3D examination of physical and volumetric changes of the condyle after fixation in mandibular fractures

Purpose: To examine the changes in condyle volume, position, symmetry and joint space before and after treating parasymphysis and angulus fractures in the mandible. Materials and Methods: 16 patients (11 men and 5 women) who had isolated parasymphysis fractures (8 patients) or accompanying angulus fractures (8 patients) in the mandible without maxillofacial or congenital deformities and who underwent surgical treatment were included in this study. Cone beam computed tomography (CBCT) records were taken from the patients before surgery and at least 6 months after surgery (6-83 months). DICOM images of CBCT recordings were evaluated three-dimensionally using Materialize Mimics 25.0.0.550 software. Statistical analysis was performed using the parameters Shapiro-Wilk, Wilcoxon, t-test and Mann-Whitney U. Results: After surgery, significant changes were found in the condyle in groups with parasymphyseal and angulus fractures. When all patients were evaluated, a statistically significant difference was found in the increase in the most condyle volume and right condyle height. Compared to angulus fractures, a more significant increase in condyle volume occurred in parasymphysis fractures. A statistically significant increase in condylar height was found in the right condyle in parasymphyseal fractures, but other condylar changes were found to be statistically insignificant. In angle fractures, there was an increase in the right sagittal condylar position and the left sagittal condylar angle, and a statistically significant difference was found. In these measurements, there was a decrease in parasymphysis fractures and the increase in angulus fractures was found to be statistically significant compared to the reduction of parasymphysis fractures. When looking at the differences between genders, there was a decrease in the axial condylar position of the left condyle in women. In contrast, an increase in men's left axial condylar position was statistically significant. Conclusion: In this study, it has been shown that there are physical and volumetric 3D changes in the condyle in mandibles exposed to trauma and fracture. While remodelling in the fracture area is a natural process in trauma patients, It can be said that remodelling occurs in condyles without fractures and develops the ability to adapt to their new position and size in the postoperative period.