Avaliação fisiopatológica de indivíduos afetados com fratura condilar: revisão sistemática com metanálise, análise epidemiológica, clínica e tomográfica

Abstract

Mandibular injuries are the most common facial trauma with prevalence between 26% to 57% involving the condylar region. The etiology is associated with external factors such as traffic accidents, physical aggressions, sports activities, falls and industrial accidents. Therapeutic approaches are performed in an open (surgical) or closed (conservative) manner. However, due to the anatomical complexity of the region, there are complications inherent to treatments such as the presence of temporomandibular disorder (TMD), occlusal changes, pain, ankylosis, condylar deformities, mandibular deviation and injuries of the facial nerve. In view of the high prevalence of condylar fractures and the importance of functional restoration, the general objective of this paper was to evaluate, through clinical studies and systematic review, the parameters that determine the longevity and predictability of therapies adopted in affected individuals with condylar fracture. This study involved three specific objectives. Specific objective 1: to evaluate the mandibular and joint dynamics and the presence of complications associated with surgical and nonsurgical treatment of condylar fractures. Specific objective 2: to retrospectively analyze the epidemiological characteristics such as prevalence, type and treatment modalities of mandibular condylar fractures in two different centers. Specific objective 3: to assess the effect of open reduction internal fixation (ORIF) or maxillomandibular fixation (MMF) on function jaw and components of temporomandibular joint. The methods used were literature review with meta-analysis, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA Checklist). Subsequently, multicenter epidemiological survey. And finally, application of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC / TMD) and tomographic examination to associate the presence of the disorder temporomandibular and proposed treatment. In view of the analyzes, it is concluded that the fractures were prevalent in the male gender, in the age group between 21-30 years. The main etiological factor is traffic accidents. Both therapies showed predictability and longevity. The main parameters for analyzing these factors are mandibular movements and the presence of comorbidities. The results were satisfactory for long-term mandibular mobility. However, complications such as malocclusion, pain and mandibular deviation were observed with prevalence in closed treatment.