Page 129 - Open versus closed Mandibular condyle fractures

138
Chapter 4.2 Open versus Closed
Mandibular Function Impairment Questionnaire
The Mandibular Function Impairment Questionnaire (MFIQ)33,34 is a validated and reliable instrument used to measure a patient’s self-perceived mandibular function. Seventeen items describing mandibular function related to, social activities (item 1), speech (item 2), masticatory performance (items 3, 4, 5, 9, 12, 13, 14, 15, 16, and 17), daily activities (item 6), drinking (item 7), laughing (item 8), yawning (item 10), and kissing (item 11), are scored from 0 to 4 on a Likert scale. A total-item score ranging from 0 to 68 is possible, in which ‘0’ represents a good functional outcome and ‘68’ a poor functional outcome.34
Maximum mouth opening
Active maximum mouth opening (MMO) without pain (in mm) was measured using a ruler, from the incisal edge of tooth #11 in a straight line to the opposing incisor in the lower jaw, with the patient sitting in a dental chair, and corrected for overbite. In cases of edentulous patients, MMO was measured with their dentures in situ.35
Dental state and self-perceived occlusion
The patient’s dental state (dentate or edentulous) and self-perceived occlusion (bad, mediocre/changed, good) were determined.
Treatment
The treatment protocol described in a previous study by the authors’ group was used in the present study.24 There were two main treatment modalities: open and closed. In open treatment, the fracture was approached via a pre-auricular skin incision and a transparotid approach.
The open protocol included no post-operative maxillomandibular fixation (MMF), but a strict soft diet, instructions on active but careful movement of the jaw, and the prescription of sufficient pain-killing medication.
The closed treatment generally consisted of a short period of MMF (using brackets, MMF screws, or arch bars), including the use of guiding elastics for approximately three weeks. Similarly, patients were advised to adhere to a strict soft diet, to engage in active but careful movement of the jaw, and were provided sufficient pain-killing medication.