Fractures Clinical Trial
Official title:
Management of Paediatric Mandibular Condylar Fractures Simply With a Mandibular Manipulation Technique and Mouth Opening Training
This study aim to evaluate the clinical and radiographic outcomes of mandibular condylar fractures in pediatrics treated simply with a mandibular manipulation technique accompanied by mouth opening training.
There is a consensus on nonsurgical approach is a priority for paediatric condylar
fractures, but a recognized nonsurgical method for treating children with condylar fractures
is still a highly debated theme. The purpose of this study is to investigate the effect of a
new nonsurgical method simply using a mandibular manipulation technique and mouth opening
training in managing children with condylar fractures.
Spiral computed tomography (CT) or Cone beam computed tomography (CBCT) will be taken before
treatment when the patients present to the department. Condylar fracture classification is
defined according to SPIESSL & SCHROLL.
These patients are then treated termly with a mandibular manipulation technique reported by
Farrar, which is an effective treatment method to reset the physiological positional
relationship between condyle and disc. Neither intermaxillary fixation nor guiding elastics
will be used after hand manipulation. Then patients are told to persist in mouth opening
training at home everyday. The mouth opening training is performed as follow: patients are
told to try to close his mouth in intercuspal position at first, then open their mouth as
wide as possible(the reference maximal mouth opening is as wide as the mouth opening after
treatment in last time), then closed back to the intercuspal position again. Patients are
recommended to follow up at every week at first two months, then every 2 weeks at third
months, 6th months, 1 year after first treatment, then yearly afterward. The mandibular
manipulation is performed at every follow-up. Meanwhile, the maximal mouth opening (MMO) is
recorded before and after hand manipulation treatment. So do the occlusion status, deviation
during opening, as well as subjective symptoms of temporomandibular joints. At first moth,
3rd month, 6th month, 1 year, then every year after first treatment, CBCT is performed.
;
Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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