Effects of the condylar process fracture on facial symmetry in rats submitted to protein undernutrition

PURPOSE: To investigate the facial symmetry of rats submitted to experimental mandibular condyle fracture and with protein undernutrition (8% of protein) by means of cephalometric measurements. METHODS: Forty-five adult Wistar rats were distributed in three groups: fracture group, submitted to condylar fracture with no changes in diet; undernourished fracture group, submitted to hypoproteic diet and condylar fracture; undernourished group, kept until the end of experiment, without condylar fracture. Displaced fractures of the right condyle were induced under general anesthesia. The specimens were submitted to axial radiographic incidence, and cephalometric mensurations were made using a computer system. The values obtained were subjected to statistical analyses among the groups and between the sides in each group. RESULTS: There was significative decrease of the values of serum proteins and albumin in the undernourished fracture group. There was deviation of the median line of the mandible relative to the median line of the maxilla, significative to undernutrition fracture group, as well as asymmetry of the maxilla and mandible, in special in the final period of experiment. CONCLUSION: The mandibular condyle fracture in rats with proteic undernutrition induced an asymmetry of the mandible, also leading to consequences in the maxilla.

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Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

Archives of Plastic Surgery ◽

10.5999/aps.2012.39.4.291 ◽

2012 ◽

Vol 39 (4) ◽

pp. 291 ◽

Cited By ~ 36

Author(s):

Kang-Young Choi ◽

Jung-Dug Yang ◽

Ho-Yun Chung ◽

Byung-Chae Cho

Keyword(s):

Mandibular Condyle ◽

Condylar Fracture ◽

Fracture Management ◽

Condyle Fracture

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Fixação interna estável de fratura condilar: relato de caso

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v9i6.5127 ◽

2020 ◽

Vol 9 (6) ◽

pp. 541-545

Author(s):

Janaina Soares Silva ◽

Rejane Kelly Andrade Beiriz ◽

Marcus Antônio Brêda Júnior ◽

Ricardo Viana Bessa-Nogueira ◽

Marcelo Marotta Araujo ◽

...

Keyword(s):

