Page 145 - Open versus closed Mandibular condyle fractures

No correlation was found between the MFIQ score and the difference in condylar volume between pre-treatment and post-treatment on the non-fractured side (P = 0.484). There was also no significant correlation between performance on the MAT and the difference in condylar volume between pre-treatment and post- treatment on the non-fractured side (P = 0.178).
Table 4. MFIQ and MAT
Correlations (Pearson)
MFIQ - Post-treatment, non-fractured MFIQ - Post-treatment, fractured MFIQ - Pre minus post, non- fractured
MAT - Post-treatment, non-fractured
MAT - Post-treatment, fractured
MAT - Pre minus post, non-fractured
*P≤0.05
DISCUSSION
Significance
P = 0.235 P = 0.477 P = 0.484
P = 0.085
P = 0.020*
P = 0.178
Pearson Correlation -.332
Cone beam computed tomography analysis
In this study, there was a significant mean decrease in condylar volume of 9.2% after a fracture of the mandibular condyle as well as significant remodelling of the non-fractured condyle. Ellis and Throckmorton stated that, because of the neuromuscular adaption after trauma, the non-fractured condyle is loaded more heavily during mastication than the fractured condyle in order to prevent loading on the damaged part of the temporomandibular joint.16 It is conceivable that this increase in loading of the non-fractured condyle causes remodelling of the condyle. Moreover, development of dysfunction in the non-fractured temporomandibular joint has been reported in patients with unilateral condyle fractures and is thought to reflect a change in chewing patterns to prevent loading of the fractured joint.17,18
In terms of skeletal adaptations, a new temporomandibular articulation occurs after trauma, i.e., regeneration of the fractured condyle with a change in the temporal component and loss of the posterior vertical dimension.16 This regeneration causes remodelling not only of the fractured condyle but also the contralateral condyle. The changes that were observed in this study seemed to occur independent of the treatment method used, although patients who undergo open treatment tend to have less neuromuscular adaptation.19
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