Skip to main content

Advertisement

SpringerLink
Log in

Interventions for the Management of Mandibular Coronoid Process Fractures: A Systematic Review

  • REVIEW PAPER
  • Published:
Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Background

The fracture of the coronoid process of mandible is one of the rarest fractures seen and the paucity of literature on the topic reflects the same. Despite the low incidence rate, the complications maybe grave which is why proper management is important. The treatment is controversial also because of the absence of standardized treatment protocol. This systematic review aims to compare the outcome of various treatment modalities available.

Methods

Registered under PROSPERO: CRD42020200700. Systematic research was conducted across databases like PubMed, Google Scholar, Pro Quest, Wiley Online. All clinical studies done till January 2021 which included participants above 14 years of age were included. Case reports, case series and studies not mentioning the treatment plan were excluded. The studies were shortlisted by the authors based on the eligibility criteria. Risk of bias was assessed using the MINORS tool and JBI checklist.

Results

A total of five studies were included. Four were retrospective studies and one was a retrospective case-controlled study. Two studies reported high, two moderate and one low risk of bias. Various treatment modalities were reported for the management of coronoid process fractures including conservative management, ORIF and coronoidectomy. Most authors preferred conservative management in asymptomatic cases and surgical management in symptomatic cases.

Discussion

No randomized control trials were found on the topic. Majority of the articles were case reports. Conservative management was preferred in minimally displaced fractures of coronoid process. However, in presence of displaced coronoid process fractures causing impediment of mandibular function surgical management is preferred.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kale TP, Aggarwal V, Kotrashetti SM et al (2015) Mandibular coronoid fractures, how rare? J Contemp Dent Pract 16:222–226. https://doi.org/10.5005/jp-journals-10024-1665

    Article  PubMed  Google Scholar 

  2. Rowe NL, Killey HCC (1968) Fractures of the facial skeleton. https://www.abebooks.com/Fractures-Facial-Skeleton-Rowe-Killey-Livingstone/4599075389/bd. Accessed 7 Oct 2020

  3. Brener MDMD, Surgery RA-O, Medicine O et al (1970) Longitudinal fracture of the coronoid process of the mandible. Report of an unusual case. Oral Surg Oral Med Oral Pathol 29:676–679. https://doi.org/10.1016/0030-4220(70)90263-X

    Article  CAS  PubMed  Google Scholar 

  4. Olson RA, Fonseca RJ, Zeitler DL, Osbon DB (1982) Fractures of the mandible: a review of 580 cases. J Oral Maxillofac Surg 40:23–28

    Article  CAS  PubMed  Google Scholar 

  5. Boffano P, Kommers SC, Roccia F et al (2014) Fractures of the mandibular coronoid process: a two centres study. J Cranio-Maxillofac Surg 42:1352–1355. https://doi.org/10.1016/j.jcms.2014.03.025

    Article  Google Scholar 

  6. Clarkson P, Wilson TH, Lawrie RS (1946) Treatment of 1,000 jaw fractures. Br Dent J 80:69. https://doi.org/10.1016/0030-4220(48)90281-3

    Article  PubMed  Google Scholar 

  7. Zhou H-H, Lv K, Yang R-T et al (2017) Risk factor analysis and idiographic features of mandibular coronoid fractures: a retrospective case–control study. Sci Rep 7:2208. https://doi.org/10.1038/s41598-017-02335-6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Genç A, Küçükçakir O, Tanyel RC (2019) Conservative management of the isolated mandibular coronoid process fracture. Bezmialem Sci 7:339–341. https://doi.org/10.14235/bas.galenos.2019.2926

    Article  Google Scholar 

  9. Shen L, Li J, Li P et al (2013) Mandibular coronoid fractures: treatment options. Int J Oral Maxillofac Surg 42:721–726. https://doi.org/10.1016/j.ijom.2013.03.009

    Article  CAS  PubMed  Google Scholar 

  10. Ogura I, Hara Y, Tokunaga S, Kaneda T (2016) Mandibular coronoid process fractures: prevalence and characteristic multidetector CT findings. Oral Sci Int 13:33–36. https://doi.org/10.1016/S1348-8643(16)00002-1

    Article  Google Scholar 

  11. Waknis PP, Mishra T (2014) Mandibular coronoid fractures: treatment options. Int J Oral Maxillofac Surg 43:132. https://doi.org/10.1016/J.IJOM.2013.10.012

    Article  CAS  PubMed  Google Scholar 

  12. Killey HC (1983) Killey’s fractures of the mandible

  13. Takenoshita Y, Enomoto T, Oka M (1993) Healing of fractures of the coronoid process: report of cases. J Oral Maxillofac Surg 51:200–204. https://doi.org/10.1016/S0278-2391(10)80023-0

    Article  CAS  PubMed  Google Scholar 

  14. Rapidis AD, Papavassiliou D, Papadimitriou J et al (1985) Fractures of the coronoid process of the mandible. Int J Oral Surg 14:126–130. https://doi.org/10.1016/S0300-9785(85)80083-1

