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Accurate Treatment of Condylar Fracture Assisted by Three-Dimensional Prototype and Bioresorbable Plates

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons(2021)

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摘要
Purpose: Although open treatments of condylar fracture have become the conventional treatment option, the accuracy is often not guaranteed. The purpose of this study was to improve the accuracy of fracture reduction assisted by three-dimensional (3D) prototype and bioresorbable plates in the treatment of condylar fractures. Methods: This was a prospective cohort study. Patients with condylar fractures were treated by surgery from October 2017 to November 2019 at School of Stomatology of China Medical University (Shenyang, China). The patients in the experimental group were treated with 3D-prototype and fixed with absorbable plates. Patients in the control group were treated routinely reduction and fixed with absorbable plates. Primary predictor variables were surgical treatment. Primary outcome was accurate reduction. Secondary outcomes were postoperative efficacy including maximum mouth opening, occlusal status, lateral excursion movements, and patient satisfaction. Other variables of interest included age, sex, type of patients. Continuous variables are reported as mean +/- standard deviation. chi(2) test and t test were used for analysis. Results: The sample was composed of 48 patients (65 sides) who were treated surgically (25 men, 23 women; mean age, 39.50 year; range, 17 to 65 year) ; 27 patients (38 sides) were treated with the 3D-prototype approach and 21 patients (27 sides) were treated with the traditional approach. All 48 patients completed reduction and fixation of fractures. Preoperative and postoperative CT comparisons showed that 4 patients did not achieve accurate reduction, all in the control group, of which 3 patients had occlusal disorder. All patients in the experimental group achieved accurate reduction, of which 1 patient had occlusal disorder. Conclusion: Our results suggest that using 3D prototype for bending the bioresorbable plate is an effective method for accurate treatment of condylar fracture. (C) 2021 Published by Elsevier Inc. on behalf of The American Association of Oral and Maxillofacial Surgeons.
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