Conservative interdisciplinary treatment of a case with multiple facial and condyle fractures

• Published in: Dental traumatology 2017-06, Vol.33 (3), p.226-229
• Main Authors: Lee, You‐Sun, Yi, Yang‐Jin, Kim, Young‐Kyun, Lee, Nam‐Ki, Larson, Brent E.
• Format: Article
• Language: English
• Subjects: bilateral condyle fractures; Case reports; Combined Modality Therapy; conservative interdisciplinary treatment; Conservative Treatment; Dental crowns; Dental Prosthesis Design; Dentistry; Fracture Fixation - methods; Fractures; Humans; Incisors; Interdisciplinary aspects; Male; Mandible; Mandibular Condyle - injuries; Mandibular Fractures - therapy; Mastication; Maxilla; Middle Aged; Molars; multiple facial fractures; Occlusal Adjustment; Orthodontics; Orthodontics, Corrective - methods; Premolars; Skull Fractures - therapy; Surgery; Teeth; Temporomandibular joint; Zirconia
• ISSN: 1600-4469; 1600-9657
• DOI: 10.1111/edt.12290

The purpose of this case report is to describe an interdisciplinary approach for a 51‐year‐old male who underwent multiple facial fractures including bilateral condyle fractures. The patient underwent emergency surgery, which included open reduction of the maxilla and mandibular symphysis and closed reduction of the bilateral condyle fractures. Although the patient recovered a comfortable range of mouth opening and alleviation of the temporomandibular joint (TMJ) symptoms after surgery, he suffered from a large anterior–posterior discrepancy due to less stability on the condyle‐fossa relationships and from open bite with contacts only on both second molars and right second premolars. In this case, first, to increase the occlusal contact, comprehensive orthodontic treatment was completed. Second, occlusal equilibration was selectively performed to relieve the interferences and establish a stable range of mandibular movement without any changes in the vertical dimension. Third, both the upper central incisors and left lateral incisor were minimally restored with splinted and single zirconia crowns, which had modified lingual contours to provide adequate anterior guidance permitting the anterior–posterior discrepancy of the posterior teeth during protrusion. This conservative interdisciplinary treatment, including open and closed reduction, orthodontic treatment, occlusal adjustment, and minimal prosthetic restorations, resulted in a stable mandibular position and recovery of mastication function.