Open reduction and internal fixation of delayed intracapsular comminuted condylar fracture of mandible with preoperative computer-aided design
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Mandible (arthropod mouthpart)
Fracture reduction
Fossa
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Oral Diseases (2011) 17 , 499–507 Objective: Injection of complete Freund’s adjuvant (CFA) into the temporomandibular joint (TMJ) causes acute swelling around the joint and subsequent morphological alterations in the condyle. We aimed to evaluate changes in the three‐dimensional architecture of the condyle induced with CFA. Materials and methods: The CFA was injected into the unilateral TMJ of rats and morphological changes in the condyle were assessed repeatedly for 14 days by in vivo micro‐CT. Results: Osseous abnormalities of condyle were first observed at 3–5 days after CFA injection on the tomographic images, and the condylar deformation became more obvious thereafter. Among 12 condyles examined at 14 days postinjection, osteophytosis was observed in all of the specimens and bone erosion coexisted in five condyles. None of the saline‐treated condyles showed architectural changes. Significant changes were detected in the mesiolateral and rostrocaudal widths of the CFA‐treated condyles at 10–14 days postinjection (P < 0.01). The extent of both condylar bone formation and resorption was greater in the CFA‐injected TMJs than in saline‐injected TMJs (P < 0.05). Conclusion: These results indicate that CFA causes dynamic morphological changes in the condyle and that our experimental approach will provide new insights into the subacute inflammatory processes in the TMJ.
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Three-dimensional (3D) imaging allows assessment of changes in condylar volume and morphology. The association between the morphology of the condyle and post-treatment functional impairment is still unclear. To analyse the volume of both condyles after a unilateral condylar fracture and to evaluate the relationship between condylar volume and mandibular function. A pilot study was performed in which data from a recently published cross-sectional study were used. In a previously published cross-sectional study a cone beam computed tomography scan was acquired of patients with a unilateral condyle fracture. These scans were analysed, and the condylar volumes were measured and related to the outcomes of the Mandibular Functional Impairment Questionnaire and the Mixing Ability Test. Patients with larger condyles have a better recovery regarding function than patient with smaller condyles, independent of the received treatment. This study showed a significant positive correlation between masticatory function and the post-treatment volume of the fractured condyle. Men tended to have larger condyle volumes than women and seem to have a better outcome in function. A larger condyle volume was associated with an increase of the mouth opening. Given that the volume of the condyle is associated with the function of the temporomandibular joint, imaging may be helpful to stratify the pathophysiological adaptation mechanisms and to improve our ability to plan individualized treatment.
X-ray microtomography
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Objective To investigate the clinical efficacy of pedicle screw internal fixation systems on treatment of tile C pelvic fracture.Methods 16 patients with tile C pelvic fracture were treated with pedicle screw systems by reduction and fixation,all patients were reexamed with X-ray and followed up statedly.Results All 16 cases were followed up from 10 to 24 months with an average of 15 months.The reduction effects were excellent in 11 cases,good in 5 cases based on Tornetta and Matta standard,and the function evaluation were excellent in 12 cases,good in 3 cases,fair in 1 case based on Majeed score system,the fine rates were 100% and 93.75%,respectively.Conclusion The good fracture reduction and function recovery could be obtained with application of pedicle screw internal fixation systems in patients with tile C pelvic fracture.
Pelvic fracture
Fracture reduction
Good reduction
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Mandible fracture is a common injury in maxillofacial surgery. It causes not only maxillofacial dysfunction but also facial deformities. Malunited fractures of the mandible have been a vast challenge in clinical treatment due to the misalignment of the broken ends and the occurrence of occlusal disorders. This case report describes using virtual surgical planning and three-dimensional printing to treat a patient with malunited fracture of the mandible. Failing to perform mandibular surgery due to severe brain trauma after the car accident, the patient got malunited healing of mandible. The authors applied virtual surgical planning to perform preoperative analysis and surgical design on this patient, three-dimensional printing to fabricate occlusal plate, and models of the preoperative and postoperative mandible to guide the operation. Finally, the authors achieved the reduction and reconstruction of the mandible with satisfactory clinical results.
Mandible (arthropod mouthpart)
Surgical Planning
Fracture reduction
Facial trauma
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Most fractures of the mandible are contralateral owing to its unique shape and types of forces applied during fracture. Triple unilateral fracture of mandible is extremely uncommon and rarely reported in literature. Dentition free segment adds to the challenges of accurate reduction. This case report talks about a case of right parasymphysis, right angle and right subcondylar fracture of mandible in a 21 year old male and the methods employed for reduction. Non dentate segment is reduced first to maintain vertical ramus height followed by reduction of angle and parasymphysis. The difficulty inherent in treating these fractures can be alleviated with the use of proper sequencing and techniques of open reduction and internal fixation.
Mandible (arthropod mouthpart)
Fracture reduction
Mandibular angle
Permanent dentition
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The purpose of the present study is to determine whether or not functional loading is critical for the normal growth and maintenance of the mandibular condyle. The effect of altered condylar function on craniofacial morphology, a craniofacial adaptation, was also examined. Fifty -one rats, 5 weeks of age, were divided into 3 groups: a condylotomized group without reduction (unfixed), a condylotomized group where the condyle was repositioned, and a sham-operated control group. Six weeks after the unilateral surgery, the animals were sacrificed and the tissue was harvested.The present results support the contention that, within limits, functional loading on the condyles may create a condylar growth closer to normal than in a static condition, although craniofacial adaptation occurs when the condylar function is deformed. When the separated condyles were refixed, the condyles had functional loading when the mandibles moved. On the other hand, nonfixed isolated condyles may only show resorption. Functional loading, therefore, is suggested to be critical for mandibular condyle growth, and craniofacial adaptation is suggested to occur when condylar functions are abnormal.
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