Intense and regular physiotherapy including exercises and special equipment to temporarily keep the jaw open is critical to the recovery of pediatric patients who suffer complications from maxillofacial trauma such as condylar fractures from falls, according to researchers at Al Azhar University in Cairo, Egypt.
This treatment plan could help prevent permanent disabilities in young patients who suffer from posttraumatic restricted mouth openings including future disorders related to the temporomandibular joint (TMJ), jaw growth problems, functional issues, and the development of chronic pain and joint stiffness.
Working with 86 patients aged 3 to 17 years who had suffered mandibular or midface fractures or trauma, the researchers found that those who followed a regular program of exercises and used mouth props to keep their jaw open for an hour several times a day recovered more quickly and completely than those who weren’t provided such treatment.
To ensure patient cooperation, especially for children under the age of 12 years, the researchers stressed that treatments were to be performed under the close supervision of their surgeons. Parents were motivated to ensure compliance after being informed of the permanent disabilities the treatment could prevent by maintaining muscle function while preventing adhesion (internal scar tissue) formation and contraction of soft tissues.
In addition to difficulties with patient cooperation, the researchers said children create special challenges for maxillofacial surgeons because their facial skeletons differ significantly from those of adults. These differences include the small bone and sinus size, growth potential, a quicker healing process, and a high incidence of TMJ issues.
Patients who followed the treatment plan returned to their preoperative mouth opening size at the fourth month with fixed normal measurements at the sixth month. The researchers then concluded that a vigorous physiotherapy treatment plan is critical in the recovery of restricted mouth openings and prevention of bone stiffness for pediatric trauma patients.
The study, “Physiotherapy Maneuver Is Critical to Recover Mouth Opening After Pediatric Trauma,” was published by the Journal of Oral and Maxillofacial Surgery.