Fractures of the mandibular condyle: treatment and outcome

In this PhD-thesis, the treatment of fractures of the mandibular condyle, the part of the lower jaw that lies near the temporomandibular joint, is analysed. The treatment of these fractures can often be done without surgery. In this so-called closed treatment, the fracture heals according to the patient's occlusion.In this study it was shown, in groups of more than 100 patients, that jaw functioning (e.g. chewing and speaking) and mouth opening generally recover well with closed treatment. This recovery can take up to one year. In some patients, for example the elderly, or patients with bilateral fractures, the recovery is less favourable.Sometimes an operative treatment is chosen, in which the mandibular condyle is surgically repositioned and fixed in the right position. Based on the best available evidence from the literature, this PhD-thesis proposes a guideline in which situations it is best to choose a closed or an operative treatment for mandibular condylar fractures.To further investigate the reasons for differences in treatment choices, patient populations were compared from two different regions: Groningen and Dresden. The treatment in Groningen was mainly closed and in Dresden both closed and operative. These differences appeared to be due to differences in the patient population, but also in the health care system and the radiographs used.If the mandibular condyle is even more damaged, it is possible to place a temporomandibular joint prosthesis. A systematic literature review showed that a temporomandibular joint prosthesis was rarely placed after a fracture of the mandibular condyle.