PMC6752114_01
Maxillofacial computed tomographic scan, coronal cut, shows a displaced intracapsular left condylar fracture.
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PMC6752114_01_eplasty19ic16_fig1.jpg
F1
Computed tomography (CT) identified a displaced intracapsular left-sided mandibular condylar fracture (Fig 1), and conservative treatment was attempted.
Preoperative intraoral physical examination shows significant malocclusion and chin deviation to the left on mouth opening.
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PMC6752114_01_eplasty19ic16_fig2.jpg
F2
After 1 week, the patient developed malocclusion and chin deviation (5 mm) (Fig 2) and subsequently was started on a 3-phase protocol utilizing elastic therapy.
Maxillomandibular fixation with dynamic elastic therapy; fixating elastics; class I elastics on the right and class II elastics on the left.
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PMC6752114_01_eplasty19ic16_fig3.jpg
F3
II ipsilateral to injury, class I contralaterally) (figure-of-eight configuration) (Fig 3). In phase II, 6-oz 1/4-inch "guiding elastics" were placed (class II ipsilaterally, class I contralaterally) (non-figure-of-eight configuration). In phase III, 6-oz 1/4-inch "supportive elastics" were placed (class I bilaterally) (non-figure-of-eight configuration).
Left image illustrates preoperative malocclusion; right image illustrates midline congruency after completion of dynamic elastic therapy.
eplasty19ic16_fig4.jpg
PMC6752114_01_eplasty19ic16_fig4.jpg
F4
At conclusion of therapy, centric occlusion with congruency of dental and facial midlines (0-mm deviation) was achieved (Fig 4).