Citation Information :
Gopalakrishnan K, John RR, Chandrasekaran B. Assessment of Condylar Position in Treated Unilateral Unfavorable Mandibular Angle Fracture After 1-year Follow-up: A Prospective Study. World J Dent 2023; 14 (6):503-509.
Aim: To assess the function and three-dimensional position of the condyle in unilateral horizontally unfavorable mandibular angle fracture preoperatively and 1-year postoperatively using the Helkimo clinical dysfunction index and computed tomography (CT), respectively.
Materials and methods: A total of 10 patients with unilateral horizontal unfavorable angle fractures were subjected to clinical and radiographic assessment before and 1-year after surgical management. The position of the condyle was evaluated through CT and compared between the following groups—group I, preoperative fractured vs nonfractured side; group II, postoperative fractured vs nonfractured side; group III, preoperative vs postoperative fractured side. Statistical analysis was done with the Chi-square and paired student t-test.
Results: Clinical evaluation showed severe dysfunction in 80% of patients preoperatively and showed no dysfunction in 80% of patients postoperatively (p = 0.001). CT evaluation in groups I and III showed changes in superior joint space (S1) and condylar angulation (CA) which was statistically significant (p < 0.05).
Conclusion: This study has given insight into the potential long-term changes in the position and function of the condyle in unilateral unfavorable angle fractures. Though CT evaluation showed changes, its implications in terms of clinical symptoms were minimal.
Clinical significance: From this study, it is understood that angle fracture influences condylar position in the sagittal and axial plane. Operating surgeons should remember that in a continuous bone-like mandible, a fracture of one part can impact the other. Therefore, appropriate fixation of angle fracture following protocols is paramount to avoid long-term Tempero Mandibular Joint (TMJ) dysfunction.
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