Fractured condyles are fractures of the bone structures that connect the lower jaw (mandible) to the skull through the temporomandibular joint (TMJ). Condyles play an important role in the movement of the jaw during speech, chewing and swallowing.

Recently, fractured or broken articular heads (condyles) have become common due to the popularity of scooters, our experience at the clinic shows.

“Scooters are proving to be quite dangerous, especially when it comes to riding them in areas with holes, bumps and all kinds of obstacles. In most cases, falls from scooters are in the forward direction. This is how people – most frequently children – hit their chin, and this leads to fracture of the condyles,” Dr Manol Ivchev says.

How to recognise such a fracture?

Whenever a child or an adult falls, and the blow lands on the lower or upper jaw, it is important to check whether their teeth are closing in the same way as before. If you notice any displacement, in any direction, if you feel that the bite and teeth contact differently even slightly (and if it is a lot, this is certainly a serious signal), then something has happened in the joint and it is important to contact your doctor.

What happens in the joint?

“According to my understanding, and according to the literature I read, the fracture of the condyles is actually a protective mechanism in our body. The moment we fall and hit our chin, our body reacts with the so-called contacting of the muscles that are attached to the articular head. The articular head automatically breaks in order to protect the inner ear, the vestibular apparatus and key areas located in the skull. Of course, this can also happen in the case of a direct trauma to the articular head, and in most cases it breaks forward or inward,” the dentist points out.

Treatment approaches

Very often, the approach in this situation is splinting. “With this approach, I see that patients often remain asymmetrical over the years and their lower jaw moves asymmetrically, which is a serious problem,” Dr Ivchev shares.

There is a much more conservative approach which does not involve surgical intervention.

Dr Manol Ivchev:

“In our practice, we treat this type of fracture quite successfully, with the caveat that the treatment is not short and requires serious patient involvement. But in the end it is successful and, if the patient collaborates, we manage to heal the fractured condyles without surgery.

How:

• We use splint therapy.
• The method is non-surgical and non-invasive.
• The treatment is entirely function-orientated – we remodel the position of the jaw.
• Physiotherapy, laser therapy, and photobiomodulation can be used.”

It is important, when this type of trauma occurs, to immediately check the following factors:

• contacts of the upper and lower teeth – how they close and whether they close as before;
• can you open your teeth in the usual way;
• can you open your mouth to the same volume as before;
• does the lower jaw move in an unusual direction when opening;
• has a noise, such as popping or clicking, appeared when opening the mouth;
• is there pain in the relevant area.

Often, patients with such trauma complain only of limited jaw opening.

These may be signals that the fall has caused an injury, and you should approach them responsibly and seek a specialist.