Three-dimensional mandibular motion after closed and open reduction of unilateral mandibular condylar process fractures.
OBJECTIVE
To detect the changes in 3D mandibular motion after two types of condylar fracture therapies.


METHODS
Using a 3D motion analyzer, free mandibular border movements were recorded in 21 patients successfully treated for unilateral fractures of the mandibular condylar process (nine patients: open reduction, rigid internal fixation, and functional treatment; 12 patients: closed reduction and functional treatment; follow-up: 6-66 months), and in 25 control subjects.


RESULTS
No differences were found among the groups at maximum mouth opening (MO), protrusion and in lateral excursions. During opening, the patients had a larger maximal deviation to the fractured side than the controls (controls 2.3 mm, open treatment 3.9 mm, closed treatment 4.2 mm; Kruskal-Wallis test, p=0.014; closed treatment vs. controls, p=0.004), with a larger coronal plane angle (controls 2.4°, open treatment 3.6°, closed treatment 4.4°; p=0.016; closed treatment vs. controls, p=0.013). In the closed treatment patients, a longer follow-up was related to increased maximum MO (p=0.04), sagittal plane angle (p=0.03), and reduced lateral mandibular deviation during MO (p=0.03).


CONCLUSIONS
Mandibular condylar fractures can recover good function; some kinematic variables of mandibular motion were more similar to the norm in the open treatment patients than in closed treatment patients.
Sforza
Chiarella
C
Functional Anatomy Research Center, Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico, Dipartimento di Morfologia Umana e Scienze Biomediche Città Studi, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, via Mangiagalli 31, I-20133 Milano, Italy. chiarella.sforza@unimi.it
Ugolini
Alessandro
A
Sozzi
Davide
D
Galante
Domenico
D
Mapelli
Andrea
A
Bozzetti
Alberto
A
D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D003799:Dental Stress Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D016014:Linear Models; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000502:physiology*; D008335:Mandibular Condyle / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000145:classification / Q000601:surgery* / Q000628:therapy*; D008875:Middle Aged; D008954:Models, Biological; D009068:Movement / Q000502:physiology; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D018709:Statistics, Nonparametric; D055815:Young Adult