scholarly journals Tratamento conservador versus cirúrgico das fraturas condilares: revisão integrativa

2020 ◽  
Vol 9 (12) ◽  
pp. e45191211418
Author(s):  
Marina Rosa Barbosa ◽  
Sérgio Bartolomeu de Farias Martorelli ◽  
Maria Regina Almeida Menezes ◽  
Caio César Gonçalves Silva ◽  
Jéssica da Silva Cunha ◽  
...  

As fraturas condilares são as fraturas maxilofaciais com maior controvérsia na literatura a respeito das formas de tratamento, uma vez que, no procedimento de escolha, envolve questões relacionadas à idade, localização e tipo de fratura, grau de deslocamento do segmento fraturado, presença de outras fraturas faciais associadas, ausência de dentes, o restabelecimento da oclusão dentária e o tempo decorrido do trauma, fatores estes que direcionam a escolha do tipo de abordagem terapêutica (cirúrgica ou conservadora, estática ou funcional). Este estudo teve como objetivo principal realizar uma revisão integrativa da literatura atual sobre o tratamento das fraturas condilares, destacando suas indicações, limitações, vantagens e desvantagens. A metodologia utilizada foi uma revisão integrativa da literatura por meio de  pesquisa bibliográfica, por meio de uma busca de artigos científicos na base de dados eletrônica PubMed e Medline, utilizando os descritores mandibular condyle, mandibular fractures, mandibular injuries, indexados no período de 2015 a 2020, que tratavam de estudos transversais, ensaios clínicos e randomizados. Após os critérios de elegibilidade, foram analisados 27 artigos integralmente publicados em língua inglesa. Os estudos demonstraram qual conduta de tratamento traz mais segurança para a intervenção, apresentando alta confiabilidade, permitindo uma evidência científica previsível e rápida, além de proporcionar um tratamento com menor custo e tempo de internação.

2021 ◽  
Vol 15 (8) ◽  
pp. 1920-1922
Author(s):  
Nabeela Riaz ◽  
Samreen Younas ◽  
Ijaz Ur Rehman ◽  
Ahmad Abdul Haseeb ◽  
Saba Hanif ◽  
...  

Aim: to explore the mandibular bone fractures in elderly patients with reference to etiology of trauma. Methodology: This was a descriptive study conducted in the department of Oral and Maxillofacial Surgery KEMU/ Mayo Hospital Lahore. Elderly patients (age 60-100years) with mandibular bone fractures. Results: Aetiology of trauma leading to mandibular fractures was as follows; there were 79(65.83%) cases of RTA, 32(26.66%) falls, 4(3.33%) assaults and there were only 3(2.5%) cases of industrial injury. Conclusion: To conclude, this study depicts that road traffic accidents were the predominant cause of injury in the studied age group. Elderly patients need more care and attention, especially after traumatic incidents and lead to financial burden in hospitals Keywords: Maxillofacial trauma, Elderly population, Mandibular injuries, Elderly fractures


2017 ◽  
Vol 46 (6) ◽  
pp. 730-739 ◽  
Author(s):  
A.C.V. Armond ◽  
C.C. Martins ◽  
J.C.R. Glória ◽  
E.L. Galvão ◽  
C.R.R. dos Santos ◽  
...  

2013 ◽  
Vol 17 (1) ◽  
pp. 38-39
Author(s):  
Tushar Peedikayil ◽  
Nicole Wieselthaler

The aim of this article is to highlight the importance of routinely reviewing the mandibular condyle on computerised tomography brain studies in a trauma setting, that often extends to involve the mandibular condyles in the scan parameters. We discuss 4 cases seen over the last 18 months at our institution, and review the relevant literature regarding paediatric mandibular fractures.


Author(s):  
González MGR ◽  
Munguía AMN ◽  
González CASJ ◽  
Tellez EB ◽  
Montes IDG

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.


