Page 139 - Open versus closed Mandibular condyle fractures

INTRODUCTION
The condyle of the mandible is prone to fractures because of the slender nature of the condylar neck.1 Such fractures may be treated via a closed (non-surgical) or open (surgical) approach.2–5 The association between the morphology of the condyle and post-treatment functional impairment is unclear.6
Most studies focusing on radiologic outcomes use two-dimensional analysis.3,7 However, with 3D imaging, changes in condylar volume and morphology can be assessed.6,8,9,10
The goal of this study was to analyse the volume and changes in volume in both condyles after a unilateral condylar fracture. The effect of the treatment modality used on condylar volume and the relationship between condylar volume and mandibular function was evaluated at least one year after the traumatic event.
PATIENTS AND METHODS
Patients
The medical records of patients who were treated for a unilateral condylar fracture at the Department of Oral and Maxillofacial Surgery of our institution between 2008 and 2016 were reviewed. Patients whose trauma occurred at least 1 year earlier were invited by letter to attend an additional appointment. If available, the CT scans acquired when the patient initially presented to the hospital were collected (pre-treatment scan). At the follow-up appointment, a CBCT scan (field of view 26 cm, diameter 23 cm, scan time 18 s, voxel size 0.4 mm at 96 kV, and 10 mA) was acquired (post-treatment scan). Each patient completed the MFIQ,11 and performed the MAT.13 Patient gender and age, cause of trauma, type of fracture, presence of other fractures, physiotherapy, duration of follow-up, maximum mouth opening (MMO), dental status, self-perceived occlusion, treatment modality, and maxillomandibulary fixation (MMF) method were recorded.
Treatment
The treatment protocol used by our study group has been described elsewhere.12 In short, there is a choice of two main treatment modalities, i.e., open (surgical procedure with internal fixation) and closed (expectative treatment or MMF).
Cone beam computed tomography analysis
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