Clinical indication for intraoperative 3D imaging during open reduction of fractures of the neck and head of the mandibular condyle.
OBJECTIVE
This study aimed to evaluate the use of intraoperative cone-beam computed tomography (CBCT) in monitoring the results of repositioning and osteosynthesis of condylar process and head (capitulum) fractures of the mandible to see if CBCT is beneficial for these patients.


METHODS
Sixty patients (22 females and 38 males, age range 16-79 years, average 36.5 years) with condylar process and head fractures according to the classification of Spiessl and Schroll were treated during the study period. Thirty-four of the 60 patients received a CBCT scan immediately after surgical treatment under aseptic conditions.


RESULTS
In all 34 cases, intraoperative CBCT provided high-quality imaging of the condylar process in all three planes. In four patients (11.8%), unsatisfactory reposition or unexpected complications were detected which could immediately be corrected with a surgical revision.


CONCLUSIONS
Intraoperative use of CBCT enables optimization of the surgical outcome for fractures of the condylar process and head of the mandible, reduces postoperative complications, and spares patients from repeated intervention. In addition, intraoperative CBCT enables safer treatment with minimally invasive approaches.
Klatt
J
J
Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. j.klatt@uke.uni-hamburg.de
Heiland
M
M
Blessmann
M
M
Blake
F
F
Schmelzle
R
R
Pohlenz
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D054893:Cone-Beam Computed Tomography / Q000706:statistics & numerical data*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000706:statistics & numerical data*; D008297:Male; D008335:Mandibular Condyle / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods* / Q000706:statistics & numerical data; D055815:Young Adult