Clinical outcome of short-term myofunctional therapy for pediatric condylar fractures : a retrospective study

Abstract

I evaluated the clinical outcome of short-term myofunctional therapy using an activator without any fixation for condylar fractures in children. This study included eight children, aged 2.8-14.6 (mean 7.5) years, with unilateral or bilateral fractured mandibular condylar processes. All patients underwent myofunctional therapy using a customized activator for 3-5 weeks without surgery, intermaxillary fixation, and functional exercises at Pediatric Dental Clinic of Tokushima University Hospital. Follow-up ranged from 1.0 to 6.9 (mean 3.8) years after treatment. The patients were assessed clinically, radiographically, and with computed tomography pre- and post-treatment. In addition, pre- and post-treatment measurements of maximal opening capacity were analyzed statistically. Evaluation after treatment showed that all patients achieved normal facial symmetry, occlusion, jaw mobility, and maximal mouth opening. However, one patient who was 14.6 years old had deviation on mouth opening. Maximal opening capacity was significantly greater from 6 months post-treatment (mean 51.1 mm) than at pretreatment (mean 22.7 mm ; p<0.01) or at the time of activator removal (mean 38.1 mm ; p<0.05). Bone remodeling and formation of a new condylar head were seen on computed tomography. The short-term use (3-5 weeks) of the removable activator is effective in the management of pediatric condylar fractures.