65例儿童髁突囊内骨折保守治疗临床预后的Helkimo指数评价

目的：应用Helkimo指数对行保守治疗的儿童髁突囊内骨折病例的临床预后进行回顾分析,探讨年龄、单侧或双侧骨折、骨折类型及治疗方法等因素对临床预后的影响。方法：对2009年8月—2019年8月65例（96侧）行保守治疗的儿童髁突囊内骨折患者的临床预后情况进行回顾,采用Helkimo指数（包括Ai指数和Di指数）作为评估工具,根据年龄、单侧或双侧骨折、骨折类型及保守治疗方法分亚组进行比较,采用SPSS 25.0软件包对数据进行非参数检验。结果：60例患者（92.31%）无明显主观症状（Ai 0和Ai I）,52例患者（80%）功能正常或有轻度功能障碍（Di 0和Di I）。不同年龄组间Ai指数的差异有统计学意义（P=0.001）;相比12~16岁组,0~5岁组（P<0.05）、6~11岁组（P<0.05）的Ai指数较小,主观临床预后更佳,但年龄对Di指数无显著影响（P=0.144）。单侧或双侧骨折（P=0.178）、不同骨折类型（P=0.139）、不同治疗方法（P=0.121）之间Ai指数无显著差异;单侧或双侧骨折（P=0.321）、不同骨折类型（P=0.692）、不同治疗方法（P=0.944）之间Di指数也无统计学差异。结论：儿童髁突囊内骨折经保守治疗的临床预后整体良好,主诉症状改善理想,部分患儿存在轻度功能障碍。     

Three-dimensional assessment of accuracy for open reduction and internal fixation of the subcondylar fracture and its implications on the TMJ function

This study used three-dimensional cone beam computed tomography (CBCT) to assist the accuracy of open reduction and internal fixation (ORIF) for the unilateral subcondylar fracture and the long-term temporomandibular joint (TMJ) function impairment.Bilateral TMJs were analyzed postoperatively on CBCT images, involving the following three-dimensional (3D) parameters: condylar position and inclination; circumferential joint space, ramus, and mandible length; and the volumetric joint space. The inclusion criteria for adult patients included having a displaced fracture >5°, a shortening in ramus length >2 mm, and mouth opening limitation. The non-fracture side was used as the comparison group. The Helkimo index was employed for the clinical assessment of the outcomes, while the paired student t-test and Pearson coefficient test were used to compare both sides.The study included 60 joints in 30 consecutive patients. The condylar inclination to the horizontal plane on the fracture and non-fracture sides was 9.29 ± 3.9°, 12.46 ± 4.2°, (p < 0.001) and was positively related to the subjective (Helkimo Hi) and objective (Helkimo Di) clinical outcomes. In contrast, the condylar position to the midsagittal plane in the fracture and non-fracture sides was 51.95 ± 3.5 mm, 50.17 ± 3.6 mm (P = 0.038), and was positively related to the objective outcomes. Additionally, the objective outcome was negatively related to the change of the posterior joint space.ConclusionThe three-dimensional assessments seem to demonstrate that the ORIF is an accurate approach for obtaining a three-dimensional reduction to the displaced subcondylar fracture.     

Aetiology,pattern and treatment of mandibular condylar fractures in 549 patients: A 22-year retrospective study

PurposeThe purpose of this study was to retrospectively investigate the aetiology, pattern, and treatment of mandibular condylar fractures in our department over the past 22 years.Patients and methodsData of patients who sustained mandibular condylar fractures from 1988 to 2009 were recorded, including fracture aetiology, pattern of condylar fracture, time, age, sex, associated injury, patient transferred by other clinics, lag time and treatment method. Data analysis included X² test, Fisher exact test, t-test, Ridit analysis and Logistic regression analysis.ResultsThe sample was composed of 549 patients (749 condylar fractures), 404 male and 145 female (male:female = 2.79:1), with a mean age of 30.12 ± 14.44 years. Road traffic accidents were the most common cause (248, 45.2%). Condylar head fractures were significantly related to a fall at ground level (p = .001). A fall from a height had a 3.19-fold risk of bilateral condylar fractures (odds ratio, 3.19; 95% confidence interval, 1.33 to 7.65; p = .010). A majority of the condylar fractures (693, 92.5%) were treated by a surgical procedure. Condylar head were mostly removed (95.0%, p < .001), condylar neck and condylar base fractures were most frequently treated by open reduction and internal fixation with miniplates (74.4%, p < .001). Most of the dislocated condylar fractures were treated by open surgery (96.5%, p = .026).ConclusionsThe anatomic position and uni/bilateral pattern of mandibular condylar fractures were positively related to situations when considerable force is involved. Open condylar surgery was based on the level of fracture and degree of displacement or dislocation.     

