Dynamics of restoration of functional activity of the mandible after fractures and prolonged immobilization; [Динамика восстановления функциональной активности нижней челюсти после переломов и длительной иммобилизации]

Fractures of the mandible are accompanied by a prolonged restriction of the volume of its movements, which can lead to the development of persistent functional disorders, which should be taken into account when developing rehabilitation measures in patients with this type of injury. The aim of the study was to conduct a comprehensive quantitative assessment of the restoration of mandibular function during the first month of the rehabilitation period in patients treated for a fracture of the mandible. Material and methods. A prospective study of 40 patients with a mandibular fracture, divided into two groups, was conducted, which was treated according to current clinical protocols: group 1 consisted of 22 people who underwent double-jaw splinting during treatment, group 2 consisted of 18 patients who, according to indications, al-so underwent an operation of bone osteosynthesis of the mandible with subsequent interdigital immobilization in the postoperative period. Each group included patients with both unilateral and bilateral lesions. After removal of splints, all patients underwent a comprehensive clinical assessment of the range of movements of the lower jaw in dynamics, during the first month of the rehabilitation period. Results and discussion. In all the studied patients, both pronounced re-striction of mouth opening and mobility of the mandible in the transversal and sagittal planes (lateral and protrusion movements) was noted. In group 2, these changes were more significant, the restoration of functional indicators was slower. Within a month, the function of the chewing apparatus has not fully recovered. Conclusion. To assess the restoration of the function of the lower jaw after its fracture, it is necessary to determine not only the degree of mouth opening, but also laterotrusion and protrusion movements. The data obtained by us indicate the need to revise clinical recommendations and develop a set of early rehabilitation measures in this category of patients. In addition, the numerical values of the parameters of the movement of the lower jaw, which were determined during the study, can be a control criterion for comparing the effectiveness and further modernization of rehabilitation techniques that can minimize the consequences of maxillofacial injuries in order to improve the stomatognathic functions of patients. © 2022 Authors. All rights reserved.