{"title":"Long-Term Outcomes of Surgical Management in Adult Mandibular Condyle Head Fractures with Various Osteosynthesis Materials: A Systematic Review.","authors":"Ragavi Alagarsamy, Babu Lal, Anish Poorna T, Aditya Dhanasekaran, Anshul J Rai, Jitendra Kumar, Savita Arora","doi":"10.1007/s12663-025-02482-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Surgical treatment of adult mandibular condylar head fractures (CHFs) is increasingly prevalent. This systematic review aims to synthesize data on long-term clinical and radiological outcomes and complications associated with various osteosynthesis materials used for CHFs.</p><p><strong>Methods: </strong>A comprehensive literature search adhering to PRISMA guidelines was conducted across four databases between 1980 and 2024. All published studies evaluating clinical and radiographic outcomes and complications in adults undergoing open reduction and internal fixation with/without disc intervention for condylar head fractures were included. Clinical outcomes such as malocclusion, mouth opening, lateral excursion, protrusion, and TMJ pain, along with radiographic outcomes including condylar remodelling and ramal height restoration, were recorded. Joanna Briggs Institute checklist for critical appraisal and ROBVIS tool generic data set were used to assess the risk of bias. Descriptive statistics were applied to obtain the results.</p><p><strong>Results: </strong>Twenty-nine studies were included. The review encompassed 848 patients (males = 364; females = 167; and gender not mentioned = 317) and 1087 sites, including 239 bilateral cases. Various osteosynthesis materials included titanium screws (<i>N</i> = 10), microplates with screws (<i>N</i> = 3), miniplates with screws (<i>N</i> = 3), resorbable screws (<i>N</i> = 2), and miscellaneous (<i>N</i> = 11). Disc repositioning was addressed in 19 studies. The risk of bias in most studies was low.</p><p><strong>Conclusion: </strong>Titanium screws were the most frequently used osteosynthesis material and demonstrated superior outcomes. Disc repositioning should be considered during open condylar fracture management. Future randomized controlled trials are imperative to determine the optimal choice among different osteosynthesis materials and soft tissue procedures.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12663-025-02482-8.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"24 5","pages":"1213-1228"},"PeriodicalIF":0.6000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496312/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Maxillofacial & Oral Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12663-025-02482-8","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/16 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Surgical treatment of adult mandibular condylar head fractures (CHFs) is increasingly prevalent. This systematic review aims to synthesize data on long-term clinical and radiological outcomes and complications associated with various osteosynthesis materials used for CHFs.
Methods: A comprehensive literature search adhering to PRISMA guidelines was conducted across four databases between 1980 and 2024. All published studies evaluating clinical and radiographic outcomes and complications in adults undergoing open reduction and internal fixation with/without disc intervention for condylar head fractures were included. Clinical outcomes such as malocclusion, mouth opening, lateral excursion, protrusion, and TMJ pain, along with radiographic outcomes including condylar remodelling and ramal height restoration, were recorded. Joanna Briggs Institute checklist for critical appraisal and ROBVIS tool generic data set were used to assess the risk of bias. Descriptive statistics were applied to obtain the results.
Results: Twenty-nine studies were included. The review encompassed 848 patients (males = 364; females = 167; and gender not mentioned = 317) and 1087 sites, including 239 bilateral cases. Various osteosynthesis materials included titanium screws (N = 10), microplates with screws (N = 3), miniplates with screws (N = 3), resorbable screws (N = 2), and miscellaneous (N = 11). Disc repositioning was addressed in 19 studies. The risk of bias in most studies was low.
Conclusion: Titanium screws were the most frequently used osteosynthesis material and demonstrated superior outcomes. Disc repositioning should be considered during open condylar fracture management. Future randomized controlled trials are imperative to determine the optimal choice among different osteosynthesis materials and soft tissue procedures.
Supplementary information: The online version contains supplementary material available at 10.1007/s12663-025-02482-8.
期刊介绍:
This journal offers comprehensive coverage of new techniques, important developments and innovative ideas in Oral and Maxillofacial Surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments, diagnostic equipment’s and modern therapeutic drugs and devices. Journal of Oral and Maxillofacial Surgery is recommended for first or priority subscription by the Dental Section of the Medical Library Association. Specific topics covered recently have included: ? distraction osteogenesis ? synthetic bone substitutes ? fibroblast growth factors ? fetal wound healing ? skull base surgery ? computer-assisted surgery ? vascularized bone grafts Benefits to authorsWe also provide many author benefits, such as free PDFs, a liberal copyright policy, special discounts on Elsevier publications and much more. Please click here for more information on our author services.