functional conservative treatment of condylar fracture in children with FKO-type splint: report of two cases and a review of the literature *
Due to the fact that pediatric condyles have a greater ability to remodel the structural changes introduced by a fracture, pediatric condylar fractures have been managed with conservative treatments. Follow-up studies of condylar fractures in children have revealed the finding of mandibular asymmetry and ankylosis of the temporomandibular joint in some cases. Two cases of 7-year-old girls with condylar fractures, presenting class Ⅴ or class Ⅵ fractures according to Spiessl & Schroll classification, were treated in a nonsurgical-functional way using a FKO-type splint for a period of four to six months. This splint is a one piece exercise device characterized by a habitual bite with a 2 mm opening between the incisal edge and is worn for at least 16 hours a day. None of the patients demonstrated subjective symptoms or limitations in interincisal opening or diet. As judged from the radiographic examination, a case with class Ⅵ fracture revealed a restitutional (anatomical) remodeling of the TMJ, and a case with class Ⅴ fracture revealed a functional remodeling of the TMJ by adjusting the head and fossa to the new situation. There may be an age-dependent remodeling ability with types of pediatric condylar fractures. Because of the good esthetic and functional results, a FKO-type splint with exercise appears to be an effective treatment for pediatric condylar fractures during the growth period. (Accepted on April 27, 2011)
