Non-surgical Treatment of Condylar Fracture in an 11-Year-Old Patient: a Case Report

Abstract

BackgroundMandibular condylar fractures commonly occur after trauma and account for 25 to 35% of all mandibular fractures; its appropriate therapy still remains a point of controversy in children. The purpose of this paper is to describe the treatment of an 11-years-old male patient affected by neck-condylar fracture as result of trauma in evolutive age.MethodsNo surgical treatment was performed. A functional therapy was applied with a jaw splint. A closed treatment for mandibular condyle fractures was preferred because the amount of condylar displacement wasn’t considerable.ResultsThe early treatment with functional therapy generated a functional adaptation of the condyle in the glenoid fossa and a normal mandibular function. After a 12-month follow-up the fracture resolution and an optimal condylar position were recorded.ConclusionsThe current case report and literature review showed that non-surgical therapy of neck-condylar fracture in a child with lower resin splint can restore mandibular movements and aesthetics. Facial growth after one year treatment resulted normal. A conservative treatment may be appropriate for children in selected cases with minimally displaced condyle.

Orthodontic Approaches in the Management of Mandibular Fractures: A Scoping Review

“…After meticulous evaluation, 8 papers were excluded because full texts were not available, and 15 other papers were not included in this scoping review because they concerned the use of non-orthodontic approaches. Thus, at the end of the selection process, 17 articles were considered for this scoping review [ 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ].…”

“…The sizes of the analyzed samples ranged from 1 to 40 subjects, and the follow-up periods (when specified) ranged from 2 months to 10 years. Twelve studies [ 56 , 57 , 58 , 59 , 61 , 63 , 64 , 65 , 68 , 70 , 71 , 72 ] included growing subjects (age range: 3–16 years), while five articles [ 60 , 62 , 66 , 67 , 69 ] included adults (age range: 16–55 years).…”

“…Regarding the study designs, most of the articles were case reports [ 57 , 59 , 63 , 65 , 66 , 68 , 71 ] or case series [ 56 , 60 ]. Other articles were designed with prospective approaches (comparative [ 67 , 69 ] or non-comparative [ 58 ]) but with a lack of a systematic randomized (controlled and non-controlled) enrolment design.…”

“…In contrast to the intermaxillary fixation (IMF) approaches, which are usually managed by a maxillofacial surgeon, such as conventional or mini-screw-retained arch bars and occlusal splints fixed with circummandibular wiring, from the results of the present review, among the conservative IMF methods that are manageable by orthodontists and pediatric dentists, the following approaches emerged: (1) mini-screws and elastics [ 62 , 66 , 70 ]; (2) bonded orthodontic brackets and elastics [ 60 , 62 , 66 , 69 , 71 ]; (3) cemented [ 56 , 61 , 63 , 65 , 67 ] or (4) removable [ 59 , 68 , 72 ] occlusal splints; and (5) functional removable appliances [ 64 ], which may be associated with functional exercises ( Figure 2 ). From the results of this review, these approaches have mainly been adopted for children and adolescents [ 56 , 57 , 58 , 59 , 61 , 63 , 64 , 65 , 68 , 70 , 71 , 72 ]. In some articles, these conservative approaches were presented and compared to the effects of acrylic splints fixed with circummandibular wires or arch bars [ 56 , 62 , 69 ] and the competence of the maxillofacial surgeons.…”

X-ray diagnosis of fractures of the condylar process of the lower jaw in children

“…Переломи нижньої щелепи (НЩ) є одними з найбільш частих і складних видів травматичних пошкоджень щелепно-лицевої ділянки в дітей і становлять 18-66% від загальної кількості переломів кісток обличчя [2,7]. Серед яких переломи НЩ у ділянці виросткових відростків зустрічаються в 25-40% випадків [1,9].…”