DOI:

10.37988/1811-153X_2022_4_130

Dynamics of restoration of functional activity of the mandible after fractures and prolonged immobilization

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Authors

  • L.U. Valieva 1, maxillofacial surgeon, postgraduate at the Maxillofacial surgery Department
    ORCID ID: 0000-0002-3990-3843
  • A.S. Pankratov 1, 2, PhD in Medical Sciences, professor of the Maxillofacial surgery Department; professor of the General and surgical dentistry Department
    ORCID ID: 0000-0001-9620-3547
  • S.Yu. Ivanov 1, 3, Russian Academy of Science corresponding member, PhD in Medical Sciences, full professor of the Maxillofacial surgery Department; full professor of the Maxillofacial surgery and surgical dentistry Department
    ORCID ID: 0000-0001-5458-0192
  • A.S. Handzratsyan 4, PhD in Medical Sciences, head of the Maxillofacial surgery ward
    ORCID ID: 0000-0003-3959-2050
  • V.V. Kogay 4, maxillofacial surgeon
    ORCID ID: 0000-0003-1482-808X
  • G.E. Asatryan 4, maxillofacial surgeon
    ORCID ID: 0000-0003-1373-7426
  • 1 Sechenov University, 119991, Moscow, Russia
  • 2 Russian Medical Academy of Continuous Professional Education, 125993, Moscow, Russia
  • 3 RUDN University, 117198, Moscow, Russia
  • 4 Municipal Clinical Hospital no. 36, 105187, Moscow, Russia

Abstract

Fractures of the mandible are accompanied by a prolonged restriction of the volume of its movements, which can lead to the development of persistent functional disorders, which should be taken into account when developing rehabilitation measures in patients with this type of injury. The aim of the study was to conduct a comprehensive quantitative assessment of the restoration of mandibular function during the first month of the rehabilitation period in patients treated for a fracture of the mandible. >. A prospective study of 40 patients with a mandibular fracture, divided into two groups, was conducted, which was treated according to current clinical protocols: group 1 consisted of 22 people who underwent double-jaw splinting during treatment, group 2 consisted of 18 patients who, according to indications, al-so underwent an operation of bone osteosynthesis of the mandible with subsequent interdigital immobilization in the postoperative period. Each group included patients with both unilateral and bilateral lesions. After removal of splints, all patients underwent a comprehensive clinical assessment of the range of movements of the lower jaw in dynamics, during the first month of the rehabilitation period. Results and discussion. In all the studied patients, both pronounced re-striction of mouth opening and mobility of the mandible in the transversal and sagittal planes (lateral and protrusion movements) was noted. In group 2, these changes were more significant, the restoration of functional indicators was slower. Within a month, the function of the chewing apparatus has not fully recovered. >. To assess the restoration of the function of the lower jaw after its fracture, it is necessary to determine not only the degree of mouth opening, but also laterotrusion and protrusion movements. The data obtained by us indicate the need to revise clinical recommendations and develop a set of early rehabilitation measures in this category of patients. In addition, the numerical values of the parameters of the movement of the lower jaw, which were determined during the study, can be a control criterion for comparing the effectiveness and further modernization of rehabilitation techniques that can minimize the consequences of maxillofacial injuries in order to improve the stomatognathic functions of patients.

Key words:

fracture mandible, rehabilitation, mouth-opening limitation, functional disorders

For Citation

[1]
Valieva L.U., Pankratov A.S., Ivanov S.Yu., Handzratsyan A.S., Kogay V.V., Asatryan G.E. Dynamics of restoration of functional activity of the mandible after fractures and prolonged immobilization. Clinical Dentistry (Russia).  2022; 25 (4): 130—136. DOI: 10.37988/1811-153X_2022_4_130

