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Condylar Injuries |
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Contusion—Injuries to the soft tissues around the joint or an effusion within the joint Dislocation—Displacement of the condylar head from the glenoid fossa but still within the capsule Fracture Intra-capsular—Condylar head or neck Extracapsular—Condylar neck or subcondylar
Clinical Features
¨ Tempromandibular joint effusion/haemarthrosis ¨ Ipsilateral posterior open bite ¨ Midline shift to contra-lateral side
Unilateral Fracture ¨ Ipsilateral premature contact posteriorly ¨ Ipsilateral midline shift
Bilateral fracture dislocations ¨ Anterior open-bite as both mandibular rami are shortened
Bilateral Dislocation of condylar heads ¨ Pseudoprognathism ¨ Unable to bring teeth into occlusion ¨ Elongated face ¨ Condyles able to be palpated
Treatment
1. Conservative treatment No active treatment if minimal displacement and lack of symptoms Persistent malocclusion or severe pain may require intermaxillary fixation
2. Surgical indications Compound and comminuted fractures Condylar displacements with gross occlusal disruption/telescoping Multiple facial fractures
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Classification
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