Morphological occlusal features following condylar fractures in children

Early fracture of the mandibular condyles may be related to an asymmetric morphologic occlusion. The aim of the study was to investigate the morphologic occlusal symmetry of non-surgically treated children after condylar fractures. The original study group consisted of 55 subjects (31 males and 24 females) who suffered temporomandibular joint condylar fractures at a young age and were treated conservatively, with physiotherapy only. Thirty-two of the respondents who were injured at a mean age of 6.5 years (range 9 months-12 years) comprised the study group. Their occlusion was re-examined intra-orally as well as on study models, at the mean age of 10.5 years (range 2.8-20.7 years). Of these, 21 suffered unilateral and 11 bilateral condylar fractures. The control group comprised a random population of 705 school children. The chi-square test was used for statistical comparison. The general distribution of occlusal patterns (Angle) differed significantly in the study group and in the controls. From the asymmetric occlusal features, only the lower midline deviation was found to be slightly more prevalent in the injured group, with almost perfect coincidence of the side of the fracture and the direction of the lower midline deviation. No significant differences were found in the distribution of posterior crossbite, anterior crossbite, and Class II subdivision in the two groups. Among children who experienced condylar fractures, a higher prevalence of malocclusion was diagnosed; the most prominent asymmetric trait was lower midline deviation coinciding with the side of the unilateral fractured condyle.