Outcome of TMJ Intracapsular Condylar Fractures in Children

Purpose: The aim of the study was to investigate the outcome of non-surgically treated children after intracapsular condylar fractures. Material: The study group consisted of 55 children with a history of TMJ intracapsular condylar fractures experienced at a young age (mean 6.5 years, range 1-12). For the orthodontic examination the control data was comprised of a random Israeli population (Ben-Bassat et al., 1997) while for the functional examination, data from the literature was used for comparison. Methods: Retrospective study, including clinical intra and extra-oral examinations, study models and facial photographs. Results: Thirty six youngsters (64%) responded to a follow-up exam 5-116 months (mean 48 months) after trauma. Four different patients were excluded from each evaluation for technical reasons. All patients were treated with physiotherapy only. Out of the 32 (mean age 10 years, range 3-21), 20 suffered unilateral and 12 bilateral condylar fractures. At the time of injury, six children were edentulous, the rest exhibited normal occlusion except for 4 with transient open-bite. At the follow-up examination no significant differences were found between the trauma and control groups in the prevalence of cross-bites and class II subdivision. The only significant finding was a mean lower midline deviation of 1.5mm (range 1-3 mm) that was found in 47% of the injured group. The mean mouth opening was 37mm, and lateral excursion 8.5mm. Two patients had asymmetrical mouth opening and three had skeletal asymmetry at rest. Conclusion: Patients after TMJ intracapsular condylar fracture do not present with more asymmetric features of malocclusion or malfunction compared to a random population, except for a lower midline deviation.