Open versus closed reduction of mandibular condyle fractures : A systematic review of comparative studies

  • Kim, Jong-Sik (Department of Oral and Maxillofacial Surgery, Kangdong Sacred Heart Hospital, Hallym University) ;
  • Seo, Hyun-Soo (Department of Oral and Maxillofacial Surgery, Kangdong Sacred Heart Hospital, Hallym University) ;
  • Kim, Ki-Young (Department of Oral and Maxillofacial Surgery, Kangdong Sacred Heart Hospital, Hallym University) ;
  • Song, Yun-Jung (Department of Operative dentistry, Hallym University Dental Hosptal) ;
  • Kim, Seon-Ah (Department of Operative dentistry, Kangdong Sacred Heart Hospital, Hallym University) ;
  • Hong, Soon-Min (Department of Oral and Maxillofacial Surgery, Kangdong Sacred Heart Hospital, Hallym University) ;
  • Park, Jun-Woo (Department of Oral and Maxillofacial Surgery, Kangdong Sacred Heart Hospital, Hallym University)
  • Published : 2008.02.29

Abstract

Objective : The objective of this review was to provide reliable comparative results regarding the effectiveness of any interventions either open or closed that can be used in the management of fractured mandibular condyle Patients and Methods : Research of studies from MEDLINE and Cochrane since 1990 was done. Controlled vocabulary terms were used. MeSH Terms were "Mandibular condyle" AND "Fractures, bone". Only comparative study were considered in this review using the "limit" function. According to the criteria, two review authors independently assessed the abstracts of studies resulting from the searches. The studies were divided according to some criteria, and following were measured: Ramus height, condyle sagittal displacement, condyle Towns's image displacement, Maximum open length, Protrusion & Lateral excursion, TMJ pain, Malocclusion, and TMJ disorder. Results : Many studies were analyzed to review the post-operative result of the two methods of treatment. Ramus height decreased more in when treated by closed reduction as opposed to open reduction. Sagittal condyle displacement was shown to be greater in closed reduction. Condyle Town's image condyle displacement had greater values in closed reduction. Maximum open length showed lower values in closed reduction. In protrusive and lateral movement, closed reduction was less than ORIF. Closed reduction showed greater occurrence of malocclusion than ORIF. However, post-operative pain and discomfort was greater in ORIF. Conclusion : In almost all categories, ORIF showed better results than CRIF. However, the use of the open reduction method should be considered due to the potential surgical morbidity and increased hospitalization time and cost. To these days, Endoscopic surgical techniques for ORIF (EORIF) are now in their infancy with the specific aims of eliminating concern for damage to the facial nerve and of reducing or eliminating facial scars. Before performing any types of treatment, patients must be understood of both of the treatment methods, and the best treatment method should be taken on permission.

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