Adaptations of the masticatory system after bilateral fractures of the mandibular condylar process

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
R M TalwarG S Throckmorton

Abstract

The objective of this investigation was to evaluate the adaptations that occur in the masticatory system after treatment of bilateral fractures of the mandibular condylar process. Twenty-two patients (15 men and seven women) with bilateral condylar process fractures treated by open reduction and rigid internal fixation (n = 6), closed therapy (n = 14), or a combination of these techniques (n = 2) were compared with 22 sex- and age-matched controls. Measures of mandibular range of motion, bite force, muscle activity, estimated joint forces, and skeletal morphology were determined at 6 weeks, 6 months, and 1, 2, and 3 years after treatment in all subjects. Various statistical tests were used for comparing differences between patients and controls. There was no significant difference in the patients' morphologic measures for the open and closed reduction procedures; therefore, all of these patients were tested as a single group. After treatment, patients had significantly increased mandibular plane and gonial angles and decreased facial axis angles. They also showed a significant reduction in posterior facial height and moment arm length for the masseter and pterygoid muscles. Anterior and posterior temporalis muscle direction als...Continue Reading

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