Clinician-Recorded Temporomandibular Disorder at 12 Months After Digitally Planned Mandibular Fracture Repair: Associations with Condylar Injury and Early Functional Signs.

Background/

Objectives

Functional outcomes after digitally planned mandibular fracture repair remain incompletely characterized. This study estimated the 12-month frequency of clinician-recorded temporomandibular disorder (TMD) and examined its associations with condylar injury and clinical findings documented at 3 months.

Methods

This single-center retrospective cohort included patients treated between September 2021 and June 2023. Of 139 patients eligible after criterion review, 18 (12.9%) lacked an observed 12-month outcome and 121 were analyzed. The endpoint was the treating-team clinical diagnosis after structured symptom review and examination; preserved records did not support full Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I decision rules, subtype assignment, or Axis II instruments. Associations with condylar involvement were estimated using modified-Poisson regression with robust variance; the adjusted model included age, sex, and displacement grade. Associations with 3-month findings were exploratory and multiplicity-controlled.

Results

Thirty-three of 121 patients had clinician-recorded TMD at 12 months (27.3%; 95% confidence interval [CI], 20.1-35.8%). TMD occurred in 27 of 47 patients with condylar involvement (57.4%) and 6 of 74 without it (8.1%; risk ratio [RR], 7.09; 95% CI, 3.17-15.86). The adjusted RR was 6.87 (95% CI, 3.06-15.41), with similar results when displacement grade was categorical. Malocclusion, TMJ clicking, TMJ pain, abnormal opening pattern, limited mouth opening, and unilateral chewing at 3 months remained associated after correction (all q ≤ 0.003).

Conclusions

Clinician-recorded TMD was concentrated among patients with condylar injury. Associations with early functional abnormalities may reflect persistence or recurrence because several findings overlap with the later endpoint. These data support closer functional surveillance but do not establish causality, independent prediction, or the comparative effectiveness of digital planning.