TY - JOUR
T1 - Load distribution after unilateral condylar fracture with shortening of the ramus
T2 - a finite element model study
AU - Helmer, Loreine M. L.
AU - Klop, Cornelis
AU - Lobbezoo, Frank
AU - de Lange, Jan
AU - Koolstra, Jan Harm
AU - Dubois, Leander
N1 - Funding Information: This work was supported by the Strassbourg Osteosynthesis Research Group, Tuttlingen Germany (grant number AOCMFS-19-05H). The organization had no involvement in the study design, collection and interpretation of data, writing of the manuscript, and/or decision to submit the manuscript for publication. Publisher Copyright: © 2023, The Author(s).
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Objectives: After a fracture of the condyle, the fractured ramus is often shortened, which causes premature dental contact on the fractured side and a contralateral open bite. The imbalance could change the load in the temporomandibular joints (TMJs). This change could lead to remodelling of the TMJs to compensate for the imbalance in the masticatory system. The load in the non-fractured condyle is expected to increase, and the load in the fractured condyle to decrease. Materials and methods: These changes cannot be measured in a clinical situation. Therefore a finite element model (FEM) of the masticatory system was used. In the FEM a fractured right condyle with shortening of the ramus was induced, which varied from 2 to 16 mm. Results: Results show that, with a larger shortening of the ramus, the load in the fractured condyle decreases and the load in the non-fractured condyle increases. In the fractured condyle during closed mouth a major descent in load, hence a cut-off point, was visible between a shortening of 6 mm and 8 mm. Conclusions: In conclusion, the change of load could be associated with remodelling on both condyles due to shortening of the ramus. Clinical relevance: The cut-off point implies that shortening over 6 mm could present more difficulty for the body to compensate.
AB - Objectives: After a fracture of the condyle, the fractured ramus is often shortened, which causes premature dental contact on the fractured side and a contralateral open bite. The imbalance could change the load in the temporomandibular joints (TMJs). This change could lead to remodelling of the TMJs to compensate for the imbalance in the masticatory system. The load in the non-fractured condyle is expected to increase, and the load in the fractured condyle to decrease. Materials and methods: These changes cannot be measured in a clinical situation. Therefore a finite element model (FEM) of the masticatory system was used. In the FEM a fractured right condyle with shortening of the ramus was induced, which varied from 2 to 16 mm. Results: Results show that, with a larger shortening of the ramus, the load in the fractured condyle decreases and the load in the non-fractured condyle increases. In the fractured condyle during closed mouth a major descent in load, hence a cut-off point, was visible between a shortening of 6 mm and 8 mm. Conclusions: In conclusion, the change of load could be associated with remodelling on both condyles due to shortening of the ramus. Clinical relevance: The cut-off point implies that shortening over 6 mm could present more difficulty for the body to compensate.
KW - Condylar fracture
KW - Conservative treatment
KW - Finite element model
KW - Load
KW - Resorption
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U2 - https://doi.org/10.1186/s13005-023-00370-5
DO - https://doi.org/10.1186/s13005-023-00370-5
M3 - Article
C2 - 37422658
SN - 1746-160X
VL - 19
SP - 1
EP - 11
JO - Head & Face Medicine
JF - Head & Face Medicine
IS - 1
M1 - 27
ER -