Page 25 - Open versus closed Mandibular condyle fractures

Chapter 2.1 Closed
Table 3. Overview of retrospective studies on closed treatment of mandibular condyle fractures a
Andersson et al.19
Knak and Stoehr27 Krause and Bremerich30 MacLennan29
Niezen et al.25 Oikarinen et al.26
Rahn et al.31
Rutges et al.28 Silvennoinen et al.5 Smets et al.11 Yamamoto et al.32
23C/18T 94
128 67C/53T 142
37
116
28C (60CR) 92
60
49
+ + + + + + + + + + +
+ (5+)
+ (10-) + (10+) + (10-) +
+ (13+) + (8+) -
-
-
-
- + +
+ + +
+ + +
+ + +
+ + +
+ + +
+ + ND
+ + +
- + +
+ + +
+ + +
+ 31 years
+ 5 years (mean)
+ 7.8 years (mean)
+ 3.1 years (mean)
+ 1 year
+ 44 months (mean)
ND 3.8 years
+ 3.0 years
+ 5.4 months (mean) + 6 months to 4 years + 12 months
28
ND, not described
a +,in the study; -, not in the study
b C, clinical examination; T: telephone, CR,
Prospective studies
clinical report files
As shown in Table 4, five prospective studies were identified via the search criteria applied.20-24 Four of these were prospective cohort studies and one was a case- control study. No randomized prospective studies were identified at this stage of the review. Few studies adequately described the treatment modalities they applied.20, 23, 25
The longest period of follow-up (mean 1.2 years) was reported by Dijkstra et al..20 The primary outcomes used in that study were function (mandibular function impairment questionnaire; MFIQ33) and pain (visual analogue scale; VAS score). They concluded that the most important risk factors for functional impairment were age ≥ 25 years and gross displacement. The most important risk factors for pain identified in their study were being female and intracapsular fractures.
Of all the included studies, Marker et al. had the largest sample size; n = 348 patients.21 They reported that for their patients, non-surgical treatment of the fractures of the condyle was non-traumatic, safe, and predictable, and that serious complications such as continuous pain and malocclusion were only observed in a few cases. Furthermore, they concluded that the most important factors in the development of malocclusion were dislocation of the condylar head and bilateral fractures.
Number b
Adults Children
(<16 years)
Bilateral Unilateral
Intra- capsular
Extra- capsular
Follow-up