Efficacy Assessment of Functional Treatment of Mandibular Condyles Fractures, A long-term Follow-up Study

Fractures of the mandibular condyles are frequent in facial traumas and their treatment represents a highly controversial issue in maxillofacial traumatology, functional and surgical treatments being the two principal management modalities for such fractures. The aim of this study is to evaluate the results of functional treatment of mandibular condylar fractures in patients which received this type of treatment. Eighty-six patients between 6 and 66 years old who were previously treated fuctionally for a fracture of the mandible condyle were recalled for follow up examination with a mean postoperative observation time of 10.4 years. Mandibular function was assessed using the mandibular function impairment questionnaire and patient's complaints were assessed during physical examination. The results showed a significant increase of dysfunction index values with increasing age at the time of trauma. Radiologic abnormalities such as reduced ramus height, deviation of the mandibular midline, and irregular shape of the condyle were observed and seen frequently, but they were not correlated with the severity of dysfunction. Predictors of mandibular function impairment after closed treatment of fractures of the mandibular condyle were: great deviation, reduced mouth opening, women gender, and increased age. The results of this study support the opinion that functional treatment is sufficient in pediatric patients, whereas in older age groups the results of conservative treatment are less sufficient