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Mandibular growth and remodelling processes after condylar fracture: A longitudinal roentgencephalometric study
102
Reviews Mandibular A longitudinal Kai
md
Am.
abstracts
Growth and Remodelling Roentgencephalometric
Processes Study
After
Condylar
J. Orthod. JUll/ 19i7
Fracture:
Lund
Acta Odontol. Scud.
32: Szlpp.
64, 1974
In twenty-seven patients the fracture was unilateral; in eleven it was bilateral. Radiographically, the fractures were classified according to the level of the fracture in the condylar process (the condyle) and from the position of the condylar fragment in relation to the articular fossa. Thus, a differentiation was made between high fractures involving the condylar head of the ramus and low fractures through the base of the condylar process and type 1 fractures with the condylar head in contact with the articular fossa in contrast to type 2 fractures with the condylar head situated outside the fossa. Out of a total of forty-nine fractures, twenty-seven were high and twenty-two were low; twenty-one fractures belonged to type 1 and twenty-eight to type 2. In high fractures type 2 was dominating, and in low fractures type 1 dominated. The remodeling consisted of a combination of appositional and resorptive processes, which set in coincident with the bony healing but continued for varying times after the consolidation had taken place. This was most clearly seen in type 2 fractures, which revealed resorption of the little fragment and outgrowth of a condylelike process on the previous fracture site. In patients with incomplete remodeling, a more or less defective resorption of the little fragment was demonstrated, which in case of a marked appositional growth resulted in the typical y-shaped condyle. The time that lapsed from the time of injury until complete remodeling was found to be highly variable, and it was not possible to demonstrate any dependence on sex, maturation stage, fracture type, or height. This study has revealed that following condylar fractures in the growth period, especially when they occur around puberty, a compensatory growth on the fracture side takes place. In some cases, this results in the fracture side becoming longer than the nonfractured side, eventually with the development of an asymmetry to this side in relation to the upper face midline. Furthermore, in most cases a normal condyle is re-formed, assuming that the fracture occurs at a time when the growth is not drawing to a close. Plastic
Models
Medical
News.
Help
in “Designing”
6. A. M. A. 235:
134,
Faces
Jan. l&l976
Spiro J. Chaconas, professor and chairman of orthodontics, and co-workers at the UCLA School of Dentistry developed a set of multiple regression equations that predict a 16-year-old’s soft-tissue facial profile from the profile at the age of 10 ; twelve different “landmarks” are involved. If the predicted profile varies too much from “normal,” the lo-year-old child wears orthopedic appliances for a few years to alter the direction of facial bone growth and possibly avoid corrective surgery. Some of the landmarks at the age of 10 years were found not to be their own best predictors for the age of 16. For example, labrale inferius (the most an-
Reviews Mandibular A longitudinal Kai
md
Am.
abstracts
Growth and Remodelling Roentgencephalometric
Processes Study
After
Condylar
J. Orthod. JUll/ 19i7
Fracture:
Lund
Acta Odontol. Scud.
32: Szlpp.
64, 1974
In twenty-seven patients the fracture was unilateral; in eleven it was bilateral. Radiographically, the fractures were classified according to the level of the fracture in the condylar process (the condyle) and from the position of the condylar fragment in relation to the articular fossa. Thus, a differentiation was made between high fractures involving the condylar head of the ramus and low fractures through the base of the condylar process and type 1 fractures with the condylar head in contact with the articular fossa in contrast to type 2 fractures with the condylar head situated outside the fossa. Out of a total of forty-nine fractures, twenty-seven were high and twenty-two were low; twenty-one fractures belonged to type 1 and twenty-eight to type 2. In high fractures type 2 was dominating, and in low fractures type 1 dominated. The remodeling consisted of a combination of appositional and resorptive processes, which set in coincident with the bony healing but continued for varying times after the consolidation had taken place. This was most clearly seen in type 2 fractures, which revealed resorption of the little fragment and outgrowth of a condylelike process on the previous fracture site. In patients with incomplete remodeling, a more or less defective resorption of the little fragment was demonstrated, which in case of a marked appositional growth resulted in the typical y-shaped condyle. The time that lapsed from the time of injury until complete remodeling was found to be highly variable, and it was not possible to demonstrate any dependence on sex, maturation stage, fracture type, or height. This study has revealed that following condylar fractures in the growth period, especially when they occur around puberty, a compensatory growth on the fracture side takes place. In some cases, this results in the fracture side becoming longer than the nonfractured side, eventually with the development of an asymmetry to this side in relation to the upper face midline. Furthermore, in most cases a normal condyle is re-formed, assuming that the fracture occurs at a time when the growth is not drawing to a close. Plastic
Models
Medical
News.
Help
in “Designing”
6. A. M. A. 235:
134,
Faces
Jan. l&l976
Spiro J. Chaconas, professor and chairman of orthodontics, and co-workers at the UCLA School of Dentistry developed a set of multiple regression equations that predict a 16-year-old’s soft-tissue facial profile from the profile at the age of 10 ; twelve different “landmarks” are involved. If the predicted profile varies too much from “normal,” the lo-year-old child wears orthopedic appliances for a few years to alter the direction of facial bone growth and possibly avoid corrective surgery. Some of the landmarks at the age of 10 years were found not to be their own best predictors for the age of 16. For example, labrale inferius (the most an-