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Full mouth rehabilitation on a bilateral condylar fractured patient using orthognathic surgery and dental implant

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BACKGROUND. Mandibular displacement is a common complication of condylar fracture. In the mandibular displacement due to condylar fracture, it is difficult to restore both esthetics and function without using orthognathic surgery. CASE DESCRIPTION. This clinical report described a full mouth rehabilitation in the patient with bilateral condylar fractures and displaced mandible using bilateral sagittal split ramus osteotomy (BSSRO) and simultaneous dental implant surgery. Mandibular position was determined by model surgery through the diagnostic wax up and restoration of fractured teeth. The precise amount of the mandibular shift can be obtained from the ideal intercuspation of remaining teeth. CLINICAL IMPLICATION. Mandibular displacement by both condylar fractures can be successfully treated by orthognathic surgery. Determination of occlusal plane and visualization from diagnostic wax up are mandatory for mandibular repositioning of model surgery. Stable occlusion and regular recall check up are needed for long-term outcome.

Abstract

BACKGROUND. Mandibular displacement is a common complication of condylar fracture. In the mandibular displacement due to condylar fracture, it is difficult to restore both esthetics and function without using orthognathic surgery. CASE DESCRIPTION. This clinical report described a full mouth rehabilitation in the patient with bilateral condylar fractures and displaced mandible using bilateral sagittal split ramus osteotomy (BSSRO) and simultaneous dental implant surgery. Mandibular position was determined by model surgery through the diagnostic wax up and restoration of fractured teeth. The precise amount of the mandibular shift can be obtained from the ideal intercuspation of remaining teeth. CLINICAL IMPLICATION. Mandibular displacement by both condylar fractures can be successfully treated by orthognathic surgery. Determination of occlusal plane and visualization from diagnostic wax up are mandatory for mandibular repositioning of model surgery. Stable occlusion and regular recall check up are needed for long-term outcome.

참고문헌 (7)

  1. Kazanjian VH, "The surgical treatment of facial injuries. 3rd ed" (1974), Williams & Wilkins
  2. Spitzer WJ, "Surgical management of mandibular malposition after malunited condylar fractures in adults", J Craniomaxillofac Surg, 25, pp.91~96 (1997)
  3. Hinds EC, "Late management of condylar fractures by means of subcondylar osteotomy: reports of cases", J Oral Surg, 24, pp.54~59 (1966)
  4. Harper R, "Treatment of malunited, unusually displaced bilateral condylar fractures: report of case", J Oral Surg, 36, pp.716~719 (1978)
  5. Rubens BC, "Management of malunited mandibular condylar fractures", Int J Oral Maxillofac Surg, 19, pp.22~25 (1990)
  6. Tu¨rp JC, "Computerized axiographic evaluation of condylar movements in cases with fractures of the condylar process: a follow up over 19 years", J Craniomaxillofac Surg, 24, pp.46~52 (1996)
  7. Becking AG, "Management of posttraumatic malocclusion caused by condylar process fractures", J Oral Maxillofac Surg, 56, pp.1370~1374 (1998)

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