Sequelae in Mandibular Condyle Fractures Through Conservative and Surgical Submandibular Approach
DOI:
https://doi.org/10.56818/odontologia.v1i1.6Keywords:
Sequels, closed treatment, open treatment, submandibular approach, mandibular condyle, pain, maloclussionAbstract
Introduction: The objective of the study was to compare the frequency and type of sequels in patients with mandibular condyle fracture, treated closed reduction versus open reduction using the submandibular approach, at the Accident Hospital “Ceibal” of the Guatemalan Institute of Social Security.
Method: Forty-seven patients were included, treated between January 2016 and December 2019, 22 (46.81%) were treated closed reduction and 25 (53.19%) were treated open reduction with a submandibular approach, the level of pain, level of paresthesia, malocclusion and presence of facial paralysis, in a follow-up at 21 and 60 days after treatment, with a confidence interval of 95% (p < 0.05)
Results: 66.7% of the patients evaluated who received closed reduction presented sequels in both reevaluations, while, for open reduction, 76.9% presented sequels in both reevaluations; however, surgical treatment shows the highest percentage without sequels in both reevaluations (66.7%) compared to closed treatment (50%), demonstrating statistical differences between both types of treatment. The level of pain in the closed treatment showed a p = 0.02, for which there are statistically significant differences.
Conclusions: Surgical treatment presents more sequels in the first reevaluation, but in the second reevaluation, closed treatment presents more sequels. Surgical treatment, by open reduction and internal fixation, stabilizes in better way the fragments and helps reduce post-treatment sequels.
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Pereira. M. D., Marques, A., Ishizuka, M., Keira, S.M., Brenda, E. y Wolosker, A. B. (1995). Surgical treatment of the fractured and dislocated condylar process of the mandible. Journal of cranio maxillo-facial surgery. 23(6), 369-376. https://doi.org/10.1016/s1010-5182(05)80132-5 DOI: https://doi.org/10.1016/S1010-5182(05)80132-5
Spinzia, A., Patrone, R., Belli, E., Dell'Aversana, G., Ungari, C., Filiaci, F., Agrillo, A., De Rui, G., Meloni, S. M., Liberatore, G. y Piombino, P. (2014). Open reduction and internal fixation of extracapsular mandibular condyle fractures: a long-term clinical and radiological follow-up of 25 patients. BMC Surgery. 14(68), 1-10. https://doi.org/10.1186/1471-2482-14-68 DOI: https://doi.org/10.1186/1471-2482-14-68
Instituto Guatemalteco de Seguridad Social (IGSS) Subgerencia de Prestaciones en Salud. (2013). Manejo de las fracturas maxilofaciales. Instituto Guatemalteco de Seguridad Social. 2013. 50, 102
Landes, C. A., Day, K., Lipphardt, R. y Sader, R. (2008) Closed versus open operative treatment of nondisplaced diacapitular (Class VI) Fractures. Journal of Oral Maxillofacial Surgery. 66(8), 1586-1594. https://doi.org/10.1016/j.joms.2007.06.668 DOI: https://doi.org/10.1016/j.joms.2007.06.668
Hayward, J. y Scott, R. (1993). Fractures of the Mandibular Condyle. Journal of Oral and Maxillofacial Surgery. 51(1), 57-61. https://doi.org/10.1016/s0278-2391(10)80391-x DOI: https://doi.org/10.1016/S0278-2391(10)80391-X
Zide, M. F. y Kent, J. N. (1983). Indications for Open Reduction of Mandibular Condyle fractures. Journal of Oral and Maxillofacial Surgery. 41(2), 89-98. https://doi.org/10.1016/0278-2391(83)90214-8 DOI: https://doi.org/10.1016/0278-2391(83)90214-8
Kent, J. (1989). Open Reduction of Mandibular Condyle Fractures. AAOMS. 7-8 https://doi.org/10.1016/0278-2391(89)90458-8 DOI: https://doi.org/10.1016/0278-2391(89)90458-8
Walker, R. (1989). Closed Reduction of Mandibular Condyle Fractures. AAOMS. 9 https://doi.org/10.1016/0278-2391(89)90459-X DOI: https://doi.org/10.1016/0278-2391(89)90459-X
Patel, P. A., Mahajan, A., Shah, N., Shah, R., Kumar, A. y Kumar, P. (2020). Retrospective analysis on the outcome of open and closed reduction of mandibular condylar fractures at tertiary center of Gujarat. Journal of Oral Biology and Craniofacial Research 10(3), 294-298. https://doi.org/10.1016/j.jobcr.2020.05.006 DOI: https://doi.org/10.1016/j.jobcr.2020.05.006
Rodríguez, J., Jubilla, M., Gutierrez, R., Zubillaga, I., Sanchez, G. y Montalvo, J (2011). Abordaje transparotídeo para la reducción abierta de las fracturas subcondíleas. Técnica quirúrgica y análisis de sus complicaciones. Revista Española de Cirugía Oral y Máxilofacial 33(1), 9-14. https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-05582011000100002 https://doi.org/10.1016/S1130-0558(11)70002-8 https://doi.org/10.4321/S1130-05582011000100002 DOI: https://doi.org/10.1016/S1130-0558(11)70002-8
Danda, A., Muthusekhar, M., Narayanan, V., Baig, M. y Siddareddi, A. (2010). Open Versus Closed Treatment of Unilateral Subcondylar and Condylar Neck Fractures: A Prospective, Randomized Clinical Study. Journal of Oral Maxillofacial Surgery. 68(6), 1238- 1241. https://doi.org/10.1016/j.joms.2009.09.042 DOI: https://doi.org/10.1016/j.joms.2009.09.042
Romero, P. (2013) Estudio descriptivo de las secuelas post tratamiento quirúrgico de pacientes tratados por fracturas maxilofaciales en el servicio de Cirugía Maxilofacial Del Hospital San José. Universidad de Chile. 1-77. https://repositorio.uchile.cl/bitstream/handle/2250/117263/Estudio-descriptivo-de-las-secuelas-post-tratamiento-quirúrgico-de-pacientes-tratados-por-fracturas-maxilofaciales.pdf?sequence=5&isAllowed=y
Merlet, F., Grimaud, F., Pace, R., Mercier, J., Poisson, M., Pare, A. y 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. https://doi.org/10.1016/j.jormas.2017.10.007 DOI: https://doi.org/10.1016/j.jormas.2017.10.007
Haug, R. H. y Assael, L. A. (2001). Outcomes of Open Versus Closed Treatment of Mandibular Subcondylar Fractures. Estados Journal of Oral and Maxillofacial Surgery. 59(4), 370-375. https://doi.org/10.1053/joms.2001.21868 DOI: https://doi.org/10.1053/joms.2001.21868
Kotrashetti, S., Ligaraj, J. y Khurana, V. (2013) A comparative study of closed versus open reduction and internal (using reromandibular approach) in the management of subcondylar fracture. Oral Surgery Oral Medicine Oral Pathology Oral Radiology. 115(4), E7-E11. http://dx.doi.org/10.1016/j.oooo.2011.10.027 DOI: https://doi.org/10.1016/j.oooo.2011.10.027
Liu, Y., Bai, N., Song, G., Zhang, X., Hu, J., Zhu, S. y Luo, E. (2013). Open versus closed treatment of unilateral moderately displaced mandibular condylar fractures: a meta-analysis of randomized controlled trials. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology. 116(2), 169-173. https://dx.doi.org/10.1016/j.oooo.2013.02.023 DOI: https://doi.org/10.1016/j.oooo.2013.02.023
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