Management of Pediatric Mandibular Condyle Fracture and Malocclusion Using a Function-Generating Bite Appliance: A Case Report

BACKGROUND This report describes the case of a 9-year-old boy with unilateral fracture of the mandibular condyle and malocclusion managed using a function-generating bite (FGB) orthodontic appliance. The mandible is a frequent site of trauma in children, occurring in 12-56% of facial fractures. Condylar fractures are about 29-52% of mandibular fractures, with high-neck fractures represent 9-12%. Maxillofacial surgery during growth remains controversial, and treatment typically requires not only addressing the fracture but also any associated malocclusion. If a condylar fracture is inadequately managed, irreversible long-term consequences can occur. CASE REPORT A 9-year-and-7-month-old male patient was referred to the University of Turin Dental School with a right high-neck condylar fracture following a bicycle fall. He presented with significant right lateral deviation during mouth opening and pain, primarily when opening the mouth and chewing hard foods. Concurrently, an anterior crossbite was observed. We followed a conservative treatment approach suitable for growing patients with condylar fractures and malocclusions to be treated concurrently. We used a custom-made appliance, the FGB, built in acrylic resin with resilient stainless steel occlusal bite planes. This device prevents intercuspal contacts, aligns the occlusal plane, and allows mandibular self-repositioning in all 3 spatial planes. The treatment with the FGB restored the anatomy of the condyle during growth, improved the opening, solved the lateral deviation and the pain during chewing and concurrently corrected the malocclusion. CONCLUSIONS Conservative functional therapy with an FGB appears to be an effective option for the treatment of condylar fractures concurrently with the correction of malocclusions.