• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권5호
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• pp.303-308
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• 2022

Objectives: Selection of treatment methods for mandibular condylar fractures remains controversial. In this study, we investigated treatment methods for condylar fractures to determine the indications for open or closed reduction. Patients and Methods: Patients >12 years of age treated for mandibular condylar fractures with a follow-up period of ≥3 months were included in this study. The medical records of enrolled patients were reviewed for sex, age, fracture site, treatment method (open or closed reconstruction), postoperative intermaxillary fixation period, operation time, and complications. Radiological analysis of fracture fragment displacement and changes in ramal height difference was performed using computed tomography and panoramic radiography. Results: A total of 198 patients was investigated, 48.0% (n=95) of whom underwent closed reduction and 52.0% (n=103) underwent open reduction. There was no significant correlation between reduction method and patient sex, age, or follow-up period. No statistically significant difference between the incidence of complications and treatment method was observed. None of the patients underwent open reduction of condylar head fracture. Binary logistic regression analysis showed that open reduction was significantly more frequent in patients with subcondylar fracture compared to in those with a fracture in the condylar head area. There was no statistically significant correlation between the groups and fracture fragment displacement. However, there was a significant difference between the treatment groups in amount of change in ramal height difference between the fractured and the non-fractured sides during treatment. Conclusion: No significant clinical differences were found between the open and closed reduction methods in patients with mandibular condylar fractures. According to fracture site, closed reduction was preferred for condyle head fractures. There was no significant relationship between fracture fragment displacement and treatment method.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권3호
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• pp.270-276
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• 2001

The treatment of mandibular subcondylar fractures is a matter of controversy. The majority of mandibular subcondylar fracture are treated by closed reduction, but the displaced or dislocated mandibular subcondylar fractures may be treated by open reduction. The characteristics of open reduction are the anatomical reduction, the functional restoration, the rapid function, the maintenance of vertical ramus dimension, the better appearance and the less resultant TMJ problem etc. When an open reduction is considered, the wire, miniplate, lag screw and Kirschner wire are available with internal fixation. Of these, Kirschner wire is a simple method relatively and correct positioning of the wire achieves rigid fixation. But many open reduction methods for mandibular subcondylar fractures require extraoral approach. The extraoral approach has some problems, the facial scar and the risk of facial nerve injury. On the other hand, the intraoral approach eliminates the potency of the facial scar and the facial nerve injury, but is difficult to access the operation site. Since the intraoral approach was first described by Silverman (1925), the intraoral approach to the mandibular condyle has been developed with modifications. The purpose of this article is to describe the intraoral technique with the Kirschner wire on mandibular subcondylar fractures. Conclusion : The intraoral reduction with Kirschner wire on mandubular subcondylar fractures avoids the facial scar and facial nerve injury and is simple method to the extraoral approach. And it has minimal morbidity and better esthetics.

• Imaging Science in Dentistry
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• 제33권2호
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• pp.85-90
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• 2003

Purpose : To investigate the differences between the position of the mandibular condyles in temporomandibular joints of patients presenting with normal occlusion and skeletal class III malocclusion. Materials and Methods: Forty-two subjects with normal occlusion and thirty-seven subjects exhibiting skeletal class III malocclusion prior to orthodontic treatment were included in the study. Transcranial radiographs of each subject were taken at centric occlusion and 1 inch mouth opening. The positional relationship between the mandibular condyles with articular fossae and articular eminences at two positional states were evaluated and analyzed statistically. Results: The mandibular condyles of the skeletal class III malocclusion group were found to be located more anteriorly from the center of the articular fossae compared to the normal occlusion group in centric occlusion. The mandibular condyles of the skeletal Class III malocclusion group were located more superiorly from the middle of articular height than those of the normal occlusion group in centric occlusion. However, these differences were not statistically significant. At 1 inch mouth opening, the mandibular condyles of the skeletal class III malocclusion group were placed more posteriorly from the articular eminences than those of the normal occlusion group. The mean angle of the articular eminence posterior slope were 56.51 ° ± 6.29° in the normal occlusion group and 60.37° ± 6.26° in the skeletal Class III malocclusion group. Conclusions: The mandibular condyles of the skeletal Class III malocclusion group were placed more anteriorly at centric occlusion and more posteriorly at 1 inch mouth opening when compared with those of the normal occlusion group.

• 대한치과의사협회지
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• 제58권6호
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• pp.364-376
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• 2020

Internal derangement of the temporomandibular joint (TMJ) is condition in which articular disc has become displaced from its normal functional relationship with the mandibular condyle and the articular portion of the temporal bone. Common types of internal derangement include disc displacement with reduction (with or without intermittent locking), and disc displacement without reduction (with or without limited opening) classified according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Treatment varies depending on diagnosis. Therefore, differential diagnosis should be made for appropriate treatment.