Effect of ageing on healing of bilateral mandibular condyle fractures in a rat model

To examine the hypothesis that conservative treatment is applicable to younger patients with bilateral mandibular condylar fractures, we studied the effect of ageing on the healing of bilateral mandibular condylar fractures in a rat model. Male Sprague–Dawley rats aged 3, 6, and 36 weeks (n = 25/cohort, total n = 75) were divided into a fracture group (n = 12) and a sham control group (n = 12); one rat from each cohort was used as a normal unoperated control. Cell proliferation was evaluated using the bromodeoxyuridine (BrdU) labelling index (LI). Osteochondrogenesis was assessed by the expression of Indian hedgehog (Ihh), type X collagen, and osteocalcin in the condylar head. Condylar fracture healing was found to be delayed by ageing. BrdU LI values in the fracture groups were higher in younger rats than in older rats at 8 weeks after fracture. The number of Ihh-positive cells in the fracture groups increased significantly up to 2 weeks after fracture, and then gradually decreased until 8 weeks after fracture. The findings of this study support the clinical concept of conservative treatment of bilateral condylar fractures in younger patients, but functional issues regarding ramus height and its consequences on occlusion have not been tested in this study.     

Functional outcomes following surgical treatment of bilateral mandibular condylar fractures

Debate continues regarding unilateral or bilateral treatment for mandibular condylar fractures. This retrospective study evaluates the functional outcomes of bilateral condylar process fractures after surgical intervention. From May 1994 to December 2004, 51 adult patients with bilateral mandibular condylar process fractures were studied. There were 33 cases of bilateral condylar fractures (type I); 12 cases of condylar-subcondylar fractures (type II); and six cases of bilateral subcondylar fractures (type III). All patients underwent open reduction and internal fixation. Four patients had chin deviation, six had malocclusion, three had poor chewing function and eight had limited mouth opening. Type I patients had a significantly higher incidence of limited mouth opening (P = 0.039) and associated maxillary fractures (n = 12) and psychiatric disease (n = 6) which yielded significantly poor functional outcomes. Complications included transient facial paresis (n = 4), fracture and loosening of postoperative plates (n = 3) and surgical wound infections (n = 2). Open reduction with rigid fixation for bilateral condylar fractures provided satisfactory functional outcomes in this study. Concomitant maxillary fractures and underlying psychiatric problems are poor outcome factors. Aggressive rehabilitation in the first 9 months is important for early functional recovery.     

A preauricular long-corniform approach for open reduction and internal fixation of mandibular condylar fractures

IntroductionWe report functional and clinical outcomes following use of a preauricular long-corniform incision for open reduction and internal fixation (ORIF) of mandibular condylar fractures.Materials and methodsPatients with mandibular condylar fractures who underwent ORIF via a 120° preauricular long-corniform incision were included in the study. A total of 78 patients (100 condyles) were included. Follow-up occurred 10 days and 1–6 months after surgery, and included assessments of clinical, functional outcome, complications, and bone fusion.ResultsThere were 38 high neck, 26 low base, and 35 diacapitular condylar fractures. All measures of functional outcome significantly improved over time after surgery regardless of fracture type (all P < 0.001). The vast majority of patients in all fracture type groups had good occlusion (≥88.5%), no pain (≥89.5%), and anatomical reduction 10 days after surgery (≥81.6%). Fracture healing was complete in all patients after 6 months. There were no long-term complications and all patients were satisfied with their postoperative appearance.ConclusionsOur findings suggest that a preauricular long-corniform incision provides a good visual field during surgery, and allows for effective ORIF of mandibular high neck, low base, and diacapitular condylar fractures, with positive outcomes and minimal postoperative complications.     

