Conservative versus surgical treatment of condylar fractures: an integrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v9i12.11418

Keywords:

Mandibular injuries; Jaw; Oral and maxillofacial surgery; Internal fixation.

Abstract

Condylar fractures are the maxillofacial fractures with greater controversy in the literature regarding forms of treatment, since, in the procedure of choice, it involves issues related to age, location and type of fracture, degree of displacement of the fractured segment, presence of other associated facial fractures, absence of teeth, restoration of dental occlusion and the time elapsed from trauma, factors that direct the choice of the type of therapeutic approach (surgical or conservative, static or functional). This study aimed to carry out an integrative review of the current literature on the treatment of condylar fractures, highlighting its indications, limitations, advantages and disadvantages. The methodology used was an integrative literature review through bibliographic research, through a search for scientific articles in the electronic database PubMed and Medline, using the keywords mandibular condyle, mandibular fractures, mandibular injuries, indexed in the period from 2015 to 2020, which dealt with cross-sectional studies, clinical and randomized trials. After the eligibility criteria, 27 articles published in English were analyzed. Studies have shown which treatment conduct brings the most safety to the intervention, presenting high reliability, allowing for predictable and rapid scientific evidence, in addition to providing treatment with lower cost and length of stay.

Author Biography

Sérgio Bartolomeu de Farias Martorelli, Faculdade de Odontologia do Recife

Professor de cirurgia traumatologia buco-maxilo-facial na FOR - Faculdade de Odontologia do Recife.

References

Al-Moraissi, E. A., Louvrier, A., Colletti, G., Wolford, L. M., Biglioli, F., Ragaey, M., Meyer, C., & Ellis, E. (2018). Does the surgical approach for treating mandibular condylar fractures affect the rate of seventh cranial nerve injuries? A systematic review and meta-analysis based on a new classification for surgical approaches, Journal of Cranio-Maxillofacial Surgery, 46(3), 398-412.

Al-Moraissi, E. A., Ellis, E., & Neff, A. (2018). Does encountering the facial nerve during surgical management of mandibular condylar process fractures increase the risk of facial nerve weakness? A systematic review and meta-regression analysis. J Craniomaxillofacial Surg. 46(8), 1223-1231. doi: 10.1016/j.jcms.2018.04.015. PMID: 29929912.

Aslan, C., Hoşnuter, M., Baş, S., Tan, O., Işık, D., & Durgun, M. (2016) Retromandibular transparotid approach to mandibular subcondylar and high ramus fractures: two-point fixation. Ulus Travma Acil Cerrahi Derg. 22(1), 40-5. doi: 10.5505/tjtes.2015.21774.

Bae, S. S., & Aronovich, S. (2018). Trauma to the Pediatric Temporomandibular Joint. Oral Maxillofac Surg Clin North Am. 30(1), 47-60. doi: 10.1016/j.coms.2017.08.004. PMID: 29153237.

Chan, & Au-Yeung. (2017). A paediatric case of bilateral mandibular condyle fracture presenting with bloody otorrhoea following trauma. BMJ Case Rep. bcr2016218995. doi: 10.1136/bcr-2016-218995. PMID: 28433980; PMCID: PMC5534912.

Closs Ono, M. C., de Morais, A. D., Freitas, R. D. S., & de Oliveira E Cruz, G. A. (2018). Surgical Treatment for Extracapsular Condylar Fractures of the Mandible. J Craniofac Surg. 29(5):1312-1315. doi: 10.1097/SCS.0000000000004344.

Dalla Torre, D., Burtscher, D., Widmann, G., Pichler, A., Rasse, M., & Puelacher, W. (2015). Surgical treatment of mandibular condyle fractures using the retromandibular anterior transparotid approach and a triangular-positioned double miniplate osteosynthesis technique: A clinical and radiological evaluation of 124 fractures. J Craniomaxillofac Surg. 43(6):944-9. doi: 10.1016/j.jcms.2015.04.019.

Farber, S. J., Nguyen, D. C., Harvey, A. A., & Kamlesh, B. (2016). Patel, An Alternative Method of Intermaxillary Fixation for Simple Pediatric Mandible Fractures, Journal of Oral and Maxillofacial Surgery, 74(3), 582.e1-582.e8,

Han, X., Shao, X., Lin, X., Gui, W., Zhang, M., & Liang, L. (2020). Open Surgery Versus Closed Treatment of Unilateral Mandibular Condyle Fractures. J Craniofac Surg. 31(2), 484-487. doi: 10.1097/SCS.0000000000006080.

Jie, Li., Hongbin, Y., & Lin, H. (2019). Open versus closed treatment for unilateral mandibular extra-capsular condylar fractures: A meta-analysis, Journal of Cranio-Maxillofacial Surgery, 47(7), 1110-1119.

Kommers, S. C., Boffano, P., & Forouzanfar, T. (2015). Consensus or controversy? The classification and treatment decision-making by 491 maxillofacial surgeons from around the world in three cases of a unilateral mandibular condyle fracture. J Craniomaxillofac Surg. 43(10), 1952-1960. doi:10.1016/j.jcms.2015.08.031.

Kuang Shi-Jun, M. D., He Yi-Qing, M. D., Zheng, You-Hua, M. D., & Zhang, Zhi-Guang. (2019). Open reduction and internal fixation of mandibular condylar fractures: A national inpatient sample analysis, 2005–2014MS Medicine Zigong. 98: p e16814, doi: 10.1097/MD.0000000000016814.

