Temporomandibular joint replacement as a method of treatment mandibular fractures; [Эндопротезирование височно-нижнечелюстного сустава как метод лечения переломов нижней челюсти]

The aim of the study was to improve the effectiveness of treatment of patients with fracture of the mandibular condyle. Materials and methods. The study involved 24 patients from 18 to 65 years old with a fracture of the mandibular condyle at the level of the head and neck with medial displacement (S02.62). The patients were divided into 2 groups: in group I 14 patients underwent classical open repositioning of bone fragments with subsequent metal osteosynthesis, 10 patients of group II underwent endoprosthesis of temporomandibular joint (TMJ) according to our own method. In both groups a combined surgical access —intraoral and transtragal access —was performed. Results. During the first month after the operation the patients of group II had a steady increase of the mouth opening value in comparison with the patients of group I — 35.4±0.7 and 23.4±2.6 mm, respectively. The intensity of pain syndrome according to VAS decreased to 1.1±0.7 points in group I and to 0.5±0.5 points in group II. The deviation of the mandible was preserved in 70% of patients in group I and was absent in group II. Neurological deficit of the facial nerve branches, transient paresis, was observed in 38% of cases: in 43% of group I patients and in 30% of group II patients. Conclusion. In mandibular condyle fractures the method of choice for surgical treatment can be considered total TMJ endoprosthesis with individual constructions on the basis of preliminary three-dimensional planning and prototyping. This approach helps to reduce the risks of postoperative complications both in the early and late postoperative period. © 2024 Clinical Dentistry LLC. All rights reserved.