Comparison of temporomandibular joint function and morphology after surgical and non-surgical treatment in adult condylar head fractures

PurposeThe aim of this study was to evaluate whether surgical treatment can distinctly improve temporomandibular joint (TMJ) function and morphology in adult patients with condylar head fractures (CHFs) when compared with conservative treatment.Patients and methodsA retrospective study was performed to evaluate surgical and conservative outcomes in all patients who had suffered CHFs. In this study, all patients were divided into a surgical group and a conservative group. In the surgical group patients were treated by open reduction and internal fixation (ORIF) combined disc anchorage, while in the conservative group patients were treated by a removable splint combined with intermaxillary elastics. Clinical and radiological outcomes were evaluated and functional outcomes were assessed using the Helkimo index score. Paired t-tests, Wilcoxon signed rank tests, independent t-tests and χ² tests were used to assess inter-group differences.Results75 TMJs in 56 patients were included in this study and were divided into a surgical group (56 TMJs in 40 patients) and a conservative group (19 TMJs in 16 patients). The results showed that the Helkimo index score for TMJ in the surgical group was better than in the conservative group (p_Ai = 0.032, p_Di = 0.001, respectively). Ramus height in the surgical group (61.08 ± 4.04 mm) recovered more than in the conservative group (54.82 ± 3.06 mm) (p = 0.012). Discs became shorter, moved further forward, and became severely distorted in the conservative group (disc length = 7.32 ± 1.35 mm). In contrast, discs became longer, retained a normal disc–condyle relationship, and formed a normal shape in the surgical group (disc length = 11.05 ± 2.07 mm) (p = 0.003). According to the MRI images, joint effusion, retrodiscal tear, and lateral capsular tear were better cured in the surgical group (p = 0.001, p < 0.001, p = 0.012, respectively).ConclusionBased on these results, it seems that surgical treatment of condylar head fractures should be the preferred approach if there are no contraindications for general anesthesia.     

Three-dimensional evaluation of condylar morphology after closed treatment of unilateral intracapsular condylar fracture in children and adolescents

PurposeTo investigate the condylar morphology after closed treatment of unilateral intracapsular condylar fracture in children and adolescents through three-dimensional evaluation and to explore the influence of age, types of fracture, follow-up period, treatment methods, and concomitant fractures on the treatment effectiveness.Materials and methodsThe medical records of patients who underwent closed treatment for condylar fractures from January 2006 to December 2018 were reviewed. The fractured sides were included in the study group and the opposite healthy joints were included in the control group. The height of articular eminence, depth of glenoid fossa, length & width & thickness of condylar process, length & width of the ramus, and deviation of pogonion were measured three-dimensionally.Results31 participants were included in the study. The length of condylar process was 2.10 ± 3.77 mm (P = 0.004) shorter, the depth of glenoid fossa was 1.09 ± 2.13 mm (P = 0.040) shallower, and the length of ramus was 1.55 ± 2.49 mm (P = 0.002) longer in fractured side than the ones in healthy side after closed treatment. The pogonion deviated 0.48 ± 1.7 mm to the fractured side, but no statistical significance was found (P = 0.129).ConclusionsChildren had great growth potential to compensate the shortening of condylar process after intracapsular condylar fracture, so closed treatment could be an effective therapy for young children and adolescents.     

CAD/CAM and conventional reconstruction of the mandibular condyle by fibula free flap: a clinical and radiological evaluation

The aim of this study was to analyse the radiological and clinical outcomes of condylar reconstruction by fibula free flap (FFF), comparing conventional freehand and CAD/CAM techniques. Fifteen patients (nine CAD/CAM, six freehand) who underwent condylar reconstruction with a FFF were reviewed retrospectively regarding pre- and postoperative computed tomography/cone beam computed tomography scans and clinical function. After surgery, all patients were free of temporomandibular joint pain. Mean postoperative mouth opening was 30.80 mm, with no significant difference between the freehand and CAD/CAM groups. In all patients, laterotrusion was decreased to the contralateral side (P = 0.002), with no difference between freehand and CAD/CAM, while the axis of mouth opening deviated to the side of surgery (P < 0.001). All patients showed significant radiological deviation of the fibular neocondyle in the laterocaudal direction (lateral: P = 0.015; caudal: P = 0.001), independent of the technique. In conclusion, reconstruction of the mandibular condyle by FFF provided favourable functional results in terms of mouth opening, reduction of pain, and mandibular excursions. Radiological deviation of the neocondyle and deviation of laterotrusion and mouth opening did not impair clinical function. CAD/CAM planning facilitated surgery, decreased the surgery time, and improved the fit of the neocondyle in the fossa.     

