Discopexy and orthognathic surgery as part of rehabilitation of patients with bilateral fracture of the mandibular condyles

Abstract

A current relevant issue is how to treat intracapsular fractures of mandibular condyles. Despite a great number of publications on this topic, the professional community hasn’t come to a unanimous consensus on the treatment tactics of patients with such trauma.Thus, the purpose of this publication is to demonstrate a comprehensive approach to rehabilitating patients with traumatic deformation of mandibular condyles and malocclusion by introducing elements of orthognathic surgery and disc surgery into a standard protocol.
Materials and methods.
A 35-year-old patient came to the clinic with complaints about malocclusion, pain and limited mouth opening after an injury that she had suffered three months previously. After a examination a diagnosis was established of “Bilateral intracapsular splintered fracture of the articular heads, the right and left mandibular condyles with displacement of bony fragments and a fracture in the chin area of the mandible” (S02.60). The defects were eliminated with the use of bilateral sagittal osteotomy of the mandible, reconstruction of the articular heads and mandibular condyles with discopexy.
Results.
After 24 months the patient had stable occlusion, full-range mouth opening of 45 mm and no pain in the TMJ.
Conclusion.
The acquired treatment result demonstrates a significant role of articular disc repositioning and normalizing physiologic occlusion in reconstructive interventions in cases of fractures in the condylar area for prevention of ankylosis in the TMJ.