Marwan, H., & Sawatari, Y. (2019). What Is the Most Stable Fixation Technique for Mandibular Condyle Fracture? J Oral Maxillofac Surg. 77(12), 2522.e1-2522.e12. doi:10.1016/j.joms.2019.07.012.

Merlet, F.-L., Grimaud, F., Pace, R., Mercier, J. M., Poisson, M., Pare, A., & Corre, P. (2018). Outcomes of functional treatment versus open reduction and internal fixation of condylar mandibular fracture with articular impact: A retrospective study of 83 adults, Journal of Stomatology, Oral and Maxillofacial Surgery, 119(1), 8-15.

Monteiro, J. L. G. C., de Arruda, J. A. A., de Melo, A. R. S., Barbosa, R. J. V., Carneiro, S. C de A. S., & Vasconcelos, B. C do E. (2019). Updated Review of Traumatic Dislocation of the Mandibular Condyle Into the Middle Cranial Fossa. Journal of oral and maxillofacial surgery, 77, 132.e1-132.e16.

Niezen, E. T., Bos, R. R. M., Van Minnen, B., Eckelt, U., Tavassol, F., & Dijkstra, P. U. (2018). Fractures of the mandibular condyle: A comparison of patients, fractures and treatment characteristics between Groningen (The Netherlands) and Dresden (Germany). J Craniomaxillofac Surg. 46(10):1719-1725. doi:10.1016/j.jcms.2018.07.010.

Nogami, S., Yamauchi, K., Yamashita, T., Kataoka, Y., Hirayama, B., Tanaka, K., & Takahashi, T. (2015) Elderly patients with maxillofacial trauma: study of mandibular condyle fractures. Dent Traumatol.31(1):73-6. doi: 10.1111/edt.12129. PMID: 25233910.

Ortiz-Gutiérrez, A. L., Beltrán-Salinas, B., & Cienfuegos, R. (2019). Mandibular condyle fractures: A diagnosis with controversial treatment. Cir. 87(5):587-594. 10.24875/CIRU.18000507.

Parihar, V. S., Bandyopadhyay, T. K., & Chattopadhyay, P. K (2019). Retromandibular transparotid approach compared with transmasseteric anterior parotid approach for the management of fractures of the mandibular condylar process: a prospective randomised study. Br J Oral Maxillofac Surg. 57(9):880-885. doi: 10.1016/j.bjoms.2019.07.010

Powers, D. B. (2016) Classification of Mandibular Condylar Fractures. Atlas Oral Maxillofac Surg Clin North Am. 25(1):1-10. doi: 10.1016/j.cxom.2016.11.001.

Rozeboom, A., Dubois, L., Bos, R., Spijker, R., & de Lange, J. (2017). Open treatment of unilateral mandibular condyle fractures in adults: a systematic review. Int J Oral Maxillofac Surg. 46(10):1257-1266. doi:10.1016/j.ijom.2017.06.018.

Santos, M. S dos., Gonçalves, K. K N., Silva, C. C. G., Diniz, D. A., & Vasconcelos, B. C do E. (2019) Surgical management of gunshot injury to the temporomandibular joint. Journal of craniofacial surgery, 30, 1-2257-2260. 10.1097/scs.0000000000005989.

Shiju, M., Rastogi, S., Gupta, P., Kukreja, S., Thomas, R., Bhugra, A. K., Parvatha Reddy, M., & Choudhury, R. (2015). Fractures of the mandibular condyle--Open versus closed--A treatment dilemma. J Craniomaxillofac Surg. 43(4), 448-51. doi: 10.1016/j.jcms.2015.01.012.

Vajgel, A., Santos, T.de S., Camargo, I. B., de Oliveira, D. M., Laureano Filho, J. R., Vasconcellos, R. J., Lima, S. M Jr., Pereira Filho, V. A., Mueller, A. A., & Juergens, P. (2015). Treatment of condylar fractures with an intraoral approach using an angulated screwdriver: results of a multicentre study. J Craniomaxillofac Surg. 43(1):34-42. doi: 10.1016/j.jcms.2014.10.006.

Vernhet, E., De Boutray, M., Hoarau, R., Jammet, P., Galmiche, S., & Breton, I. (2019). Exclusive Functional Treatment for Mandibular Condylar Fractures. J Oral Maxillofac Surg. 77(12): 2523.e1-2523.e8. doi: 10.1016/j.joms.2019.06.188.

Vincent, A. G., Ducic, Y., & Kellman, R. (2019) Fractures of the Mandibular Condyle. Facial Plast Surg. Dec; 35(6):623-626. doi: 10.1055/s-0039-1700888.

Weiss, J. P, & Sawhney, R. (2016). Update on mandibular condylar fracture management. Cur Opin Otolaryngol Head Neck Surge. 24(4):273-278. 10.1097/MOO. 0000000000000272.

Published

28/12/2020

How to Cite

BARBOSA, M. R.; MARTORELLI, S. B. de F. .; MENEZES, M. R. A. .; SILVA, C. C. G. .; CUNHA, J. da S. .; DINIZ, D. A. .; SOUZA JÚNIOR, F. A. de . .; CAHÚ, A. K. M. .; NASCIMENTO, V. H. S. do .; MENDONÇA, T. L. R. . Conservative versus surgical treatment of condylar fractures: an integrative review. Research, Society and Development, [S. l.], v. 9, n. 12, p. e45191211418, 2020. DOI: 10.33448/rsd-v9i12.11418. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/11418. Acesso em: 28 dec. 2024.

Issue

Section

Health Sciences