Conservative Management of Pediatric Mandibular Condylar Fractures: A Systematic Review.

Mandibular condylar fractures are common mandibular injuries in children. Conservative treatment is generally favored because of the remodeling capacity of the growing condyle, although rehabilitation protocols and the criteria for operative treatment remain variable. This systematic review synthesized current evidence on the clinical and radiographic outcomes of conservative management of pediatric mandibular condylar fractures. The review was conducted according to PRISMA 2020 and included original clinical studies published between 2016 and 2026. Ten studies met the predefined eligibility criteria. Conservative treatment was generally associated with favorable recovery of mandibular function, satisfactory occlusal stability, and progressive condylar remodeling, although residual radiographic alterations were common. Younger age was associated with greater remodeling potential. Because most included studies were retrospective and heterogeneous in fracture classification, treatment protocols, outcome definitions, imaging, and follow-up, no single conservative protocol could be identified as superior. Conservative functional management is an appropriate first-line option for many pediatric condylar fractures, but treatment must be individualized. Functional status and its evolution-including pain, mouth opening, mandibular excursions, mastication, occlusal stability, and facial symmetry-should be considered together with age, fracture characteristics, associated injuries, and remodeling potential when deciding between continued conservative care and surgery.