2017 ◽  
Vol 89 (3) ◽  
pp. 31-35 ◽  
Author(s):  
Kh. R. Pohranychna ◽  
A.R. Stasyshyn ◽  
U.D. Matolych

A rapidly increasing number of mandibular condylar fractures and some complications related to injuries of temporomandibular elements make this study important. Intra-articular disorders lead to secondary pathological findings such as osteoarthritis, deforming osteoarthrosis, and temporomandibular joint ankylosis that limits mouth opening, mastication, swallowing, breathing, and decreased/lost working capacity or disability. Early diagnosis of intra-articular disorders can prevent from long-lasting functional complications caused by temporomandibular joint injuries. This study was performed for the purpose of early detection and investigation of organic pathological changes in the cartilaginous and osseous tissues of the temporomandibular joint caused by traumatic fractures of the mandibular condyle. Twenty patients underwent a general clinical examination, magnetic resonance imaging (MRI), and immune-enzyme testing for biochemical markers of connective tissue injury (pyridinoline and deoxypyridinoline) in urine. Disk dislocation, deformation, adhesion, perforation or squeeze, tension or disruption of ligaments, and injury of articular surfaces are among complications of mandibular fractures that can be revealed on MRI. As regards biochemical findings, we revealed a sharp rise in the levels of pyridinoline and deoxypyridinoline before treatment and a lack of stabilization within 21 days of treatment.


Author(s):  
Eugênio Braz Rodrigues Arantes

ResumoUm dos maiores desafios no tratamento de fraturas cominutivas da mandíbula é restaurar o contorno anatômico das áreas fraturadas, pois, a maioria dos casos apresenta deslocamento ósseo severo e perda óssea que diminuem a previsibilidade da redução dos fragmentos. Nesse contexto o tratamento deste tipo de fraturas mandibulares ainda permanece um desafio para a cirurgia maxilofacial no que se refere à técnica de redução. Nesse sentido, a redução aberta com fixação interna rígida se apresenta como uma boa opção de tratamento, por encurtar o tempo de reabilitação orofuncional e diminuir as chances de infecção. O presente trabalho tem como objetivo apresentar o caso clínico de um paciente do sexo masculino vítima de acidente com animal cursando com múltiplas fraturas de face. A abordagem cirúrgica eleita para o tratamento da fratura mandibular cominutiva foi a redução aberta e instalação de placa de reconstrução e parafusos de titânio. A abordagem aberta evitou o bloqueio maxilo-mandibular pós-operatório em um paciente jovem. Esta técnica permitiu a redução precisa dos fragmentos devolvendo a função mastigatória de maneira precoce.Palavras-chave: Fraturas maxilomandibulares, traumatismos mandibulares, redução aberta, fixação de fratura.AbstractOne of the biggest challenges in treating comminuted jaw fractures is restoring the anatomical contour of the fractured areas. Most cases have severe bone dislocation and bone loss that decreases reduction predictability. In this context, the treatment of this type of mandibular fractures still remains a challenge for maxillofacial surgery regarding the reduction technique. In this sense, open reduction with rigid internal fixation is a good treatment option because it decreases orofunctional rehabilitation time and reduces the chances of infection. The present work aims to present the clinical case of a male patient victim of animal accident with multiple facial fractures. The chosen surgical approach for the treatment of comminuted mandibular fracture was open reduction and installation of reconstruction plate and titanium screws. The open approach favored not performing postoperative maxillomandibular block in a young patient. This technique allowed the precise reduction of fragments and the early masticatory function.Key-words: Jaw fractures, mandibular injuries, open fracture reduction, fracture fixation.


2021 ◽  
Vol 33 (2) ◽  

Temporomandibular joint (TMJ) ankylosis is an intracapsular union of the disc–condyle complex to the temporal articular surface that confines the mandibular drive, including the fibrous adhesions/ bony fusion between condyle, disc, glenoid fossa, and eminence. It is a severe and incapacitating ailment that can cause mastication, digestion, speech, appearance, and hygiene concerns. This is an unusual case of a 42-year-old adult patient, who suffered from bilateral recurrent TMJ ankylosis and reported following trauma to the face. The patient had a history of mandibular condyle fracture at ten years of age. Excision of existing ankylotic mass followed by reconstruction with patient-specific total joint replacement (TJR) was carried out. Postoperative physiotherapy exercises in the presented case improved patient’s mouth opening, and mandibular movement. Patient-specific TJR procedures and postoperative physiotherapy will be helpful in cases with TMJ ankylosis. Keywords: Genioplasty; Mandibular Condyle; Mandibular fractures; Temporomandibular Ankylosis; Temporomandibular Joint


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