J Adv Prosthodont.  2011 Mar;3(1):51-55. 10.4047/jap.2011.3.1.51.

Full mouth rehabilitation on a bilateral condylar fractured patient using orthognathic surgery and dental implant

• Park JY
• Ahn KM
• Lee JH
• Cha HS

• KMID: 1975116
• DOI: http://doi.org/10.4047/jap.2011.3.1.51

Abstract

BACKGROUND
Mandibular displacement is a common complication of condylar fracture. In the mandibular displacement due to condylar fracture, it is difficult to restore both esthetics and function without using orthognathic surgery. CASE DESCRIPTION: This clinical report described a full mouth rehabilitation in the patient with bilateral condylar fractures and displaced mandible using bilateral sagittal split ramus osteotomy (BSSRO) and simultaneous dental implant surgery. Mandibular position was determined by model surgery through the diagnostic wax up and restoration of fractured teeth. The precise amount of the mandibular shift can be obtained from the ideal intercuspation of remaining teeth. CLINICAL IMPLICATION: Mandibular displacement by both condylar fractures can be successfully treated by orthognathic surgery. Determination of occlusal plane and visualization from diagnostic wax up are mandatory for mandibular repositioning of model surgery. Stable occlusion and regular recall check up are needed for long-term outcome.

Keyword

Condylar fracture; Orthognathic surgery; Dental Implant; Full mouth rehabilitation

MeSH Terms

Dental Implants
Dental Occlusion
Displacement (Psychology)
Esthetics
Humans
Mandible
Mouth
Mouth Rehabilitation
Orthognathic Surgery
Osteotomy, Sagittal Split Ramus
Tooth
Dental Implants

Figure

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  Fig. 1 Initial facial photos and radiograph. A: Lateral facial profile, B: Frontal facial profile, C: Panoramic radiograph, D: Intraoral frontal view.

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  Fig. 2 Facebow transfer A and diagnostic model mounted on a semi-adjustable articulator B.

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  Fig. 3 Diagnostic wax up and model surgery. A: Occlusal view of Maxilla, B: Occlusal view of Mandible, C: Initial status of mounted model, D: Remounting of lower cast to simulate BSSRO.

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  Fig. 4 Initial overbite and overjet relationship with try in of final metal-ceramic crown.

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  Fig. 5 Panoramic radiograph after implant and BSSRO surgery.

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  Fig. 6 A: Panoramic radiograph after one year later from delivery of prosthesis, B: Frontal view of definitive fixed prosthesis at one year recall check up.

Reference

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