title: Analysis of different treatment protocols for fractures of condylar process of mandible.
abstract: OBJECTIVE
  The present study was conducted to provide an overall perspective on the diagnosis of condylar fractures, to analyze the technique and results of different treatment methods used, and to evolve a protocol for the selection of an appropriate treatment modality for an individual case.
  
  
  METHODS
  A total of 28 patients with a condylar fracture were selected and were classified with the help of orthopantomogram and reverse Towne view radiographs. Of the 28 patients, 22 had unilateral fractures of the mandibular condyle process and 6 had bilateral fractures. They were treated with no invasive treatment, closed reduction with maxillomandibular fixation, or open reduction with internal semirigid fixation.
  
  
  RESULTS
  No significant difference was observed in the occlusion, maintenance of fixation of anatomically reduced fractured bony segments, trismus index, movements of the mandible (ie, opening, protrusion, and lateral excursions), or masticatory efficiency. The only significant difference was the subjective discomfort of the surgically treated patients in terms of pain on movement and mastication, swelling, neurologic deficit, and parotid fistula formation.
  
  
  CONCLUSIONS
  Patients with a condylar fracture with no displacement, dislocation, or derangement of occlusion seem best treated with medication only for symptomatic relief without any invasive treatment. Patients with derangement of occlusion or displacement of fractured fragments, especially in unilateral cases, seem best treated with closed reduction and maxillomandibular fixation, with medication for symptomatic relief and postoperative physiotherapy. Patients with deranged occlusion, displaced bony fractured fragments, and a dislocated condylar process out of the glenoid fossa, especially bilateral cases, seem best treated with open reduction with internal semirigid fixation.
authors.affiliation: Department of Oral and Maxillofacial Surgery, M. M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India. monikabox@yahoo.com
authors.forename: Monika
authors.initials: M
authors.lastname: Gupta
authors.forename: Nageshwar
authors.initials: N
authors.lastname: Iyer
authors.forename: Debdutta
authors.initials: D
authors.lastname: Das
authors.forename: Jagannath
authors.initials: J
authors.lastname: Nagaraj
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D003766:Dental Occlusion; D004487:Edema / Q000209:etiology; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D019248:Jaw Fixation Techniques; D004204:Joint Dislocations / Q000601:surgery / Q000628:therapy; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries*; D008337:Mandibular Fractures / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology; D010149:Postoperative Pain / Q000209:etiology; D010305:Parotid Diseases / Q000209:etiology; D011183:Postoperative Complications; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D012467:Salivary Gland Fistula / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult