BACKGROUND AND AIM: The aim of this study was to assess whether the duration of intermaxillary block in patients with non-condylar mandibular fractures can interfere with restored mandibular function and whether there is a statistically significant correlation between the duration of joint immobilisation and the onset of temporo-mandibular joint pathologies. METHODS: A clinical evaluation was made of 40 patients treated for non-condylar mandibular fractures during the period 1991-1992. The patients were subdivided into two groups depending on the type of treatment and the duration of the intermaxillary block. Group A included patients treated with intermaxillary block alone lasting more than 25 days. Group B included patients treated surgically with intrafocal osteosynthesis with immobilisation lasting less than 15 days. RESULTS: The follow-up of results (3.7 years) showed a maximum mean aperture in Group A of 45.1 mm compared to 50.1 mm in Group B. The mean score for mandibular clinical dysfunction in patients in Group A was 5.0 points (SD +/- 4.75), whereas it was 0.7 points (SD +/- 1.45) in patients in Group B. This difference between the two groups was statistically significant (p < 0.01). CONCLUSIONS: The results of this study suggest that jaw immobilisation in mandibular fractures may be potentially damaging for the temporo-mandibular joint, sometimes leading to painful dysfunctional syndromes. For this reason, even in the case of mandibular fractures without decomposition, the authors feel that it is advisable to avoid long periods of immobilisation in patients with a positive history of mandibular dysfunction.
[Effect of immobilization after treatment of mandibular fractures]
AIMETTI, Mario
1999-01-01
Abstract
BACKGROUND AND AIM: The aim of this study was to assess whether the duration of intermaxillary block in patients with non-condylar mandibular fractures can interfere with restored mandibular function and whether there is a statistically significant correlation between the duration of joint immobilisation and the onset of temporo-mandibular joint pathologies. METHODS: A clinical evaluation was made of 40 patients treated for non-condylar mandibular fractures during the period 1991-1992. The patients were subdivided into two groups depending on the type of treatment and the duration of the intermaxillary block. Group A included patients treated with intermaxillary block alone lasting more than 25 days. Group B included patients treated surgically with intrafocal osteosynthesis with immobilisation lasting less than 15 days. RESULTS: The follow-up of results (3.7 years) showed a maximum mean aperture in Group A of 45.1 mm compared to 50.1 mm in Group B. The mean score for mandibular clinical dysfunction in patients in Group A was 5.0 points (SD +/- 4.75), whereas it was 0.7 points (SD +/- 1.45) in patients in Group B. This difference between the two groups was statistically significant (p < 0.01). CONCLUSIONS: The results of this study suggest that jaw immobilisation in mandibular fractures may be potentially damaging for the temporo-mandibular joint, sometimes leading to painful dysfunctional syndromes. For this reason, even in the case of mandibular fractures without decomposition, the authors feel that it is advisable to avoid long periods of immobilisation in patients with a positive history of mandibular dysfunction.
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