Change of the Inclination Angle in a Pediatric Bilateral Condylar Fracture Treated With Intermaxillary Fixation and an Occlusal Stop

초록

This paper presents the outcomes of a pediatric bilateral condylar fracture treated with intermaxillary fixation (IMF) and an occlusal stop. A 6-year-old girl presented with the complaint of pain on her chin. She had fallen down, whereas riding a bicycle and her face hit the road. She had limited mouth-opening (10 mm). Panoramic radiography and computed tomography confirmed a bilateral con-dylar fracture. The inclination of the fractured condyle (IFC) was 39.2 degrees and 42.4 degrees on the left and right sides, respectively. On the third post-trauma day, arch bars were applied and IMF was performed with a prefabricated wafer (occlusal stop) and rubber bands. The rubber bands were changed to wires on post-IMF day (PMF) 4. Immediately after IMF, the IFCs increased (left: 50.1 degrees and right: 68.1 degrees). On PMF 1, the IFCs had improved (44.5 degrees and 46.9 degrees, respectively). On PMF 3, 12, 28, and 35, the left and right IFCs were 46.9 degrees and 70.7 degrees,38.9 degrees and 72.0 degrees,38.0 degrees and 56.5 degrees, and 36.4 degrees and 44.6 degrees, respectively. On PMF 42, the IFCs had changed to 34.5 degrees and 36.1 degrees, and wires were changed to rubber bands. On PMF 49, the IFCs were 34.0 degrees and 36.5 degrees, and rubber bands were applied at night only. On PMF 56, the IFCs had improved to 35.0 degrees and 34.8 degrees, and the arch bars were removed. The changes of IFC were fitted to an exponential regression model (left: y = 44.134e (0.005x) and right: y = 11.378e (0.043x)). This case shows that pediatric bilateral mandibular condyle fractures can be treated by vertical lengthening using an occlusal stop and IMF.

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