Open versus closed treatment for unilateral mandibular extra-capsular condylar fractures: A meta-analysis |
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| Institution: | 1. Executive Senior Physician (formerly), Department of Oral and Craniomaxillofacial Surgery, Klinikum Rechts der Isar der Technischen Universität München, Munich, Germany;2. Head of Department of Oral and Maxillofacial Surgery, Medical University Innsbruck, Innsbruck, Austria;3. Department of Oral and Craniomaxillofacial Surgery, Klinikum Rechts der Isar der Technischen Universität München, Munich, Germany;4. Department of Diagnostic Radiology, Klinikum Rechts der Isar der Technischen Universität München, Munich, Germany;5. Head of Department of Oral and Craniomaxillofacial Surgery, Klinikum Rechts der Isar der Technischen Universität München, Munich, Germany;6. Head of Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg, and Faculty of Medicine, Philipps University, Marburg, Germany;1. Reader, Oral and Maxillofacial Surgery and Oral Implantology, Institute of Dental Sciences, Moradabad, Uttar Pradesh, India;2. Oral and Maxillofacial Surgeon and Oral Implantologist, Institute of Dental Sciences, Moradabad, Uttar Pradesh, India;3. Professor and Head, Oral and Maxillofacial Surgery and Oral Implantology, ITS-Dental College, Moradabad, Uttar Pradesh, India;4. Professor and Head, Oral and Maxillofacial Surgery and Oral Implantology, Jaipur Dental College, Moradabad, Uttar Pradesh, India;5. Reader, Oral and Maxillofacial Surgery and Oral Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India;1. State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China;2. Department of Stomatology, Ningbo First Hospital, Ningbo, 315000, China;3. Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510140, China;1. University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands;2. University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Groningen, The Netherlands;3. University of Groningen, Faculty of Behavioural and Social Sciences, Department of Special Needs Education and Childcare, Groningen, The Netherlands;4. University of Groningen, University Medical Centre Groningen, Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands;5. University of Groningen, University Medical Centre Groningen, Department of Oral and Maxillofacial Surgery, Centre for Rehabilitation, School for Health Research, Groningen, The Netherlands;1. Division of Maxillofacial Surgery, University Hospital “Maggiore della Carità”, University of Eastern Piedmont, Novara, Italy;2. Department of Oral and Maxillofacial Surgery, Hasanuddin University, Makassar, Indonesia;3. Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands;4. Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain;5. Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia;6. Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria;7. Private practice of oral surgery, Plovdiv, Bulgaria;8. Department of maxillofacial surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria;9. Department of maxillo-facial surgery, North Estonia Medical Centre Foundation, Tallinn, Estonia;10. Faculty of Medicine, University of Tartu, Tartu, Estonia;11. Bogomolets National Medical University, Stomatological medical center, Kyiv, Ukraine;12. Bogomolets National Medical University, Kyiv City Clinical Emergency Hospital, Kyiv, Ukraine;13. Division of Maxillofacial Surgery, CHU de Nantes, Nantes, France;14. Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia;15. Department of Maxillofacial surgery, School of Dental Medicine, University of Belgrade, Serbia;p. Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark;1. Department of Oral and Maxillofacial Surgery, Academic Medical Centre of Amsterdam, University of Amsterdam, The Netherlands;2. Department of Oral and Maxillofacial Surgery, Academic Medical Centre of Groningen, University of Groningen, The Netherlands |
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| Abstract: | PurposeTo compare the functional outcomes between open reduction and internal fixation (ORIF) and closed reduction (CR) for unilateral mandibular extra-capsular condylar fractures in patients over 12 years old.Materials and methodsA comprehensive electronic search of PubMed, Embase and the Cochrane Library databases was conducted up to October 31, 2018. The evaluated functional outcomes included malocclusion, temporomandibular joint (TMJ) pain, protrusion, laterotrusion, maximum inter-incisal opening and lateral deviation during maximum inter-incisal opening.ResultsFourteen studies appeared to meet the inclusion criteria. Statistically significant differences between ORIF and CR treatment were observed for the outcomes of malocclusion (P = 0.001), maximum inter-incisal opening (P = 0.0008), lateral deviation during maximum inter-incisal opening (P = 0.007) and laterotrusion (P < 0.0001), but not for the outcomes of protrusion (P = 0.33) and TMJ pain (P = 0.29).ConclusionsORIF treatment of unilateral mandibular extra-capsular condylar fractures provides better functional outcomes in comparison to CR treatment with regard to occlusion, maximum inter-incisal opening, lateral deviation during maximum inter-incisal opening and laterotrusion, whereas there was no statistically significant difference between ORIF and CR group with regard to protrusion and TMJ pain. |
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| Keywords: | Mandible Condylar neck fracture Condylar base fracture Open reduction and internal fixation Closed reduction Meta-analysis |
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