Effect of bilateral sagittal split ramus osteotomy on temporomandibular joint symptom and condylar position in patients with skeletal class Ⅲ malocclusion by cone beam computed tomography

目的 探讨双侧下颌骨升支矢状劈开截骨后退术（BSSRO）对行正畸—正颌联合治疗的骨性Ⅲ类错牙合患者颞下颌关节（TMJ）症状及髁突位置的影响。方法 选取24例行正畸-正颌联合治疗的骨性Ⅲ类错牙合患者,分别在BSSRO术前、术后1个月、术后12个月按Helkimo指数整理记录关节症状,并行锥形束CT（CBCT）扫描,在三维方向上测量髁突水平位及冠状截面最大径、髁突短轴径、髁突颈部宽度、髁突高度、不同角度（45°、90°、135°）下关节间隙宽度、双侧髁突间距及髁突角度（水平角、垂直角、受力角）,分析不同时期TMJ症状及骨性结构的变化情况。结果 BSSRO术前与术后的Helkimo指数均为Ai、Di 0级或1级,二者之间无差异。与术前相比,术后1个月时髁突水平角、45°及90°下关节间隙宽度增大,135°下关节间隙宽度减小（P<0.05）;术后12个月时,除髁突水平角增大（P<0.05）外,其余测量项目间差异均无统计学意义（P>0.05）。结论 在正畸—正颌联合治疗中,BSSRO不会对Helkimo指数为Ai、Di 0级或1级的骨性Ⅲ类错牙合患者的TMJ症状及髁突位置产生明显的影响。     

Paediatric mandibular fracture—a diagnostic challenge?

The purpose of this study was to clarify the frequency of missed mandibular fractures and to identify possible predictive factors for missed diagnosis. This was a retrospective study that included patients <20 years of age with a recent mandibular fracture. The outcome variable was missed mandibular fracture, which was determined when a fracture was not suspected or diagnosed during the patient’s first assessment in primary healthcare. The primary predictor variable was age group (i.e. children <13 years or teenagers/adolescents aged 13–19 years). The explanatory variables were sex, mechanism of injury, and type of facial facture. Other variables were clinical symptoms and findings. Mandibular fracture was missed at first contact in 27 of 182 patients (14.8%). Fracture was missed significantly more often in patients <13 years than in older patients (33.3% vs. 8.8%, P < 0.001). The only significant symptom or clinical finding that was associated with missed fractures was skin wound of the jaw (P = 0.009). There was no association between missed fracture and sex or mechanism of injury. Mandibular fractures in children are often missed at the first healthcare contact. Careful examination is necessary in paediatric mandibular injuries, particularly in the youngest age groups. Consultation should be smooth between paediatric trauma units and maxillofacial surgeons.     

Non-surgical management of paediatric and adolescent mandibular condyles: A retrospective review of 49 consecutive cases treated at a tertiary referral centre

IntroductionMandibular fractures account for over 50% of all facial fractures in children, with the majority of these occurring at the condyle. There is currently no consensus on the management of mandibular condyle fractures in the paediatric population. Treatment options range from conservative management, with or without maxillomandibular fixation (MMF) and physiotherapy, to open reduction and internal fixation (ORIF).MethodsThis was a retrospective review of all patients who attended Alder Hey Children's Hospital with fractured condyle(s) between the years 2000 and 2015. All patients were managed non-surgically and included those managed conservatively and/or with MMF. The following variables were recorded: age, sex, mechanism of injury, concomitant mandibular fractures, imaging, SORG classification, complications and follow-up intervals. The following exclusion criteria applied: patients who underwent open reduction internal fixation of their condylar fracture and patients aged 16 years or over.ResultsForty-nine patients (38 male, 11 female) underwent non-surgical management of condylar fractures during the 15-year study period. The mean age at time of injury was 12 years (range 2–15 years).The etiology of fractures comprised mechanical falls (n = 22), assault (n = 14), sport (n = 5), road traffic accident (n = 3), epileptic fit (n = 1), and unknown mechanism (n = 4). The mean length of hospital stay was 3 days, ranging from 0 to 14 days. Thirty-seven patients had a concomitant mandibular fracture and 12 had an isolated unilateral condylar fracture. Follow-up intervals ranged from 1 to 133 weeks, with a median length of 12 weeks. Fifteen patients underwent MMF, while 34 had soft diet and physiotherapy only. Ninety-two per cent of patients had no complications. No patient had failure of treatment requiring a return to theatre and/or ORIF. Occlusion, interincisal distance, asymmetry and TMJ symptoms were examined in 43/49 patients who attended their postoperative appointments. Four patients (8%) had complications in the postoperative period, namely: lateral open bite (n = 2), deviation to the affected side on wide opening (n = 1), and non-specific TMJ dysfunction (n = 1). None of these patients presented with any subjective symptoms and none developed asymmetry or needed any further surgical intervention.ConclusionPaediatric and adolescent mandibular condyle fractures can be safely and predictably managed using conservative methods. In our, albeit small, study cohort all patients were managed conservatively, and all had a satisfactory outcome with no requirement for further operative intervention.     

