Treatment of condylar fractures in children and youths: the clinical value of the occlusal plane orientation and correlation with facial development (case reports)

Abstract

The relative position of the plane of occlusion to the cranial base determines the direction of the forces generated in the cranium during occlusal function. When the plane of occlusion is level and when the neuromuscular system is in harmony, the vectors of forces created by the closing muscles are directed to the central area of the cranium in a symmetrically balanced way. Unfortunately,TMJ fractures may alter completely this balance with loss of the support to the mandible against the temporal component and loss of the functional effect of the lateral pterygoid muscle on the mandible. Changes in orientation of the occlusal plane may result in facial alteration and asymmetries. In our experience, the restoration of a plan of occlusion orthogonally aligned to the forces of occlusion for a correct transfer of forces through the maxilla to the rest of the cranial bones is essential to allow proper face development. Two, quite similar cases of unilateral, dislocated condylar fracture treated in a different way, will be reported to demonstrate how this can occur. Available clinical data will be illustrated.