References

  1. Gualtieri M., Pisapia F., Fadda M.T., Priore P., Valentini V. Mandibular fractures epidemiology and treatment plans in the center of Italy: A retrospective study. J Craniofac Surg. 2021; 32 (4): e346-e349. PMID: 33170830
  2. Ghosh R., Gopalkrishnan K. Facial fractures. J Craniofac Surg. 2018; 29 (4): e334-e340. PMID: 29381610
  3. Wang H., Song G., Ren W., Zhou Y., Li C., Ou L., Liu J., Xiang L. Traumatic facial fractures in children and adolescents. J Craniofac Surg. 2018; 29 (7): 1809—1812. PMID: 30234718
  4. Pankratov A.S. The analysis of postoperative complications with the use of modern technologies of osteosynthesis of the lower plate of four-jaw position. Russian Journal of Dentistry. 2016; 5: 237—244 (In Russ). eLIBRARY ID: 27379978
  5. Choi K.Y., Yang J.D., Chung H.Y., Cho B.C. Current concepts in the mandibular condyle fracture management part II: Open reduction versus closed reduction. Arch Plast Surg. 2012; 39 (4): 301—8. PMID: 22872831
  6. Ellis E. 3rd Management of fractures through the angle of the mandible. Oral Maxillofac Surg Clin North Am. 2009; 21 (2): 163—74. PMID: 19348981
  7. Fadeev R.A., Ovsiannikov K.A. Etiology and pathogenesis of diseases of temporomandibular joint and masticatory muscles. Vestnik NovSU. 2020; 4 (120): 50—59 (In Russ). eLIBRARY ID: 44169557
  8. Ellis E. 3rd An algorithm for the treatment of noncondylar mandibular fractures. J Oral Maxillofac Surg. 2014; 72 (5): 939—49. PMID: 24480758
  9. Jensen T., Jensen J., Nørholt S.E., Dahl M., Lenk-Hansen L., Svensson P. Open reduction and rigid internal fixation of mandibular condylar fractures by an intraoral approach: a long-term follow-up study of 15 patients. J Oral Maxillofac Surg. 2006; 64 (12): 1771—9. PMID: 17113444
  10. Silva A.P., Sassi F.C., Andrade C.R. Oral-motor and electromyographic characterization of patients submitted to open a nd closed reductions of mandibular condyle fracture. Codas. 2016; 28 (5): 558—566. PMID: 27812671
  11. Vega L.G. Reoperative mandibular trauma: management of posttraumatic mandibular deformities. Oral Maxillofac Surg Clin North Am. 2011; 23 (1): 47—61, v-vi. PMID: 21272766
  12. Alyahya A., Bin Ahmed A., Nusair Y., Ababtain R., Alhussain A., Alshafei A. Mandibular condylar fracture: a systematic review of systematic reviews and a proposed algorithm for management. Br J Oral Maxillofac Surg. 2020; 58 (6): 625—631. PMID: 32245577
  13. He L., Zhang Z., Xiao E., He Y., Zhang Y. Pathogenesis of traumatic temporomandibular joint ankylosis: a narrative review. J Int Med Res. 2020; 48 (11): 300060520972073. PMID: 33213251
  14. Pankratov A.S. Issues of clinical efficacy of modern technologies in osteosynthesis of the lower jaw. Clinical Dentistry (Russia). 2018; 1 (85): 44—49 (In Russ). eLIBRARY ID: 32759411
  15. Bianchini E.M., Paiva G., de Andrade C.R. Mandibular movement patterns during speech in subjects with temporomandibular disorders and in asymptomatic individuals. Cranio. 2008; 26 (1): 50—8. PMID: 18290525
  16. Asim M.A., Ibrahim M.W., Javed M.U., Zahra R., Qayyum M.U. Functional Outcomes Of Open Versus Closed Treatment Of Unilateral Mandibular Condylar Fractures. J Ayub Med Coll Abbottabad. 2019; 31 (1): 67—71. PMID: 30868787
  17. Krishna Ch.V., Mahendranadh R.K., Gupta N., Mahadev S.Y., Chandra S.N., Aditya V., Reddy G.V. Fabrication of customized sectional impression trays in management of patients with limited mouth opening: a simple and unique approach. Case Rep Dent. 2013; 2013: 275047. PMID: 23984110
  18. Ihara Y., Nakamichi Y., Tashimo Y., Nozue S., Hayashi K., Ishiguro M., Takahashi K. The Device of Ethylene Vinyl Acetate Sheet for Trismus Caused by Bilateral Mandible Fractures. Case Rep Dent. 2021; 2021: 8340485. PMID: 34484840
  19. Palanivel I., Narayanan V., Chandran S., Ramakrishnan K., Gurram P. Open Reduction Internal Fixation of Condylar Head/Diacapitular Fracture of Mandible: Case Series. J Maxillofac Oral Surg. 2021; 20 (3): 404—408. PMID: 34408367
  20. da Silva A.P., Sassi F.C., Bastos E., Alonso N., de Andrade C.R.F. Oral motor and electromyographic characterization of adults with facial fractures: a comparison between different fracture severities. Clinics (Sao Paulo). 2017; 72 (5): 276—283. PMID: 28591339
  21. Borba A.M., Porto A.N., Santini A., dos Santos T.I., Miloro M., Borges A.H., Pedro F.L.M. The effect of facial fractures on mouth opening range: a case series. Revista Sul-Brasileira de Odontologia. 2017; 14 (3): 142—146.
  22. Dos Santos K.W., Rech R.S., Wendland E.M.D.R., Hilgert J.B. Rehabilitation strategies in maxillofacial trauma: systematic review and meta-analysis. Oral Maxillofac Surg. 2020; 24 (1): 1—10. PMID: 31802332
  23. Celić R., Jerolimov V., Knezović Zlatarić D., Klaić B. Measurement of mandibular movements in patients with temporomandibular disorders and in asymptomatic subjects. Coll Antropol. 2003; 27 Suppl 2: 43—9. PMID: 12971170
  24. Schneider M., Erasmus F., Gerlach K.L., Kuhlisch E., Loukota R.A., Rasse M., Schubert J., Terheyden H., Eckelt U. Open reduction and internal fixation versus closed treatment and mandibulomaxillary fixation of fractures of the mandibular condylar process: a randomized, prospective, multicenter study with special evaluation of fracture level. J Oral Maxillofac Surg. 2008; 66 (12): 2537—44. PMID: 19022134
  25. Pankratov A.S., Ivanov S.Yu. Questions of the use of treatment protocols in the provision of medical care to patients with mandibular fractures. Clinical Dentistry (Russia). 2021; 3: 85—90 (In Russ). eLIBRARY ID: 46657560

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Received

September 8, 2022

Accepted

September 22, 2022

Published on

December 21, 2022