ABSTRACT
O côndilo mandibular apresenta-se como um dos locais mais comumente acometidos nas fraturas mandibulares, sendo, na maioria das vezes, decorrente de um trauma na região de sínfise ou de para-sínfise mandibular. A ptar pelo tratamento cirúrgico ou conservador é motivo de controvérsias, principalmente devido às diversas complicações pós-tratamento relatadas na literatura. Uma das principais indicações para a redução cirúrgica consiste na impossibilidade de estabelecer uma satisfatória oclusão dentária pelo tratamento conservador, geralmente associado às fraturas bilaterais. O sucesso do tratamento está relacionado a uma aderência cuidadosa nos princípios cirúrgicos e fisiológicos e em um acompanhamento pós-operatório rigoroso, aumentando a capacidade funcional a longo prazo e possibilitando uma menor incidência de complicações. Este trabalho objetiva relatar um caso clínico de redução cirúrgica de fratura bilateral de côndilo associada à fratura de corpo mandibular, enfocando, principalmente, os aspectos relacionados às indicações e complicações desse tipo de tratamento.
The mandibular condyle is presented as one of the most commonly sites involved in jaw fractures, most often due to trauma in the region of the mandibular symphysis. The choice of surgical or conservative treatment is a highly controversial issue, mainly due to the various post-treatment complications reported in the literature. One of the main indications for surgical reduction is the inability to establish a satisfactory dental occlusion by conservative treatment, usually associated with bilateral fractures. Successful treatment is related to a careful adherence to surgical and physiological principles with a rigid follow up, increasing the long-term functional capacity and allowing a lower incidence of complications. This study reports a case of surgical reduction of bilateral condyle fracture associated with fracture of the mandibular body, focusing on aspects related with indications and complications of this treatment.
ABSTRACT
Objective: To study the role of activating transcription factor 2 (ATF-2) in the growth of mandibular condyle cartilage. Methods: Primary chondrocytes of condyle were cultured. Expression plasmid of ATF-2 and plasmid bcl-2 promoter were transfected into chondrocytes. Luciferase assay and Western blot were used. Results: The absence of ATF-2 in mandibular condyle chondrocytes resulted in a decline in bcl-2 promoter activity, reduction in bcl-2 protein level. Conclusion: The results strongly imply that ATF-2 is required for adequate bcl-2 expression, and play a significant role in controlling growth plate chondrocyte progression.
ABSTRACT
Mandible fractures are common in maxillofacial trauma, and condyle fracture accounts for about 25% to 35% of all mandibular fractures. Malocclusion, deviation of the mandible, temporomandibular joint dysfunction and ankylosis may result in sequelae of condylar fractures. Over the years, there has been a continuous dispute over conservative versus open surgical treatment of mandibular condylar fractures. Surgeons who prefer closed treatment cite the reduced morbidity, while surgeons who prefer surgical treatment cite minimal sequelae. From 2000 to 2003, the authors performed open reduction on 10 patients with mandible condyle fractures. Immediate relief from malocclusion and correction of mandibular midline shifting were seen in all the patients. Late temporomandibular dysfunction, ankyloses were not seen. In patients who present symptoms preoperatively, benefits of open surgery can be determined to far outweigh the morbidity in the experienced hands.