Pediatrik ünilateral kondil kýrýðýnda konservatif tedavi yaklaþýmý: Olgu Raporu

Pediatrik hastalarda travma sonrasý kondil kýrýklarýna rastlanma sýklýðý yüksektir. 9 yaþýnda kýz hasta, bisikletten düþtükten sonra alt çene ucuna aldýðý darbe sonucu sað çenesinde geliþen aðrý þikayeti ile kliniðimize baþvurdu. Aðýz açmada kýsýtlýlýk ve aðýz kapamada sað tarafta erken temas gözlendi. Panoramik röntgende sað kondil boynunda horizontal kýrýk hattý gözlendi ve dental volumetrik tomografisinde kýrýk segmentin mediale deviasyon gösterdiði saptandý. Tedavi planlamasýnda genel anestezi altýnda kapalý redüksiyon ve intermaksiller fiksasyon (IMF) yapýlmasýna karar verildi. Hastanýn karýþýk diþlenmesi ve daimi azý diþlerindeki çürükler sebebiyle her iki çeneye arch bar ile modifiye edilmiþ akrilik splint yerleþtirilmesine karar verildi. Operasyon esnasýnda üst çeneye adapte edilen splintin kýrýlmasý ile tedavi planý deðiþtirildi. Çoðunluðu daimi diþlerden oluþan üst çeneye ligatür telleri yardýmý ile arch bar uygulandý ve elastikler ile IMF saðlandý. Ekstrakapsüler kýrýklarýn tedavisinde en iyi yaklaþýmýn çiðneme olmayan beslenme ve elastik rehberliðinde yapýlan kapalý redüksiyon olduðu belirtilmektedir. Süt diþlerine arch bar uygulamasý ile avülsiyon riski bulunsa da doðru planlama, komplikasyon oluþma ihtimalini düþürmektedir. Bu olgu sunumunda karýþýk diþlenme döneminde pediatrik hastada meydana gelen tek taraflý kondil kýrýðýna uygulanan konservatif tedavi yaklaþýmýnýn sunulmasý amaçlanmaktadýr.

Conservative treatment approach in pediatric unilateral condylar fracture: A Case Report

The incidence of condylar fractures after trauma is high in pediatric patients. A 9-year-old female patient was admitted to our clinic with the complaint of pain in her right jaw as a result of a blow to the tip of her lower jaw after falling off the bicycle. Limitation of mouth opening and early contact on the right side during mouth closing were observed. A horizontal fracture line was observed in the right condyle neck on the panoramic x-ray and dental volumetric tomography revealed medial deviation of the fractured segment. In the treatment planning, it was decided to perform closed reduction and intermaxillary fixation (IMF) under general anesthesia. Due to the patient's mixed dentition and caries in her permanent molar teeth, it was decided to place acrylic splints modified with arch bar in both jaws. The treatment plan was changed during the operation after the fracture of the splint that was adapted to the upper jaw. An arch bar was applied to the upper jaw, mostly consisting of permanent teeth, with the help of ligature wires, and the IMF was provided with elastics. It is stated that the best approach in the treatment of extracapsular fractures is non-chewing nutrition and closed reduction with elastic guidance. Although arch bar application on deciduous teeth runs the risk of avulsion, correct planning reduces the possibility of complications. In this case report, it is aimed to present the conservative treatment approach applied to unilateral condyle fractures in a pediatric patient during mixed dentition.