Critical Review ◽

Rio De Janeiro ◽

Mandibular Condyle ◽

Surgical Approaches ◽

Condylar Fracture ◽

Condylar Process ◽

Fracture Management ◽

Open Treatment ◽

Condyle Fracture ◽

Condylar Fractures

As fraturas mandibulares são o segundo tipo de fraturas mais comum que acomete a face, e elas podem ter um impacto negativo na estética e anatomia facial, bem como causar problema em atividades cotidianas como falar e mastigar. Este artigo tem por objetivo relatar o caso clínico de um paciente vítima de agressão física, que apresentou uma fratura unilateral de côndilo associada à fratura oblíqua de sínfise. Paciente do gênero masculino, 32 anos, leucoderma, através das radiografias PA de mandíbula e Towne foram constatadas fratura da região de sínfise mandibular e côndilo do lado esquerdo. A escolha para o tratamento desta fratura, foi o tratamento cirúrgico com fixação interna da fratura condilar com sistema 2.0mm. Após sete dias foi iniciada a fisioterapia com espátulas de madeira para o restabelecimento de adequada abertura bucal, apresentando ao final uma recuperação satisfatória, sem intercorrências. O uso de placas e parafusos para o tratamento cirúrgico de fraturas de côndilo mandibular e sínfise se mostrou eficaz, resultando no sucesso cirúrgico com um pós-operatório sem complicações e no reestabelecimento funcional e da oclusão. Descritores: Fraturas Mandibulares; Côndilo Mandibular; Fixação de Fratura. Referências Bastos EO, Goldenberg DC, Alonso N. Acesso retromandibular transparotídeo: uma via simples, eficaz e segura para tratamento das fraturas de côndilo mandibular. Rev Soc Bras Cir Craniomaxilofac. 2009;12(1):10-5. Araújo CFSN, Braga PLS, Ferreira JDB. Tratamento tardio de fratura condilar: Relato de caso. Rev cir traumatol buco-maxilo-fac. 2013;13(3):17-24. Gois Filho DM, Amarante AS, Moura RQ, Dultra JA, Carneiro Júnior B. Uso do acesso retromandibular para tratamento de fratura bilateral de côndilo mandibular: relato de caso. Rev cir traumatol buco-maxilo-fac. 2013;13(1):29-34. Rodrigues CMC, Santos DM, Oliveira MMM, Silva MCP, Furtado LM. Tratamento conservador de fratura condilar alta: relato de caso. Rev Odontol Bras Central. 2019;28(85):87-90. Mendonça JCG, Bento LA, Freitas GP. Tratamento das fraturas de côndilo mandibular: revisão da literatura. Rev Bras Cir Craniomaxilofac. 2010;13(2):102-6. Ellis E 3rd, Throckmorton G. Facial symmetry after closed and open treatment of fractures of the mandibular condylar process. J Oral Maxillofac Surg. 2000;58(7):719-28;729-30. Dantas BPSS, Fialho PV, Fernandes ACF, Silva DT, Queiroz CS. Fratura complexa de mandíbula: relato de caso. Rev Odontol Araçatuba. 2017;38(3):43-8. Trento G, Corso PFCL, Scariot R, Kluppel LE, Costa DJ, Rebellato NLB. Tratamento cirúrgico de fratura da cabeça de mandíbula com parafusos bicorticais: relato de caso. Arq bras odontol. 2014;10(2):12-9. Bagheri SC, Bell RB, Khan HA. Terapias atuais em cirurgia bucomaxilofacial. Rio de Janeiro: Elsevier; 2013. Manganello LC, Silva Alexandre AF. Fraturas do Côndilo Mandibular: classificação e tratamento. Rev Bras Otorrinolaringol. 2002;68(5):249-55. Vieira WM, Siqueira OV, Scherma AP, Miranda LR. Fratura bilateral de côndilo mandibular: tratamento tardio e complicações. Rev Bras Cir Craniomaxilofac. 2011;14(2):115-18. Rampaso CL, Mattioli TMF, Andrade Sobrinho J, Rapoport A. Avaliação da prevalência do tratamento das fraturas de côndilo mandibular. Rev Col Bras Cir. 2012;39(5):373-76. Pogrel MA, Kahnberg KE, Andersson MA. Cirugia Bucomaxilofacial. Rio de Janeiro: Santos; 2016. Alencar MGM, Rebelo HL, Silva EZ, Breda Junior MA, Medeiros Junior MD. Tratamento de fratura complexa de mandíbula por abordagem transcervical: Relato de caso. Rev cir traumatol buco-maxilo-fac. 2015; 15(4):43-8. Rampaso CL, Mattioli TMF, Sobrinho JA. Rapoport Estudo epidemiológico das fraturas do côndilo da mandíbula. Rev Bras Cir Cabeça Pescoço. 2009;38(1):19-21. Ramalho RA, Farias Junior ON, Cardoso AB. Tratamento cirúrgico de fratura bilateral de côndilo associada à fratura de corpo mandibular: relato de caso. Rev cir traumatol buco-maxilo-fac. 2013;13(2):69-73. Kumaran S, Thambiah LJ. Analysis of two different surgical approaches for fractures of the mandibular condyle. Indian J Dent Res. 2012;23(4):46-68. Valiati R, Ibrahim D, Abreu ME, Heitz C, de Oliveira RB, Pagnoncelli RM, Silva DN. The treatment of condylar fractures: to open or not to open? A critical review of this controversy. Int J Med Sci. 2008;5(6):313-18. Choi KY, Yang JD, Chung HY, Cho BC. Current concepts in the mandibular condyle fracture management part I: overview of condylar fracture. Arch Plast Surg. 2012;39(4):291-300. Ellis E, Throckmorton GS. Treatment of mandibular condylar process fractures: biological considerations. J Oral Maxillofac Surg. 2005;63(1):115-34. Iwaki Filho L, Pavan AJ, Camarini ET, Tondin GM. Tratamento das fraturas de côndilo mandibular: cirúrgico ou conservador? Rev cir traumatol buco-maxilo-fac. 2005;5(4):17-22.

