Two pediatric cases of bilateral mandibular condylar fracture with follow-up of morphological recovery process of the condyles

Abstract

It has been reported that bone growth is vigorous in the condylar process of the mandible in children, and that morphological recovery can be obtained even if dislocation occurs due to fracture. Most reports are of unilateral cases, with few reports of bilateral cases. Among these, there is no report on temporal CT observation of the morphological recovery of dislocated condyles after bilateral mandibular condylar fracture (BMCF). Here, we report the recovery process of two pediatric BMCF cases. Case 1 was a 12-year-old boy who fell off a bicycle and hit his chin. Case 2 was a 12-year-old girl who fell and hit her chin at school after losing consciousness. They were diagnosed with BMCF, with all fracture sites being the condylar neck. The fracture type was deviation-dislocation in all condyles. Both cases underwent conservative treatment that consisted of intermaxillary fixation for 10-14 days followed by mouth opening training for 3 months. In both cases, posttreatment CT observation showed resorption of the dislocated mandibular head and vertical bone addition from the fracture margin. Recovery to nearly-normal morphology of the articular process was observed at four years after treatment in Case 1 and at one year after treatment in Case 2. During follow-up observation, no notable temporomandibular joint dysfunction and occlusal abnormality were observed in either case.