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Main Instructor Zwei-Chieng Chang
Ming-Hsien Lan
Department / Institution Division of Orthodontic and Dentofacial Orthopedic, Department of Dentistry, National Taiwan University Hospital
Classification Case report
Management of condylar fractures has still been controversial on whether open reduction is needed compared to conservative treatment. And no matter surgery is performed or not, complications, such as malocclusion, may occur after treatment. It’s important for orthodontists to understand the different choice about treating condylar fractures, and to know what we should pay attention for during malocclusion correction.
This is a 26-year-old male patient who suffered from a bicycle accident. He was diagnosed with subcondylar fracture at left side and intracapsular fracture at right side. Tooth 12 avulsion and teeth 11, 21, 22 intrusive luxation were also noted. After open reduction with intermaxillary fixation, the condition of his temporomandibular joint was stable and the maximum mouth opening was in the normal range. However, malocclusion with anterior open bite was noted. Full mouth orthodontic treatment was performed. Bilateral class I canine, molar relationship and normal overjet, overbite was achieved.
  Discussion and summary
Open reduction is recommended for severely displaced or dislocated condyle and deranged occlusion. With the evolution of the use of endoscope, minimal invasive surgery of this region can be performed. However, malocclusion may occur due to several reasons such as healing disorders or unsuccessful surgery. Orthodontic treatment or orthognathic surgery is performed after the joint condition is stable to achieve ideal occlusion.
Management of Condylar Fractures and Malocclusion Secondary to Them