Page 35 - Open versus closed Mandibular condyle fractures

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Chapter 2.1 Closed
The need for follow-up and the duration of follow-up after treatment were not mentioned in the studies. In a study by Throckmorton et al., it was reported that after 12 months of follow-up no substantial reformation could be expected.55 According to the authors of that study, a minimum follow-up period of 12 months is therefore justified.
To informatively evaluate the results of closed treatment reported in the different studies, the outcome variables need to be compared.
Unfortunately, parameters such as‘overall function’have been described differently in most of the studies reported to date. Some studies used the MFIQ to evaluate the functional outcome, while others used the Helkimo index.56-58 Other outcome measures of closed treatment reported in the studies analysed included the degree of malocclusion, mouth opening, ROM, and pain.
As shown in Table 7, most studies reported good results with regard to these outcome measures. The recovery of occlusion ranged from 76 to 100%. Similar results were shown for the full recovery of mouth opening, which ranged from 68 to 100%. Lateral movements, which are included in the ROM, were fully restored in 65 to 100% of patients. Pain as a late symptom was not often seen.
However, Krause and Bremerich reported that 16% of patients perceived pain.30 The study by Rutges et al. reported the most adverse outcomes with regard to mouth opening and ROM,28 followed by the study by Smets et al..11
Nevertheless, the descriptions of these measurements were insufficient in most studies. No clear associations between the adverse outcomes and the treatments applied could be determined.
A potential shortcoming of this review is that the studies included focused on closed treatment only. Therefore, data on closed treatment from studies investigating open versus closed treatment were omitted. On the other hand, it is the authors’ opinion that studies on open versus closed treatment tend to focus on the controversy rather than on the separate treatment modalities, and that each center in these studies would most probably have a specific treatment that they focus on, whether open or closed, resulting in a skewed impression.23