Temporomandibular Dysfunction After Surgery of Mandibular Fractures Not Involving the Mandibular Condyle: A Prospective Follow-Up Study

Abstract

PurposeFacial trauma may lead to temporomandibular dysfunction (TMD). The aim of this study was to clarify the occurrence and characteristics of TMD in patients surgically treated for mandibular fractures not involving mandibular condyle. MethodsThis prospective, single-center follow-up study was comprised of patients who underwent surgery for a non-condylar mandibular fracture. Patients were first evaluated at presentation, and again six months post-surgery to assess the function of the masticatory system, using the Helkimo index.Specifically, this index incorporates two complementary sub-indices: the subjective symptomatic (anamnestic) index (A i ), and the objective clinical dysfunction index (D i ). The A i was recorded both at presentation and the six month follow-up. The D i was recorded at the six month follow-up. ResultsThirty-one patients completed the study. All patients were men (mean age 26.2, range 18-47 years). Four (12.9%) patients developed severe symptoms of dysfunction during the study period according to the A i . Clinical findings (D i ) were observed in 25 (80.6%) patients, but these were not associated with symptoms of dysfunction. Conclusions TMD is common six months after surgery in patients with non-condylar mandibular fractures.Patients with such fractures should be evaluated for dysfunction during follow-ups, and referred for further treatment if necessary. Evaluation of temporomandibular functionThe Helkimo anamnestic (A i ) and clinical (D i ) indices were used to identify the occurrence and severity of TMD 17 . During the pre-operative visits, patients' anamnestic subjective symptoms (A i ) were assessed using a questionnaire and an interview. At the six month follow-up, patients were evaluated again with the same questionnaire and interview. In addition, a comprehensive clinical examination of the masticatory system was performed according to the Helkimo clinical index (D i ).This index was only recorded at the six month follow-up; pre-operative TMD status could not be

Health-related quality of life in patients surgically treated for orbital blow-out fracture: a prospective study

“…This patient had been assaulted and was diagnosed with temporomandibular dysfunction (TMD) during the follow-up visits. According to previous studies, TMD is common after mandibular and zygomatic trauma [ 21 , 22 ]. In this case, it could be hypothesized that during the assault this patient received multiple forces towards the face, and some could have been directed to or transmitted to the temporomandibular joint (TMJ), causing soft tissue damage to the area without fracture of bones.…”

Recovery of Post-Traumatic Temporomandibular Joint after Mandibular Fracture Immobilization: A Literature Review

“…The TMDs etiology is multifactorial and includes biologic, environmental, social, psychological, and physical causes. Mandibular fractures are one of the etiological factors of TMJ disorders [10][11][12][13] and can produce mechanical changes within the TMJ such as: limitation or deviation of jaw opening, hemarthrosis, dislocation, fibrous adhesion, and ankylosis [14][15][16].…”

“…Condyle fractures represent 37% of the mandible fractures and can be extracapsular or intracapsular, undisplaced or displaced, deviated, or dislocated [10]. The effects of trauma in non-condylar mandibular fracture on the TMJ are yet poorly studied [10].…”

“…Two studies reported mandible trauma as a major factor of TMDs when adult patients with a non-condylar mandibular fracture were compared to healthy patients [10].…”