The impact of condylar fracture management on facial soft tissue changes and TMJ function: a 3D CBCT evaluation of open vs. closed reduction.

OBJECTIVES

The influence of condylar fracture treatment on facial symmetry and its relationship with mandibular parameters remains relatively unexplored. Understanding the effects of different treatment modalities on skeletal remodeling and temporomandibular joint (TMJ) function is important for improving clinical outcomes. In this study, facial soft tissue-related linear measurements derived from CBCT were evaluated in relation to underlying skeletal changes and TMJ functional outcomes following different management approaches for condylar fractures.

METHODS

A retrospective study was conducted on 60 patients with condylar fractures who underwent plate fixation, screw fixation, or closed reduction. Cone-beam computed tomography was used to assess craniofacial measurements and soft-tissue changes at three-time intervals. Mandibular parameters, facial symmetry indices, and TMJ dysfunction scores were analyzed and compared among the treatment groups.

RESULTS

Treatment modality and follow-up time significantly affected skeletal and soft-tissue outcomes. At 6 months, the tragion-pogonion (T-Pog) distance was 136.64 ± 6.10 mm in the plate group, with mean reductions of 3.58 mm, 4.82 mm, and 4.54 mm in the plate, screw, and closed reduction groups, respectively. The closed reduction group exhibited significantly higher TMJ dysfunction scores. Ramus length was positively correlated with T-Pog distance, whereas mediolateral condylar inclination was negatively associated with facial measurements.

CONCLUSION

Condylar fractures Management significantly influences mandibular dimensions and facial symmetry, particularly following closed reduction. Surgical fixation methods provide greater skeletal stability and improved functional outcomes.

CLINICAL RELEVANCE: Treatment modality plays a key role in facial symmetry and TMJ function, with surgical fixation resulting in better outcomes. Optimal results may depend on precise anatomical reduction supported by advanced surgical techniques.