scholarly journals Fixação interna estável de fratura condilar: relato de caso

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.

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

2012 ◽  
Vol 39 (4) ◽  
pp. 291 ◽  
Author(s):  
Kang-Young Choi ◽  
Jung-Dug Yang ◽  
Ho-Yun Chung ◽  
Byung-Chae Cho
Keyword(s):  
Mandibular Condyle ◽  
Condylar Fracture ◽  
Fracture Management ◽  
Condyle Fracture

scholarly journals MANDIBULAR CONDYLE FRACTURES

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.

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

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

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

2011 ◽  
Vol 26 (2) ◽  
pp. 88-93 ◽  
Author(s):  
Lucimar Rodrigues ◽  
Luciana Corrêa ◽  
João Gualberto de Cerqueira Luz
Keyword(s):  
Serum Proteins ◽  
Mandibular Condyle ◽  
Median Line ◽  
Condylar Fracture ◽  
Fracture Group ◽  
Facial Symmetry ◽  
Maxilla And Mandible ◽  
The Right ◽  
Condyle Fracture ◽  
Cephalometric Measurements

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.

scholarly journals Open Treatment of Mandibular Condyle by Direct Transparotid Approach: Our Experience

2020 ◽  
Vol 13 (2) ◽  
pp. 109-114
Author(s):  
Mohammed Salman Basha ◽  
Hussain AlAithan ◽  
Nyer Firdoose
Keyword(s):  
Surgical Technique ◽  
Facial Nerve ◽  
Nerve Injury ◽  
Mandibular Condyle ◽  
Surgical Practice ◽  
Salivary Fistula ◽  
Facial Nerve Injury ◽  
Major Complications ◽  
Open Treatment ◽  
Condyle Fracture

The fractures of the mandibular condyle are commonly encountered in maxillofacial surgical practice. The controversies to open or not to open are still ongoing. We have used both techniques, to successfully manage our patients. Open treatment of condyle fracture with or without dislocation is technically challenging. We used a “Direct Transparotid” approach in treating 13 condyle fractures over a period of 4 years. The patients were evaluated for facial nerve injury, salivary fistula, scar, function, and occlusion over a period of 12 months. There were no major complications with acceptable scar, both intraoperatively and postoperatively. The script aims at presenting our experience of direct transparotid approach surgical technique.

scholarly journals Aktualne poglądy na temat leczenia złamań wyrostka kłykciowego żuchwy

2018 ◽  
Vol 64 (4) ◽  
Author(s):  
Maciej Sikora ◽  
Tomasz Olszowski ◽  
Dariusz Chlubek
Keyword(s):  
Surgical Approach ◽  
Condylar Fracture ◽  
Appropriate Treatment ◽  
Pubmed Database ◽  
Open Treatment ◽  
Materials Used ◽  
The Right ◽  
Meta Analyses ◽  
Condylar Fractures ◽  
Resorbable Materials

ABSTRACTThe aim of this review was to present and discuss current views on the treatment of condylar fractures (CFs). The authors addressed the following issues: the etiology, epidemiology and mechanisms of CFs; strategies and methods for the treatment of CFs. Moreover, the choice of surgical approach for the open treatment of CFs as well as techniques and materials used for fixation of CF are discussed.The PubMed database was used to search for relevant articles published between 2000 and 2018. The analysis referred to both original and review papers (including meta-analyses) that concerned adult patients. There are still differences in opinions among researchers regarding the choice of appropriate treatment – closed or open. There is no consensus among open treatment supporters in choosing the right surgical approach. The important question is which material to choose for osteosynthesis of the condylar fracture.Recent studies show satisfactory results in terms of stability of condylar osteosynthesis with the use of 3D plates. Further discussion is required on the choice of material for fixation of the condylar fracture and, in particular, on the possibility of using resorbable materials.

scholarly journals Retromandibular Approach as a Method for Open Reduction and Internal Fixation of Mandibular Condyle Fractures. Experience in the Regional Hospital 1º de Octubre, ISSSTE and Literature Review

2021 ◽  
Vol 7 (7) ◽  
Author(s):  
González MGR ◽  
Munguía AMN ◽  
González CASJ ◽  
Tellez EB ◽  
Montes IDG
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Surgical Techniques ◽  
Mandibular Condyle ◽  
Middle Cranial Fossa ◽  
Sufficient Evidence ◽  
Mandibular Fractures ◽  
Open Treatment ◽  
Condylar Fractures

Mandibular condyle fractures constitute 17.5% to 52% of mandibular fractures. Open reduction with internal fixation and closed reduction are described for their treatment. Fonseca describes the absolute indications for open treatment when there is displacement of the mandibular condyle to the middle cranial fossa, foreign body invasion, extra capsular displacement of the condyle, and/or malocclusion not susceptible to closed reduction. It includes indications with vast evidence for open treatment of bicondyle fractures, condylar displacement greater than 45 degrees, reduction in the height of the mandibular ramus greater than or equal to 2mm, fractures associated with fractures of the middle third and when there is unstable occlusion. The above establishes sufficient evidence to perform open treatment in various situations of condylar fractures. Regarding the approach of the mandibular condyle region there are different surgical techniques, such as, the preauricular, retroauricular, submandibular, retromandibular, and rhytidectomy approaches.

scholarly journals 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

2014 ◽  
Vol 7 (3) ◽  
pp. 218-223 ◽  
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.

scholarly journals The Use of 3D Titanium Miniplates in Surgical Treatment of Patients with Condylar Fractures

2020 ◽  
Vol 9 (9) ◽  
pp. 2923 ◽  
Author(s):  
Maciej Sikora ◽  
Maciej Chęciński ◽  
Marcin Sielski ◽  
Dariusz Chlubek
Keyword(s):  
Three Dimensional ◽  
Mandibular Condyle ◽  
Rigid Fixation ◽  
Good Reliability ◽  
Open Treatment ◽  
The Stability ◽  
Condylar Fractures ◽  
Affect Bone Healing ◽  
Observation Period

The aim of this study was to evaluate the effectiveness of open treatment of mandibular condyle fractures using 3D miniplates. A group of 113 patients has been chosen for evaluation, including 100 men and 13 women. After hospitalization, each patient underwent a 6-month postoperative follow-up. The material chosen for the analysis consisted of data collected during the patient’s stay in the hospital as well as the postoperative outpatient care. A single 4-hole Delta Condyle Compression Plate (4-DCCP) was used in 90 out of 113 (79.6%) cases. In 16 out of 113 (14.2%) patients, the Trapezoid Condyle Plate (4-TCP or 9-TCP) was used. The remaining cases required more than one miniplate. No 3D miniplate fractures were found in the study subjects during the analyzed observation period. Loosening of one or more osteosynthesis screws was observed in 4 out of 113 (3.5%) patients. Screw loosening was a complication that did not affect bone healing in any of the patient cases. The conducted research confirms that titanium 3D mini-plates are easy to adjust and take up little space, therefore they can easily be used in cases of mandibular condyle base and lower condyle neck fractures. The stability of the three-dimensional miniplates for osteosynthesis gives very good reliability for the rigid fixation of the fractured mandibular condyle.

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