Pathological changes in the temporomandibular joint and its endoprosthesis as a complication of the mandibular condylar processes fractures
DOI:
https://doi.org/10.32782/2786-7684/2024-1-1Keywords:
temporomandibular joint, condylar fractures, joint replacement, arthroscopy, endoprosthesisAbstract
Injuries of condylar processes and related pathological conditions in the temporomandibular joints are currently the subject of constant discussions and conflicting views among the current problems of oral and maxillofacial surgery. The aim of the study was to compare different strategies for treating condylar fractures, both as curative surgical tactics and as prevention of internal disorders of the TMJ by performing open reposition with maxillary fixation, open reposition with internal fixation, and endoscopic reposition with internal fixation. A retrospective analysis of the medical histories of patients with fractures of the condylar process of the mandible was performed. Presentation of the main research material. Closed repositioning, according to data, especially from foreign authors, is considered a standard treatment for fractures of the condylar processes of the lower jaw. The assumption that closed reduction would result in fewer complications, although the aesthetics and functionality would be the same as treatment by open reduction with internal fixation, prompted its careful study. The non-invasive nature of this method, as a result, according to our observations, leads to very minor damage to the facial nerve in 22% of cases. Despite numerous discussions, the authors still cannot agree on the optimal treatment algorithm for fractures of this nosology. In 11% of cases, we found no significant difference between the results of open or closed treatment. However, in some other studies, closed treatment is considered undesirable. Research conclusion. Currently, endoscopic surgery is certainly a good substitute for classical operative approaches in the surgical treatment of condylar fractures and prevents the occurrence of complications related to the internal temporomandibular joint and its endoprosthetics, as well as complications associated with the traditional open technique, such as damage to the facial nerve, formation of scars and complications associated with open reposition with maxillary fixation and open reposition with internal fixation.
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