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A Biomechanical Comparison of Three 1.5-mm Plate and Screw Configurations and a Single 2.0-mm Plate for Internal Fixation of a Mandibular Condylar Fracture

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0034-1375172 ◽

2014 ◽

Vol 7 (3) ◽

pp. 218-223 ◽

Cited By ~ 1

Author(s):

Peter Aquilina ◽

William C.H. Parr ◽

Uphar Chamoli ◽

Stephen Wroe ◽

Philip Clausen

Keyword(s):

Internal Fixation ◽

Material Properties ◽

Plate Fixation ◽

Pure Titanium ◽

Mandibular Condyle ◽

Titanium Implants ◽

Condylar Fracture ◽

Square Plate ◽

The Stability ◽

Condyle Fracture

The most stable pattern of internal fixation for mandibular condyle fractures is an area of ongoing discussion. This study investigates the stability of three patterns of plate fixation using readily available, commercially pure titanium implants. Finite element models of a simulated mandibular condyle fracture were constructed. The completed models were heterogeneous in bone material properties, contained approximately 1.2 million elements and incorporated simulated jaw adducting musculature. Models were run assuming linear elasticity and isotropic material properties for bone. No human subjects were involved in this investigation. The stability of the simulated condylar fracture reduced with the different implant configurations, and the von Mises stresses of a 1.5-mm X-shaped plate, a 1.5-mm rectangular plate, and a 1.5-mm square plate (all Synthes (Synthes GmbH, Zuchwil, Switzerland) were compared. The 1.5-mm X plate was the most stable of the three 1.5-mm profile plate configurations examined and had comparable mechanical performance to a single 2.0-mm straight four-hole plate. This study does not support the use of rectangular or square plate patterns in the open reduction and internal fixation of mandibular condyle fractures. It does provide some support for the use of a 1.5-mm X plate to reduce condylar fractures in selected clinical cases.

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The Influence of the Mandibular Chin Angle on the Occurrence of Mandibular Condylar Fracture: A Retrospective Study

The Scientific World JOURNAL ◽

10.1155/2021/2380840 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Sunil S. Nayak ◽

S. Arun ◽

Abhay Taranath Kamath ◽

Bharath Jaladhigere Lakshmanagowda ◽

Eshita Dubey ◽

...

Keyword(s):

Retrospective Study ◽

Mandibular Condyle ◽

Ct Scans ◽

Reference Plane ◽

Cerebral Aqueduct ◽

Condylar Fracture ◽

Web Based ◽

Fracture Group ◽

History Of ◽

Condylar Fractures

Background. Condylar fractures are commonly associated with symphysis/parasymphysis fractures. Condylar fractures have been attributed to direct and indirect traumatic forces, the direction and magnitude of the forces, and the condylar anatomy. The chief aim of this study was to determine the association between the newly defined mandibular chin angle and the occurrence of condylar fractures. Materials and Methods. A retrospective study was conducted to analyze two-dimensional computed tomography (2D CT) scans of patients with a history of chin trauma. The outcome was a symphysis/parasymphysis fracture with or without fracture of the mandibular condyle. The Mediff InstaRISPACS web-based platform was used to measure the chin angle. The cerebral aqueduct of Sylvius in the corresponding 2D CT midsagittal image was the standard reference plane to measure the chin angle. The SPSS Version 20 (IBM Corp, Armonk, NY) was used for data analysis. Results. The sample size included 120 2D CT scans of patients with symphysis/parasymphysis fractures (60 associated with condylar fractures and 60 without condylar fractures). The mean chin angle in the group without condylar fracture was 133.35 ± 3.87°, which was approximately 15° lesser than in the condylar fracture group (mean, 148.56 ± 5.49°), and these findings were statistically significant P < 0.05 . Conclusion. Individuals with a high chin angle are potentially at a higher risk of sustaining associated condylar fractures.

