Abstract
Treatment of condylar process fractures in children is especially important due to the risk of a mandibular growth center in the cartilage of the condylar head. Functional treatment using a removable orthodontic appliance (activator) is usually given for conservative treatment at pediatric dental clinic in our hospital. The concept of using the activator is to promote normal mandibular growth in the disrupted anatomy of the soft and hard tissue of mandible. In addition, a chin cap is effective to have younger children keep the activator at the suitable position.
To evaluate the healing process of the damaged tissue and the effectiveness of the functional treatment using the activator, we provided functional treatment for a condylar process fracture in a 5-yearold boy and observed the remodeling process using images with three-dimensional computedtomography (3 DCT).
He was injur ed in a traffic accident when riding bicycle.3 DCT images confirmed displacement and dislocation fracture of the left condylar process at pretreatment. Functional treatment was given with the activator and chin cap for 17 days. Remodeling of the condylar process was observed with CT examination after 1,4,7 and 15 months with agreement of the parents of the patient.3 DCT images suggested conspicuous bone resorption of the fracture fragments and rapid formation of a new condyler head with additional bone after 4 months. After 7 months, the regenerated condylar head was observed to be nearly completely remodeled with morphology in mandibular fossa. After 15months, the condylar head was healed completely. Clinical outcome of this case was successful with normal occlusion, pain-and-noise-free TMJ, normal jaw opening and symmetry at follow-up 2 year and 4 months later.
These obser vations indicated that the functional treatment using activator is a very effective conservative management for condylar process fractures in children.
