Long-Term Outcomes of Surgical Management in Adult Mandibular Condyle Head Fractures with Various Osteosynthesis Materials: A Systematic Review.

IF 0.6 Q4 DENTISTRY, ORAL SURGERY & MEDICINE
Journal of Maxillofacial & Oral Surgery Pub Date : 2025-10-01 Epub Date: 2025-02-16 DOI:10.1007/s12663-025-02482-8
Ragavi Alagarsamy, Babu Lal, Anish Poorna T, Aditya Dhanasekaran, Anshul J Rai, Jitendra Kumar, Savita Arora
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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.

不同骨合成材料治疗成人下颌髁头骨折的远期疗效:系统综述。
目的:成人下颌髁头骨折(CHFs)的手术治疗越来越普遍。本系统综述旨在综合各种骨合成材料用于治疗CHFs的长期临床和放射学结果及并发症的数据。方法:根据PRISMA指南对1980 - 2024年间的4个数据库进行全面的文献检索。所有已发表的评估成人髁突头骨折行切开复位和内固定伴/不伴椎间盘干预的临床和影像学结果及并发症的研究均被纳入。记录临床结果,如错牙合、开口、外侧偏移、突出和TMJ疼痛,以及影像学结果,包括髁重构和颧部高度恢复。采用乔安娜布里格斯研究所关键评估清单和ROBVIS工具通用数据集来评估偏倚风险。采用描述性统计方法得到结果。结果:纳入29项研究。该综述包括848例患者(男性= 364,女性= 167,性别未提及= 317)和1087个部位,包括239例双侧病例。各种植骨材料包括钛螺钉(N = 10)、带螺钉的微孔钢板(N = 3)、带螺钉的微型钢板(N = 3)、可吸收螺钉(N = 2)和杂项螺钉(N = 11)。19项研究涉及椎间盘复位。大多数研究的偏倚风险很低。结论:钛螺钉是最常用的植骨材料,效果良好。在开放性髁突骨折治疗中应考虑椎间盘复位。未来的随机对照试验是必要的,以确定不同的骨合成材料和软组织手术的最佳选择。补充资料:在线版本包含补充资料,下载地址:10.1007/s12663-025-02482-8。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Maxillofacial & Oral Surgery
Journal of Maxillofacial & Oral Surgery DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
1.90
自引率
0.00%
发文量
138
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.
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