Effects of Distal Mandibular Skeletal Injury on Temporomandibular Joint Soft Tissue without Bony Injury to the Joint: An Arthroscopic Screening Survey

Abstract

Introduction: Trauma to the temporomandibular joint (TMJ) may be associated with injury to its associated soft tissues along with the bony condyle. However, it is often neglected that even in the absence of fracture of the mandibular condyle, there may be damage to the associated soft tissues of the joint. The routine radiographic study does not reveal the soft-tissue injury around the joint and its extent. Such injuries may progress to temporomandibular joint disorders (TMDs) in the future.

Materials and Methods: A prospective study was conducted among 50 patients diagnosed with anterior mandibular fractures without condylar fracture. The patients were assessed for soft-tissue injury around the TMJ using an arthroscopic examination by a single qualified operator. Patients were evaluated clinically and arthroscopic examination was performed to examine the TMJ soft tissues at the time of surgery for facial fracture reduction under general anesthesia.

Results: Among the 50 patients, n = 37 (74%) patients had severe injury to the soft tissues surrounding the TMJ. Majority of the patients had arthroscopic evidence of soft-tissue injury around the joint.

Conclusion: From this study, we observe that patients with mandibular fracture without condylar involvement should be evaluated for TMJ soft-tissue injuries and subjected to long-term follow-up to prevent TMDs in the late postoperative period.