Retrospective Analysis Of Diacapitular Condylar Fracture Of The Mandible

Objective: Through a retrospective analysis of the clinical data of 25 patients with unilateral diacapitular condyle fractures of mandible in Oral and Maxillofacial Surgery of the First Affiliated Hospital of Dalian Medical University in 10 years,to study the clinical effect after surgical and non-surgical treatment of different classification of the unilateral diacapitular condylar fracture,with comparative analysis of functional improvement of maximum mouth opening,occlusion and the mobility of condyle movement(protrusion and mediotrusion),to provide reference for clinical treatment methods for diacapitular condyle fracture of mandible.Methods: 25 cases unilateral diacapitular condyle fractures of mandibles started in January 2002 and was terminated after 10 years in December 2012 were retrospectively review,In each case basic information,data of fracture type,treatment method,curative effect and complications for analysis.The study included 25 patients,9 cases were treated with non-surgical managements(intermaxillary fixation / observation only)and 16 cases were treated by surgical treatment(open reduction and internal fixation,ORIF /free bone removal + articular disc repositioning)respectively.Assessment was based on clinical data(maximum mouth opening,open type,condyle movement mobility,occlusion,facial nerve paresis,and function of temporalmandibular joint)of pre-and post-treatment dental panoramicradiographs and CT scan,and follow-up period durations 1-12 months.Results: 20(77%)patients presented after 12 months-8 non-surgical treatment cases,and 12 surgical treatment cases.The mouth opening,mobility of condyle movement,pain and occlusal shows no significant statistical difference in all patients.Occlusal disorders showing significant statistical difference between surgical and non-surgical management cases(P<0.05).All cases evinced normal vertical opening,and the mobility of condyle movement(protrusion and mediotrusion)and pain and defluxion demonstrated no significant statistical difference between surgical and non-surgical management cases(P>0.05).Partial facial paresis was not encountered in all operated patients.The reposition of condyle location and reduction of condyle absorption condyle demonstrated significant statistical difference between surgical and non-surgical management cases(P<0.05),while the deforming of condyle shape and ankylosis with no significant statistical difference.Conclusion: For the recovery of the motion of mandible condyle and mouth opening and ankylosis prevention,surgical treatment and non-surgical treatment recurrence rates fairly,and for the restoration of normal occlusion and the reposition of location of the condyle,surgical treatment is prior to non-surgical treatment.It is helpful to reduce condylar resorption by surgical treatment.