Trapezoidal interdental spacer in the treatment of mandibular condylar fractures

Background. In case of mandibular condylar fractures with the displacement of the fracture fragments along the axis of the mandibular ramus and conservative orthopedictreatment, reposition and mandibular pull-through operation as part of bonding using interdental spacers are required. The purpose is to develop a method for obtaining a conical (trapezoidal) interdental spacer allowing to form its supporting surfaces in accordance with the position of the downward mandibular displacement in case of condylar fractures with the overriding along the axis of the mandibular ramus. Materials and Methods. The methods of manufacturing interdental spacers in the conservative orthopedic treatment of mandibular condylar fractures with the displacement of the fracture fragments along the axis of the mandibular ramus, which differ in the materials they are made of, as well as how contact with the retainer teeth of the opposing jaws was taken into account, were studied. The analysis allowed to develop new approaches in the manufacture of interdental spacers in the treatment of patients. According to the proposed method of manufacturing a conical interdental spacer, namely, pre-planning of its dimensions and position as related to the mandibular and maxillary teeth in case of the downward mandibular displacement to erupt fracture fragments of the condyle, with determination of the retainer teeth ratio, by modeling individual surfaces. Results. An individual interdental spacer is made of fast-hardening plastic. Its height (distal end) depends on the degree of displacement (overriding) of the fracture fragments of the condyle and is determined according to dental X-ray printouts. The height of its distal and medial ends is calculated using the formula. It has a smooth surface facing the maxillary teeth. This allows the mandibula to slide along the upper arch in case of its distoversion during a fracture. This method is rapid. Conclusions. Key features of a trapezoidal interdental spacer: Fracture fragment reposition. It helps to adjust and stabilize a mandibular condylar fracture by correctly positioning its fragments. Bonding. An interdental spacer stabilizes fragments and reduces the risk of further displacement of the fracture fragments during healing. Reduced load on periodontal tissues. Due to the proper teeth pressure distribution, an interdental spacer helps to reduce pressure on periodontal tissues. Enhanced stability. The trapezoidal shape of a spacer allows better adaptation to the anatomy of the dentition and provides a more stable attachment.