J Korean Assoc Oral Maxillofac Surg 2017; 43(5): 331~335
Protrusive maxillomandibular fixation for intracapsular condylar fracture: a report of two cases
Yeong Kon Jeong, Won-Jong Park, Il Kyung Park, Gi Tae Kim, Eun Joo Choi
Department of Oral and Maxillofacial Surgery and Dental Research Institute, College of Dentistry, Wonkwang University, Iksan, Korea
Eun Joo Choi
Department of Oral and Maxillofacial Surgery and Dental Research Institute, College of Dentistry, Wonkwang University, 460 Iksan-daero, Iksan 54538, Korea
TEL: +82-63-850-6931 FAX: +82-63-857-4002
E-mail: cejoms@wku.ac.kr
ORCID: http://orcid.org/0000-0002-6981-8439
Received May 21, 2017; Revised July 14, 2017; Accepted July 31, 2017.; Published online October 31, 2017.
© Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Clinical limitations following closed reduction of an intracapsular condylar fracture include a decrease in maximum mouth opening, reduced range of mandibular movements such as protrusion/lateral excursion, and reduced occlusal stability. Anteromedial and inferior displacement of the medial condyle fragment by traction of the lateral pterygoid muscle can induce bone overgrowth due to distraction osteogenesis between the medial and lateral condylar fragments, causing structural changes in the condyle. In addition, when conventional maxillomandibular fixation (MMF) is performed, persistent interdental contact sustains masticatory muscle hyperactivity, leading to a decreased vertical dimension and premature contact of the posterior teeth. To resolve the functional problems of conventional closed reduction, we designed a novel method for closed reduction through protrusive MMF for two weeks. Two patients diagnosed with intracapsular condylar fracture had favorable occlusion after protrusive MMF without premature contact of the posterior teeth. This particular method has two main advantages. First, in the protrusive position, the lateral condylar fragment is moved in the anterior-inferior direction closer to the medial fragment, minimizing bone formation between the two fragments and preventing structural changes. Second, in the protrusive position, posterior disclusion occurs, preventing masticatory muscle hyperactivity and the subsequent gradual decrease in ramus height.
Keywords: Mandibular condyleclosed fracture reduction, Maxillomandibular fixations


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