retrospective study

Mittal

Yadav

Shekhawat

2020

Dental Traumatology

View full text Add to dashboard Cite

show abstract

“…2,21 Disruption of the condylar growth center with dissection or fixation often results in facial skeletal deficiency (class II skeletal malocclusion or facial asymmetry) and can cause negative, long-term, functional and aesthetic sequelae. 2,30,31 This, combined with the aforementioned risks of open techniques and inconsistent results of ORIF in the literature, 10,19,32 has led us to utilize closed reduction for the treatment of pediatric and adult subcondylar fractures.…”

Section: Discussionmentioning

confidence: 99%

Predictable and Effective Treatment of Bilateral Subcondylar Fractures Using Closed Reduction With a Novel Acrylic Wedge Splint

Luby

Sacks

Buchman

et al. 2020

FACE

View full text Add to dashboard Cite

Treatment of bilateral subcondylar fractures is a challenging clinical problem, and optimal management of these fractures remains controversial. Similar to unilateral subcondylar fractures, bilateral injuries present with significant malocclusion due to fracture segment displacement; however, the loss of vertical stops on both sides of the mandible mandate a more concerted approach to surgical management. Closed reduction and maxillomandibular fixation (MMF) alone in bilateral subcondylar fractures carry a higher risk of recurrent anterior open bite postoperatively secondary to the absence of a vertical stop with fracture segment displacement and persistent shortening of the posterior facial height. Therefore, some surgeons consider bilateral subcondylar fractures an indication for open reduction and internal fixation (ORIF). Unfortunately, open approaches involving the proximal subcondylar fracture segment are riddled with potential risks including facial nerve damage, parotid gland injury, and temporomandibular joint (TMJ) damage. Given that neither approach is optimal, investigation of new approaches for the treatment of bilateral subcondylar fractures is warranted. The objective of this paper is to present our novel technique for the treatment of bilateral subcondylar fractures, which utilizes a combination of traditional closed reduction and MMF with a custom “wedge” occlusal splint to overcorrect the traumatic shortening of the posterior mandibular height.

show abstract

“…Radiological signs of resorption were observed in patients with detachment of the lateral pterygoid muscle from the proximal fragment (53) and the number of patients experiencing condylar resorption following open reduction can be as high as 100% (11). However, other authors point out that conservative therapy with MMF produces very good treatment results in children and adolescents (50,54).…”

Section: Diagnosis Of Mandibular Condyle Traumamentioning

confidence: 99%

Preauricular Swelling Mimicking a Tumour: Dissolution of Mandibular Capitulum Following Trauma in a 15-Year Old Child

Friedrich

Kohlrusch

2020

In Vivo

View full text Add to dashboard Cite

Aim: The report is about diagnosis, therapy, and follow-up of a 15-year old boy, who experienced facial swelling and impaired mouth opening after a sport accident. Case Report: Diagnosis of mandibular damage was delayed due to inadequate clinical investigation and radiography after trauma and only became clear after a parotid swelling occurred sometime later resulting from the dissolution of the upper part of the articular process. Follow-up control over a period of three years showed a partial restoration of the articular process but some inhibition of mouth opening combined with slight deviation of the mandible to the affected side remained over the years. Conclusion: This report reminds us that parotid swelling can be the result of mandibular trauma without a recent history of physical injury to this region. Therefore, the basic standards of radiologic diagnosis should be maintained and the limited restoring capacity of the condylar process in adolescence should be acknowledged.

show abstract

Conservative orthodontic fixed appliance management of pediatric mandibular bilateral condylar fracture

Abstract: Conservative treatment of a mandibular fracture by fixed orthodontic means is a viable treatment option that is relatively straightforward and cost-effective and has a high level of patient acceptance and comfort.

Cited by 15 publications

References 30 publications

Conservative management of pediatric mandibular distal fractures—A retrospective study

Conservative management of pediatric mandibular distal fractures—A retrospective study

Predictable and Effective Treatment of Bilateral Subcondylar Fractures Using Closed Reduction With a Novel Acrylic Wedge Splint

Preauricular Swelling Mimicking a Tumour: Dissolution of Mandibular Capitulum Following Trauma in a 15-Year Old Child

Contact Info

Product

Resources

About