    Article  CAS  PubMed  Google Scholar 

  15. de La Torre ÒEI, Klok EV, Roig AMI et al (2001) Jacob’s disease: report of two cases and review of the literature. J Cranio-Maxillofac Surg 29:372–376. https://doi.org/10.1054/JCMS.2001.0247

    Article  Google Scholar 

  16. Rankow RM, Mignogna FV (1978) Ankylosis of the temporalis- coronoid complex of the mandible. Ann Plast Surg 1(3):280–285

    Article  CAS  PubMed  Google Scholar 

  17. Natvig P, Sicher H, Fodor PB (1970) The rare isolated fracture of the coronoid process of the mandible. Plast Reconstr Surg 46:168–172. https://doi.org/10.1097/00006534-197008000-00011

    Article  CAS  PubMed  Google Scholar 

  18. Fiamminghi L, Gennari PU (1978) About an unusual case of fracture of the coronoid process of the mandible. Acta Biomed Ateneo Parmense 49:305–309

    CAS  Google Scholar 

  19. Frim SP (1978) Fracture of the coronoid process. Oral Surg Oral Med Oral Pathol 45:978–979. https://doi.org/10.1016/S0030-4220(78)80021-8

    Article  CAS  PubMed  Google Scholar 

  20. Yaremchuk MJ (1992) Rigid internal fixation of a displaced mandibular coronoid fracture. J Craniofac Surg 3:226–229. https://doi.org/10.1097/00001665-199212000-00010

    Article  CAS  PubMed  Google Scholar 

  21. Vanhove F, Dom M, Wackens G (1997) Fracture of the coronoid process: report of a case. Acta Stomatol Belg 94:81–85

    CAS  PubMed  Google Scholar 

  22. Philip M, Sivarajasingam V, Shepherd JP (1999) Bilateral reflex fracture of the coronoid process of the mandible. Int J Oral Maxillofac Surg 28:195–196. https://doi.org/10.5348/ijcri-2012-07-145-cr-6

    Article  CAS  PubMed  Google Scholar 

  23. de Oliveira DM, de Vasconcellos RJH, Laureano Filho JR, Cypriano RV (2007) Fracture of the coronoid and pterygoid processes by firearms: case report. Braz Dent J 18:168–170. https://doi.org/10.1590/S0103-64402007000200016

    Article  PubMed  Google Scholar 

  24. Delantoni A, Antoniades I (2010) The iatrogenic fracture of the coronoid process of the mandible. A review of the literature and case presentation. Cranio J Craniomandib Pract 28:200–204

    Google Scholar 

  25. Rivera JC, Corona HM, Masso GG (2011) Fracture of coronoid apophysis of the mandible. A clinical case and literature review. Rev Mex Cir Bucal Maxilofac 7(3):89–91

    Google Scholar 

  26. Lambade PN, Saha TK, Lambade D, Dolas RS (2012) Unusual longitudinal fracture of coronoid process of mandible: a case report. Int J Case Rep Imag 3:23. https://doi.org/10.5348/ijcri-2012-07-145-cr-6

    Article  Google Scholar 

  27. Baykul T, Aydin M, Aksoy M, Findik Y (2014) Unusual unilateral fracture of the condylar and coronoid processes of the mandible. J Clin Imaging Sci 4:3. https://doi.org/10.4103/2156-7514.141909

    Article  PubMed  PubMed Central  Google Scholar 

  28. Baliga M, Baptist J (2014) Fracture of the coronoid process associated with frontosphenoidal fractures. Craniomaxillofac Trauma Reconstr 7:330–332. https://doi.org/10.1055/s-0034-1378177

    Article  PubMed  PubMed Central  Google Scholar 

  29. Belmoubarik A, Ahed K, Abouchane M et al (2015) Anterior transverse route in osteosynthesis of a type III fracture of the coronoid process in an adolescent: report of a case and literature review. Pan Afr Med J 20:165. https://doi.org/10.11604/pamj.2015.20.165.6077

    Article  PubMed  PubMed Central  Google Scholar 

  30. Jowett A, Abdullakutty A, Bailey M (2015) Pathological fracture of the coronoid process secondary to medication-related osteonecrosis of the jaw (MRONJ). Int J Surg Case Rep 10:162–165. https://doi.org/10.1016/j.ijscr.2015.02.049

    Article  PubMed  PubMed Central  Google Scholar 

  31. Al-Khalisi N, Kumar K, Acosta N (2016) Isolated non-traumatic bilateral coronoid process fracture of the mandible. Cureus. https://doi.org/10.7759/cureus.829

    Article  PubMed  PubMed Central  Google Scholar 

  32. Agbaje JO, Salem AS, Lambrichts I et al (2016) Possible association between mandibular repositioning device for sleep apnea and osseous lytic lesion with fracture of the coronoid process of the mandible: a case report Jimoh. Quintessence Int. https://doi.org/10.3290/j.qi.a34805

    Article  PubMed  Google Scholar 

  33. Motamedi-Azari F (2017) JISHANT Spontaneous isolated fracture of the coronoid process of the mandible. J Int S Head Neck Trauma

  34. Kisnisci R (2013) Management of fractures of the condyle, condylar neck, and coronoid process. Oral Maxillofac Surg Clin North Am 25(4):573–590

