Restor Dent Endod.  2012 May;37(2):110-113.

Re-establishment of occlusion after unilateral condylar fracture

• Kim Y
• Park SH
• Roh BD

Abstract

Complications resulting from condylar fracture include occlusal disturbance due to loss of leverage from temporomandibular joint (TMJ). In general, closed reduction with active physical training has been performed, and under favorable circumstances, adaptation occurs in attempt to restore the articulation. The patient in this case report had unilateral condylar fracture accompanied with multiple teeth injuries, but he was left without any dental treatment for 1 mon which led to unrestorable occlusal collapse. Fortunately, delayed surgical repositioning of dislocated maxillary anterior teeth followed by consistent long-term physical training has been proved successful. Normal occlusion and satisfactory remodeling of condyle were obtained on 10 mon follow-up.

Keyword

Condylar fracture; Delayed reduction; Dental injury; Occlusion; Physical training

MeSH Terms

Follow-Up Studies
Humans
Temporomandibular Joint
Tooth
Tooth Injuries

Figure

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  Figure 1 Preoperative panoramic view. Diagnosed as mandibular fracture, bilateral parasymphysis and left condyle. Multiple teeth injury with dislocation is also noticeable on upper anterior area.

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  Figure 2 Panoramic view after open reduction of mandible, parasymphysis. Arch bar fixation was done without any dental treatments.

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  Figure 3 Initial photograph. Upper anterior teeth are dislocated, including severe intrusion on #12. Patient complained premature contact of dislocated anterior teeth, and no posterior teeth were in contact.

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  Figure 4 Cast analysis. (a) Initial occlusion; (b) Reduction of anterior contacts; (c) Dramatic changes showing complete seating on both sides.

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  Figure 5 Surgical repositioning under flap operation.

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  Figure 6 Occlusal view, before and after physical training (Black dots indicate CO stop). (a) 3 month; (b) 10 month after trauma. CO, centric occlusion.

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  Figure 7 Panoramic view on 10 month follow up. Left condyle reveals successful bone remodeling.

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  Figure 8 Clinical image on 10 month follow up.

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