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rev port estomatol med dent cir maxilofac . 2018;59(1):44-48 47

The treatment option for condylar fractures should
Discussion
allow the least morbidity with stable and predictable func-
The treatment options for MC fractures are quite controver- tional and esthetic outcomes. The clinical evaluation of
sial in the literature. It is believed that the particularities and mandibular movements and type of displacement are the
functional and aesthetic characteristics of each case should most important parameters for this decision. During initial
be evaluated before the treatment is selected. The procedures planning for conservative treatment, if the occlusion be-
used during the closed treatment of condylar fractures are tween the arches is not ideal, the most indicated treatment
not adequately described in the literature. There is no con- would be an open reduction with internal fixation. In the
sensus when it comes to indications, treatment protocols, present case report, despite the displacement observed in
6
and lengths of treatment. Conservative treatment is profita- image exams, this displacement occurred in a medial direc-
ble and scientifically grounded. It may be performed using tion, and the clinical signs of the patient did not allow a
intermaxillary fixation modalities (arch bars, interdental wi- surgical management.
rings or orthodontic appliance). 7
Several studies have grouped precise clinical indications
for the surgical management of MC fractures. An author re- Conclusion
ported two clinical indications for open treatment, namely
condylar displacement laterally or superiorly to the zygomat- Based on the present case report, it can be concluded that
ic arch and condylar intrusion into the cranial fossa. 8,13 non-surgical treatment may be adequate even in cases of se-
The authors of a study compared the mandibular and fa- vere bone displacement of MC fractures, especially if the
cial symmetry of 146 patients with condylar fractures after mandibular function is preserved.
undergoing conservative treatment with reduction and surgi-
cal fixation of the fracture. They concluded that patients trea-
ted with the conservative approach developed asymmetries Ethical disclosures
characterized by a reduction in posterior facial height on the
affected side, which may result from an attempt to reestablish Protection of human and animal subjects. The authors de-
the new position of the temporomandibular joint. However, clare that no experiments were performed on humans or an-
some patients did not notice this asymmetry. 9 imals for this study.
In another study with 20 patients with subcondylar frac- Confidentiality of data. The authors declare that no patient
tures, 10 were submitted to conservative treatment and 10 to data appear in this article.
the surgical approach. After a six-month follow-up, the au-
thors did not observe statistically significant differences be- Right to privacy and informed consent. The authors declare
tween groups regarding mouth opening, laterality and protru- that no patient data appear in this article
5
sion movements, deviation in mouth opening and occlusion ,
10
and pain in the TMJ. These results are consistent with the Conflicts of interest
present case report.
A study that compared performing the open reduction The authors have no conflicts of interest to declare.
with internal fixation with the closed reduction for the mana-
gement of a unilateral displaced subcondylar and condylar references
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care is taken. 10