Page 161 - Open versus closed Mandibular condyle fractures

Further development of closed treatment protocols, including a schedule for strict follow-up, use of less demanding MMF methods, e.g., (blocked) brackets with elastics, further understanding of adaptation mechanisms of the (contralateral) condyle and (guiding) physiotherapy, will bring this treatment method to a higher level, and would be expected to have a higher success rate.
Future opportunities for open treatment need to be explored, including the development of advanced and less technically demanding endoscopic and intraoral techniques, the role of nerve integrity monitoring during surgery (e.g., the NIM stimulator; Medtronic, Minneapolis, MN),52 and perhaps the use of intraoperative surgical imaging or augmented reality.
For now, closed treatment seems to be a safe and appropriate treatment modality for most unilateral condylar fractures. Although open treatment in general showed similar outcomes, it should be reserved for limited indications. Adequate clinical decision-making is the pivotal factor for avoiding unwanted surgery-related complications.
In conclusion, the answer to the question of ‘open or closed?’ lies ahead, and by learning from each other’s difficulties during this journey, we may eventually resolve this controversy.
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General Discussion and Future Prospects
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