正颌外科治疗对颞下颌关节功能影响的研究

目的　观察正颌手术后颞下颌关节病各种症状及体征的变化 ,比较不同固定方式及手术方式对于颞下颌关节的影响。方法　正颌手术矫治的连贯患者 46例 ,术前 1周内及术后 1年记录患者的颞下颌关节情况。结果　全组Helkimo主诉症状指数 (Ai) ,临床指数 (Di)的差异无显著性 ,术后最大开口度与下颌前伸度皆减小 ,但只有 1%差别 ,无明显临床意义。单双颌手术及升支的 3种术式之间比较 ,各项症状与体征的变化差异无显著性。结论　正颌外科治疗对颞下颌关节的影响不大 ,不同的术式间对颞下颌关节的影响无明显不同     

Stability of bioabsorbable fixation systems according to different locations of mandibular fracture: A three-dimensional analysis

This study aimed to elucidate whether the stability of an unsintered hydroxyapatite particles/poly-_l-lactide (uHA/PLLA) system is comparable with that of titanium, according to different load-bearing areas of the mandible. The study included patients who underwent open reduction and internal fixation of the mandibular body, angle, or subcondylar fracture. The stability of uHA/PLLA systems was compared between the immediate and 6-month postoperative time points using three-dimensional cone-beam CT image analysis. The positional changes of each landmark were measured in three-dimensional (3D) coordinate systems using simulation software. Among 36 patients, there were more displacements of the landmarks between the immediate and 6-month postoperative time points after subcondylar fracture reduction than after body or angle fracture reductions. Strong upward displacements of the landmarks after subcondylar fracture reduction were found in the lateral pole [mean (SD) = 1.75 (3.16), p-value = 0.003] and medial pole [mean (SD) = 1.64 (2.50), p-value = 0.024], but not in the center. Subgroup analyses revealed similar unstable results in males on the condylar landmarks after subcondylar fracture reduction. There were tendencies for lateral displacement of the coronoid process in the body fracture group [mean (SD) = 0.8 (0.83)] and angle fracture group [mean (SD) = 0.75 (0.58)] postoperatively (p-value = 0.01). This study concluded that bioresorbable osteosynthesis can be recommended for body or angle fractures, while the indication for subcondylar fractures is less clear.     

Comparison between 3D delta plate and conventional miniplate in treatment of condylar fracture: A randomised clinical trial

The aim of the study was to conduct a randomized clinical trial comparing the efficacy of standard non-compression miniplate and 3-dimensional (3D) titanium plate in the open reduction internal fixation (ORIF) of the mandibular condylar fractures.Patients who underwent open reduction of mandibular condylar fracture were recruited for the study. The patients satisfying the inclusion criteria were randomly assigned to two groups in a 1:1 ratio. Group A comprised patients treated using conventional miniplates, and Group B comprised patients treated using 3D Delta Plate. Informed consent was provided. All the patients underwent ORIF under GA via retromandibular approach.The sample size was set at 20 participants, with 10 participants in each group who were randomly allocated. Our study showed that patients in Group A had a significant statistical difference operating time (141.20 ± 2.59 min) than that of Group B (117.2 ± 9.63 min). Mouth opening was significantly greater in the 3^rd-month follow-up in Group B (mean = 42.40 ± 1.82) compared to Group A (mean = 35.80 ± 1.30). Biting efficiency in Group B was observed to be clinically and statistically better compared to Group A (P = 0.012). Wound dehiscence was managed efficiently by judicious use of antibiotics and wounds were free of any signs of infections or discharge in the consecutive follow-ups. No plate removal was required in either group.Patients treated with 3D delta plates have superior outcomes with regard to operation time, mouth opening, and biting efficiency compared with miniplates. Hence, it can be concluded that the triangular shape of the 3D Delta plate allows the stress distribution to be superior and multidimensional, leading to better post-operative stability, faster healing, and reduced complications.     

