2019 Journal of oral and maxillofa…

Temporomandibular Dysfunction After Surgery of Mandibular Fractures Not Involving the Mandibular Condyle: A Prospective Follow-Up Study.

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Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons Vol. 77 (8) : 1657-1662 • Aug 2019

PURPOSE: Facial trauma can lead to temporomandibular dysfunction (TMD). The aim of this study was to clarify the occurrence and characteristics of TMD in patients surgically treated for mandibular fractures not involving the mandibular condyle. MATERIALS AND METHODS: This prospective single-center follow-up study was composed of patients who underwent surgery for non-condylar mandibular fracture. Patients were evaluated at presentation and 6 months after surgery to assess the function of the masticatory system using the Helkimo index. Specifically, this index incorporates 2 complementary subindices: the subjective symptomatic (anamnestic) index (A(i)) and the objective clinical dysfunction index (D(i)). The A(i) score was recorded at presentation and 6-month follow-up. The D(i) score was recorded at 6-month follow-up. RESULTS: Thirty-one patients completed the study. All patients were men (mean age, 26.2 yr; range, 18 to 47 yr). Four (12.9%) developed severe symptoms of dysfunction during the study period according to the A(i). Clinical findings (D(i)) were observed in 25 patients (80.6%), but these were not associated with symptoms of dysfunction. CONCLUSIONS: TMD is common 6 months after surgery in patients with non-condylar mandibular fractures. Patients with such fractures should be evaluated for dysfunction during follow-ups and referred for further treatment if necessary.

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