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Condylar Fracture in a Child with Entrapment of the Inferior Alveolar Nerve

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0035-1563391 ◽

2016 ◽

Vol 9 (2) ◽

pp. 149-151

Author(s):

Constantinus Politis ◽

Yi Sun ◽

Jimoh Agbaje ◽

Ivo Lambrichts ◽

Maria Piagkou ◽

...

Keyword(s):

Pediatric Population ◽

Infratemporal Fossa ◽

Inferior Alveolar Nerve ◽

Mandibular Condyle ◽

Condylar Fracture ◽

Lower Lip ◽

Pterygoid Process ◽

Subcondylar Fracture ◽

Rubbing Behavior ◽

The Right

The aim of this article is to report the clinical case of a right subcondylar fracture in a 4-year-old boy. The displaced and medial angulated fragmented mandibular condyle in coexistence with an enlarged lateral pterygoid process was compressing the inferior alveolar nerve (IAN) during its course in the area of the infratemporal fossa. This was expressed by exhibiting a rubbing behavior with resulting superficial ulceration at the right lower lip. Hypoesthesia of the lower lip may be a sign of the IAN entrapment after a subcondylar fracture in a child. In contrast to the adults where an open reduction is necessary to relieve the symptoms of hypoesthesia, in pediatric population, a conservative approach seems sufficient.

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Facial symmetry evaluation after experimentally displaced condylar process fracture in methotrexate treated rats

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502012000300002 ◽

2012 ◽

Vol 27 (3) ◽

pp. 210-216 ◽

Cited By ~ 2

Author(s):

Samantha Cristine Santos Xisto Braga Cavalcanti ◽

Luciana Corrêa ◽

João Gualberto de Cerqueira Luz

Keyword(s):

Body Weight ◽

Low Dose ◽

Mandibular Condyle ◽

High Dose ◽

Linear Measurements ◽

Facial Symmetry ◽

Condylar Process ◽

Dose Methotrexate ◽

Condyle Fracture ◽

Group D

PURPOSE: To investigate the facial symmetry of high and low dose methotrexate (MTX) treated rats submitted to experimentally displaced mandibular condyle fracture through the recording of cephalometric measurements. METHODS: One hundred male Wistar rats underwent surgery using an experimental model of right condylar fracture. Animals were divided into four groups: A - saline solution (1mL/week); B - dexamethasone (DEX) (0,15mg/Kg); C - MTX low dose (3 mg/Kg/week); D - MTX high dose (30 mg/Kg). Animals were sacrificed at 1, 7, 15, 30 and 90 days postoperatively (n=5). Body weight was recorded. Specimens were submitted to axial radiographic incidence, and cephalometric mensurations were made using a computer system. Linear measurements of skull and mandible, as well as angular measurements of mandibular deviation were taken. Data were subjected to statistical analyses among the groups, periods of sacrifice and between the sides in each group (α=0.05). RESULTS: Animals regained body weight over time, except in group D. There was reduction in the mandibular length and also changes in the maxilla as well as progressive deviation in the mandible in relation to the skull basis in group D. CONCLUSION: Treatment with high dose methotrexate had deleterious effect on facial symmetry of rats submitted to experimentally displaced condylar process fracture.

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MANDIBULAR CONDYLE FRACTURES

The Professional Medical Journal ◽

10.29309/tpmj/2016.23.06.1611 ◽

2016 ◽

Vol 23 (06) ◽

pp. 705-708

Author(s):

Syed Ghazanfar Hassan ◽

Dr. Salman Shams ◽

Mujeeb Rehman ◽

Suneel Kumar

Keyword(s):