Clinical results of two different three-dimensional titanium plates in the treatment of condylar neck and base fractures: A retrospective study

PurposeThe aim of this study was to examine two different types of three-dimensional plate for their suitability for the treatment of condylar neck and base fractures, and to evaluate the most frequent complications, while considering three different surgical approaches.Materials and methodsThis retrospective study was conducted in patients who received two different types of three-dimensional plate for the treatment of condylar neck and base fractures, using three different surgical approaches, from January 2016 to December 2018. Medical records were obtained during an average follow-up period of 9 months after the traumatic event, with data collected on factors affecting success and failure of miniplates, clinical outcome parameters, and complications.ResultsA total of 43 fractures (38 patients) were examined. No differences were found between the two plate designs (mean = 0.093, SD = 0.294, p = 0.562). All fractures achieved complete bone healing, but in four cases, a revision operation had to be performed. No significant complications were found regardless of the surgical approaches chosen. There was no correlation between plate system (mean = 0.419, SD = 0.492, p = 0.497) or surgical access (mean = 0.163, SD = 0.432, p = 0.247) and the occurrence of facial nerve palsy found. Due to the extraoral approach used, permanent facial nerve palsy was reported in one case. With the intraoral approach, one case of transient facial paresis was observed. No facial palsy was observed in patients treated via a preauricular approach.ConclusionDeltoid and trapezoid plates seem to perform equally in the treatment of condylar neck and base fractures.     

Conservative treatment of unilateral condylar fractures in children: a long-term clinical and radiologic follow-up of 55 patients

The purpose of this prospectively designed study was the long-term clinical and radiological evaluation of conservatively treated unilateral condylar fractures in children. Fifty-five children aged between 2 1/2 and 9 3/4 years, presenting with a singular unilateral fracture of the mandibular condyle, were treated in a nonsurgical-functional way using an intraoral myofunctional appliance. In the follow-up period, patients were investigated by standardized clinical examination and by evaluation of panoramic radiographs taken immediately post-traumatically, after 6, 12, 24, 48 and 72 weeks, and then yearly through the period of growth. With a satisfactory clinical course in all patients, there was no instance of functional disturbance or mandibular asymmetry after the respective follow-up periods. The radiographs showed a fairly good shape of the condyle (no or only slight condylar deformity) in the 47 patients of the 2-6 year age group. In the eight patients of the 7-10 year age group presenting with a class II or III condylar fracture, healing was characterized by incomplete condylar regeneration, resulting in a moderate condylar deformity in two cases, a definite reduction in condylar neck height in two cases, and a hypertrophic condylar deformity in four cases. The positive results of this study confirm the concept of a nonsurgical-functional approach in children presenting with various types of unilateral fractures of the mandibular condyle. Condylar remodeling was the mode of fracture healing in instances of displaced and dislocated condylar fractures.     

Relationship between fracture of mandibular condyle and absence of unerupted mandibular third molar—a retrospective study

Purpose

The purpose of the present study was to find, if there exists, a co-relation between presence of unerupted mandibular third molar and fracture of mandibular condyle.

Methods

A retrospective, multicenter study was done collecting the data of all mandibular condyle fractures treated from November 2006 till August 2015. Data was collected from the patient’s records and radiographs for the following information: age, sex, etiology of fracture, presence and state of lower third molars, and associated fracture. The results were subjected to statistical analysis.

Results

Out of 180 patients of condylar fracture, unerupted third molars were present in 35 (19.44 %) cases compared to 145 (80.55 %) cases of condylar fracture where the unerupted third molars were not present. The difference was statistically significant (p < 0.05). In the unerupted third molar present group, isolated bilateral condylar fracture was seen in 4 (11.4 %) cases, bilateral condylar fracture associated with other mandibular fractures in 9 (25.7 %) cases, isolated unilateral condylar fracture in 0 (0.0 %) cases, and unilateral condylar fracture associated with other mandibular fractures in 17 (48.5 %) cases and condylar fracture associated with mid face fractures in 5 (14.2 %) cases. In the unerupted third molar absent group, isolated bilateral condylar fracture was seen in 5 (3.4 %) cases, bilateral condylar fracture associated with other mandibular fractures in 30 (20.6 %) cases, isolated unilateral condylar fracture in 24 (16.5 %) cases, unilateral condylar fracture associated with other mandibular fractures in 73 (50.34 %) cases, and condylar fracture associated with mid face fractures in 13(8.96 %) cases. The difference between the groups was statistically significant (p = 0.032).

Conclusion

This study suggests that the fractures of mandibular condylar region have a significantly higher incidence in patients without an unerupted mandibular third molar.