A PI TFALL I N THE RADI OLOGI CAL
DI AGNOSI S OF PAEDI ATRI C
MANDI BULAR CONDYLAR
FRACTURES

INDIAN DENTAL ACADEMY
Leader...
INTRODUCTION



Paediatric facial fractures are not common.



Mandibular condylar fractures are relatively common site
...


Minimally displaced condylar fractures of neck without
surgery allowing the condylar head to remodel itself
naturally.
...
CASE REPORT



9 yr old girl fell from a height of about 4 feet.



3cm laceration on her chin with swelling and tendern...
Pre operative photograph

www.indiandentalacademy.com


Plain radiographs were taken including orthopantogram
and facial views.



Film demonstrated a displaced left parasymp...
Pre operative 3 Dimensional view

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Pre operative OPG and AP View

www.indiandentalacademy.com


Treatment was done with open reduction and internal
fixation using 2 titanium plates below the level of
developing teet...


Provide relief of muscular spasm for first two weeks.



Jaw motion to prevent ankylosis.



Within I week comfortabl...
Post operative OPG and AP View

www.indiandentalacademy.com
Post operative photographs

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DISCUSSION



Paediatric mand. # can often be difficult to assess and
repair due to developing permanent dentition.



C...
CONCLUSION



The case represents an injury sustained from a traumatic
blow to the chin, condylar fractures should be sus...
THAN K YOU
www.indiandentalacademy.com
Leader in continuing dental education

www.indiandentalacademy.com
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A pitfall in the radiological diagnosis of paediatric mandibular condylar fractures -oral surgery courses /certified fixed orthodontic courses by Indian dental academy

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A pitfall in the radiological diagnosis of paediatric mandibular condylar fractures -oral surgery courses /certified fixed orthodontic courses by Indian dental academy

  1. 1. A PI TFALL I N THE RADI OLOGI CAL DI AGNOSI S OF PAEDI ATRI C MANDI BULAR CONDYLAR FRACTURES INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. INTRODUCTION  Paediatric facial fractures are not common.  Mandibular condylar fractures are relatively common site of injury.  Conservative management of such fractures has been shown to be successful. www.indiandentalacademy.com
  3. 3.  Minimally displaced condylar fractures of neck without surgery allowing the condylar head to remodel itself naturally.  Following case outlines the management of a usual case of bilateral vertical fractures of the condylar heads, and illustrates the difficulty in diagnosis with conventional radiography. www.indiandentalacademy.com
  4. 4. CASE REPORT  9 yr old girl fell from a height of about 4 feet.  3cm laceration on her chin with swelling and tenderness along the left side of her mandible.  Derangement of occlusion with open bite.  Tenderness bilaterally at the TMJ. www.indiandentalacademy.com
  5. 5. Pre operative photograph www.indiandentalacademy.com
  6. 6.  Plain radiographs were taken including orthopantogram and facial views.  Film demonstrated a displaced left parasymphyseal fracture on the left and were suspicious for left condylar fracture as well.  Computed tomography was performed, which demonstrated a sagittal fracture in the lt. condylar head with medial displacement of # medial segment.  Undisplaced # noticed in the right condylar head.  Ramus height appeared of same height. www.indiandentalacademy.com
  7. 7. Pre operative 3 Dimensional view www.indiandentalacademy.com
  8. 8. Pre operative OPG and AP View www.indiandentalacademy.com
  9. 9.  Treatment was done with open reduction and internal fixation using 2 titanium plates below the level of developing teeth and tooth roots.  Monocortical screws were used on both the plates.  To treat condylar fractures orthodontic brackets were placed on molars on each side to be used for rubber 1bands.  These bands serve to guide the pt. back into normal occlusion. www.indiandentalacademy.com
  10. 10.  Provide relief of muscular spasm for first two weeks.  Jaw motion to prevent ankylosis.  Within I week comfortable mouth opening and inter incisal mouth opening of around 25mm.  Soft diet for 4 weeks.  Follow of 6 months revealed satisfactory occlusion with lower teeth per. Erupting. www.indiandentalacademy.com
  11. 11. Post operative OPG and AP View www.indiandentalacademy.com
  12. 12. Post operative photographs www.indiandentalacademy.com
  13. 13. DISCUSSION  Paediatric mand. # can often be difficult to assess and repair due to developing permanent dentition.  CT Scan has clear advantage than OPG as it has diagnostic accuracy with respect to condylar #.  With regard to the condylar # early range of motion exercises are of paramount importance in avoiding ankylosis.  Rubber bands are helpful in maintaining occlusion and providing relief of massetric swelling and spasm. www.indiandentalacademy.com
  14. 14. CONCLUSION  The case represents an injury sustained from a traumatic blow to the chin, condylar fractures should be suspected in such injuries, such # are best seen using a CT Scan.  Conservative management of such injuries has been found to be successful and should be the first choice for non-displaced condylar # or those that do not significantly affect occlusion of mand. height and symmetry. www.indiandentalacademy.com
  15. 15. THAN K YOU www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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