Changes in ramus height and mandibular movement and function were evaluated in patients with unilateral condylar process fractures who received conservative treatment.
Forty-five patients (27 men, 18 women) with a mean age of 36.3 years (range, 16-78 years) were studied. The changes in ramus height as compared with that at the time of injury were analyzed 3 months and 6 months after injury according to the level (Lindahl's classification) and type (MacLennan's classification) of fracture. Assessment of mandibular movement and function included maximum mouth opening, lateral mandibular movement, and deviation on mouth opening, evaluated at each state. The statistical analysis of the data was performed by one-way ANOVA and unpaired t-tests. Occlusion and TMJ disorders were also evaluated at each stage.
Shortening of ramus height was remarkable in the fractures of the neck and with displacement and dislocation as compared with other levels and types of fractures. Maximum mouth opening of more than 40 mm was obtained in all levels and types of fractures 3 and 6 months after injury. Lateral mandibular movement towards the non-fracture side was slightly restricted 3 months after injury, but recovered at 6 months. There were no significant differences according to level or type of fractures at this time. Deviation on mouth opening was associated with fractures of the neck and those with displacement and dislocation. All patients had good occlusion, and only a few had TMJ disorders.
Conservative treatment for unilateral condylar process fractures resulted in the shortening of ramus height, especially in fractures of the neck and those with displacement and dislocation. However, mandibular movement and function were satisfactory, without restriction of maximum mouth opening or lateral mandibular movement and only with deviation on mouth opening.
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