• 대한치과의사협회지
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• 제24권5호통권204호
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• pp.439-447
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• 1986

The occurrence of osteochondroma, osteoma in mandibular condlye is rare. Sign and symptoms of enlargement of condyle are open bite, cross bite, myofascial symptoms, facial asymmetry. They are treated via condylectomy, subcondylar ostetomy, etc. We treated osteochondroma with condylectomy, osteoma with condylectomy & arthroplasty with titanium mesh & resin ball. Followings are the results 1. Condylectomy of osteochondroma resulted in good function & esthetics except slight deviation of mandible to the operation side during mouth opening. 2. Condylectomy & arthroplasty with titanium mesh & resin ball resulted in good function & esthetics & no deviation of mandible.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권5호
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• pp.356-360
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• 2017

The tympanic plate is a small part of the temporal bone that separates the mandibular condyle from the external auditory canal. Fracture of this small plate is rare and usually associated with other bony fractures, mainly temporal and mandibular bone. There is a limited amount of literature on this subject, which increases the chance of cases being overlooked by physicians and radiologists. This is further supported by purely isolated cases of tympanic plate fracture without evidence of other bony fractures. Cone-beam computed tomography is an investigative three-dimensional imaging modality that can be used to detect fine structures and fractures in maxillofacial trauma. This article presents four cases of isolated tympanic plate fracture diagnosed by cone-beam computed tomography with no evidence of fracture involving other bones and review of the literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권3호
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• pp.204-210
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• 2007

This study was intended to compare the cranial base morphology between the mandibular prognathism and maxillary retrognathism in skeletal class III patients. The subject of the present study was composed of 88 patients divided into two groups; Group 1 (Skeletal Class III with mandibular prognathism. SNA within normal range, SNB over normal range, n=54) and Group 2(Skeletal Class III with maxillary retrognathism. SNA below normal range, SNB within normal range, n=34). Lateral cephalogram were taken immediate before surgery and 18 landmarks were used to analyze the characteristics of cranial base and maxillomandibular skeleton. The result revealed that cranial base angle is significantly smaller in Group 1 than Group 2, which implies the influence of the cranial base angulation on the mandibular position. However the posterior cranial base length did not influence the mandibular horizontal position and anterior cranial base length did not influence the maxillary horizontal position. As the anterior cranial base length was closely related with ramal height, it is recommendable to investigate the regulatory mechanism of chondrogenesis of cranial base and condyle cartilage in the future research.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권1호
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• pp.35-42
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• 2003

Purpose: This study was aimed to investigate the relationship between the mandibular asymmetry and the internal derangement of temporomandibular joint. Materials and methods: One hundred and sixty eight patients had been assessed through clinical examinations, panoramic radiographs and magnetic resonance imagings (MRIs), were selected. The samples were classified into three subgroups according to the severity of the mandibular asymmetries in the panoramic radiographs and the status of TMJ discs on the MRI were compared among each groups. Results: In an apparent asymmetry group, there was a significant difference in the number of temporomandibular disk displacement without reduction between the long and short side (66.7%, 18/27 joints on the short side) when the ratio of condylar process and coronoid process was used (p<0.05), but there was no statistically significant difference when the ratio of condyle and ramus was used. Conclusion: The probability of the disc displacement without reduction was higher at the side with relatively shorter condylar process on the panoramic radiograph, and also it might be more effective to use ratio of condylar process and coronoid process in the assessment of mandibular asymmetry. Therefore, a careful assessment on the temporomandibular disorders is necessary to diagnose and establish the treatment plans for the patients with a mandibular asymmetry and the panoramic radiograph can be used effectively on that way.

• 대한치과교정학회지
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• 제19권1호
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• pp.153-167
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• 1989

This study was undertaken to analyze the growth of mandible in surgically repaired unilateral cleft lip and palate. The subjects consisted of 63 unilateral cleft lip and palate individuals, 60 class III malocclusions and 60 normal occlusions ranging from 6 to 15 years old. Each group was divided into two age groups. (6-10 Y and 11-15 Y) The results obtained from UCLP compared with other groups were as follows: 1. The anteroposterior position of the chin was similar to that of the normal occlusions. 2. The shape of the mandible was similar to that of the class III malocclusions. 3. In mandibular size, ramus height was the smallest among three groups, but body length and overall mandibular length were similar to those of the normal occlusions. 4. The lower border of the mandible was the steepest among three groups and strong vertical or clockwise growth tendency was indicated. 5. The position of condyle in relation to the cranial base showed little difference in three groups. 6. In older age group , vertical growth tendency of the mandible decreased more or less.

• 대한치과교정학회지
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• 제16권1호
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• pp.119-131
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• 1986

The purpose of the study is to note the effects of the resection of the lateral pterygoid muscle on the mandibular growth in the growing rats. Twenty four female Wistar rats were used in the experiment. They were divided into three groups: group 1 ; bilateral sham operation group 2 ; bilateral resenction of the lateral pterygoid muscle group 3 ; unilateral resection of the lateral pterygoid muscle (The right lateral pterygoid muscle was resected and the left one was sham-operated.) Groups 1&2 were sacrificed eight weeks lateral and group 3, four weeks later. All specimens were measured with calipers, and stained with hematoxylin and eosin. Groups 1 & 2 were compared with each other. In group 3, the right side was compared with the left. The results were as follows: 1. In the growing rats, the resection of the lateral pterygoid muscle was followed by a decrease of the mandibular growth. After eight weeks, the condyle-mental foramen distance, the angular process-mental foramen distance, the size of the condylar head, the supradentale-first molar distance, and the diameter of the symphysis were significantly smaller than the control. 2. Resection of the lateral pterygoid muscle resulted in decrease of the thickness of the cartilage layer and the prechondroblastic-chondroblastic layer after four weeks. 3. After eight weeks, group 1 and group 2 were not different significantly in the histologic sections. 4. The condylar cartilage was stabilized eight weeks after the experiment.