Maxillofacial Surgery ◽

Mandibular Condyle ◽

University Hospital ◽

Condylar Fracture ◽

Common Etiology ◽

The Common ◽

Condyle Fracture ◽

Surgery Department ◽

Condylar Fractures ◽

Department Faculty

Objectives: To analyze frequency, gender, age, cause of injury and type/locationof Condylar fracture among patients reported at Liaquat university hospital Hyderabad. Settingof Study: This study was conducted at Oral & Maxillofacial Surgery Department, Faculty ofDentistry, Liaquat University Hospital, and Hyderabad. Period: 1st February 2013 to 31st January2015. Methodology: The statistics of 108 patients both males and females who had beenaffected with mandibular Condyle fracture were prospectively reviewed. Patient’s data includinggender, age, cause of injury, type of Condylar fracture were recorded on Proformas and thenprospectively analyzed. Results: Out of 108 patients 81(75%) male and 27 (25%) female wereaffected with mandibular Condylar fracture. The common age group was 2nd decade of life(11-20 years). Most common cause of injury was fall in 51 cases (47.2%) followed by RTA in43 cases (39.8%). Sub condylar fracture was most common type of fracture occurred i.e in56 cases (51.8%). Conclusion: Children’s are commonly affected with mandibular Condylefracture & fall was the most common etiology in our study sample that explains the associationbetween fall and Condylar trauma. The second common etiological factor was Road trafficaccident for Sub condylar fractures in our study sample.

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Biomechanical Evaluation of Mandibular Condyle Fracture Osteosynthesis Using the Rhombic Three-Dimensional Condylar Fracture Plate

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2019.04.020 ◽

2019 ◽

Vol 77 (9) ◽

pp. 1868.e1-1868.e15 ◽

Cited By ~ 3

Author(s):

Anas Ben Achour ◽

Heike Meißner ◽

Uwe Teicher ◽

Dominik Haim ◽

Ursula Range ◽

...

Keyword(s):

Three Dimensional ◽

Mandibular Condyle ◽

Condylar Fracture ◽

Fracture Osteosynthesis ◽

Biomechanical Evaluation ◽

Condyle Fracture

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Application of cone-beam computed tomography (CBCT) for diagnosis and management of mandibular condyle fractures

Health Renaissance ◽

10.3126/hren.v13i3.17930 ◽

2017 ◽

Vol 13 (3) ◽

pp. 73-81

Author(s):

Pradip Acharya ◽

G Ren ◽

MR Jaisani ◽

A Dongol ◽

RP Yadav ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Mandibular Condyle ◽

Supplementary Information ◽

Cone Beam ◽

Condylar Fracture ◽

Diagnosis And Management ◽

Condylar Head ◽

Condyle Fracture ◽

Condylar Fractures

Background: Cone beam computed tomography (CBCT) provides precise imaging of temporomandibular joint anatomy without superimposition and distortion. CBCT is relatively a new imaging modality and used commonly in dental practice.Objective: The aim of this study is to present detailed imaging of emporomandibular joint in case of condyle fracture using CBCT for its use in diagnosis, surgical planning and evaluation of treatment.Method: In our study, we evaluated 3D - CBCT (three dimensional Cone beam computed tomography) examinations of 18 patients with mandibular condyle fractures. All of the fractures in our cases were overlooked on CBCT, thus providing axial, coronal and para-sagittal imaging of condylar head including 3D dimensional volumetric images of the condyle and surrounding structures.Result: Out of 18 condylar fracture patient’s CBCT, 8 radiographs showed condylar head (intracapsular) fracture, 2 condylar neck, 8 subcondylar fracture. 13 condylar fractures were unilateral and 5 were bilateral fracture. 9 of the condylar fractures were not associated with the mandible fracture. Out of the 9 associated condylar fractures; 3 were associated with symphysis fracture, 4 associated with parasymphysis fracture, 1 associated with body fracture and remaining 1 associated with mandibular angle fracture. 6 of the condylar fracture showed no signs of displacement of the fractured part and among 12 displaced condylar fracture parts 8 medially and 4 laterally displaced recorded in CBCT. All of the patients were given treatment on the basis of CBCT diagnosis and the results obtained from it was clinical satisfactory without complaints.Conclusion: We concluded that CBCT is the latest sophisticated technology which provides clear image of condylar head without superimposition of other structures, presented supplementary information for a more effective diagnosis and management of mandibular condyle fractures. Health Renaissance 2015;13 (3): 73-81

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