    Article  PubMed  Google Scholar 

  35. Slim K, Nini E, Forestier D et al (2003) Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg 73:712–716. https://doi.org/10.1046/J.1445-2197.2003.02748.X

    Article  PubMed  Google Scholar 

  36. Critical-appraisal-tools - Critical Appraisal Tools | Joanna Briggs Institute. https://jbi.global/critical-appraisal-tools. Accessed 25 Jan 2022

  37. Singh AS, Perumal CJ, Bouckaert MMR, Mchenga JM (2015) An investigation into the incidence and distribution of fractures of the coronoid process in patients presenting at the Sefako Makgatho Health Sciences University, OralHealth Centre. S Afr Dent J 70:384–387

    Google Scholar 

  38. Killey H C TH (1969) Oral surgery, Vols. 1 and 2, CV Mosby Company, Saint Louis (1969). p 1264

  39. PRISMA. http://www.prisma-statement.org/PRISMAStatement/FlowDiagram. Accessed 27 Jan 2022

  40. Sakr K, Farag IA, Zeitoun IM (2006) Review of 509 mandibular fractures treated at the University Hospital, Alexandria, Egypt. Br J Oral Maxillofac Surg 44:107–111. https://doi.org/10.1016/j.bjoms.2005.03.014

    Article  PubMed  Google Scholar 

  41. Bachani Chopra L, Lingappa A, Singh M et al (2020) Mandibular fractures and their radiographic diagnosis. Act Sci Dent 4(7):161–171

    Article  Google Scholar 

  42. de Assis Santos VP, de Oliveira NK, Frare JG et al (2019) Intraoral versus extraoral single-session photobiomodulation therapy after lower third molar surgery: a pilot study. Lasers Dent Sci 3:119–127. https://doi.org/10.1007/s41547-019-00061-y

    Article  Google Scholar 

  43. Kruger GO (1974) Fractures of the jaws. In: Textbook of oral surgery, 4th ed St Louis, Mosby, pp 314–385

  44. Weissfeld B (1967) Fracture of coronoid process. N Y State Dent J 33:393–396

    CAS  PubMed  Google Scholar 

  45. Manisali M, Amin M, Aghabeigi B, Newman L (2003) Retromandibular approach to the mandibular condyle: a clinical and cadaveric study. Int J Oral Maxillofac Surg 32:253–256. https://doi.org/10.1054/IJOM.2002.0270

    Article  CAS  PubMed  Google Scholar 

  46. Narayanan V, Kannan R, Sreekumar K (2009) Retromandibular approach for reduction and fixation of mandibular condylar fractures: a clinical experience. Int J Oral Maxillofac Surg 38:835–839. https://doi.org/10.1016/J.IJOM.2009.04.008

    Article  CAS  PubMed  Google Scholar 

  47. Tang W, Gao C, Long J et al (2009) Application of modified retromandibular approach indirectly from the anterior edge of the Parotid gland in the surgical treatment of condylar fracture. J Oral Maxillofac Surg 67:552–558. https://doi.org/10.1016/J.JOMS.2008.06.066

    Article  PubMed  Google Scholar 

  48. Halazonetis JA (1968) The ‘weak’regions of the mandible. British Journal of Oral Surgery 6:37–48

    Article  CAS  PubMed  Google Scholar 

  49. Walker DG (1942) Fractures of the Ramus, condyloid and coronoid processes of the mnadible. Br Clent J 72:265

    Google Scholar 

  50. Agha RA, Franchi T, Sohrabi C et al (2020) The SCARE 2020 guideline: updating consensus surgical case report (SCARE) guidelines. Int J Surg 84:226–230. https://doi.org/10.1016/j.ijsu.2020.10.034

    Article  PubMed  Google Scholar 

  51. Agha RA, Sohrabi C, Mathew G et al (2020) The process 2020 guideline: updating consensus preferred reporting of case series in surgery (process) guidelines. Int J Surg 84:231–235. https://doi.org/10.1016/j.ijsu.2020.11.005

    Article  PubMed  Google Scholar 

Download references

Funding

The authors did not receive support from any organization for the submitted work.

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, KLE V K Institute of Dental Sciences, Nehru Nagar, Belagavi, Karnataka, 590010, India

    Radhika Pathak, Tejraj P. Kale, S. M. Kotrashetti & Harshini Patel

Authors
  1. Radhika Pathak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tejraj P. Kale
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. M. Kotrashetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Harshini Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The idea for the article: TPK, RP. Literature search: RP, TPK, SMK. Data analysis: RP, TK, SMK, HP. Draft: RP, TK, SMK, HP. Revision: RP, TK, SMK, HP.

Corresponding author

Correspondence to Radhika Pathak.

Ethics declarations

Conflict of Interest

All authors declare that they have no conflict of interest.

Consent to Participate’ and/or ‘Consent to Publish

Not applicable as this is a systematic review.

Ethics Approval

This is a systematic review registered under PROSPERO: CRD42020200700.

Research Involving Human Participants and/or Animals

Not applicable as this is a systematic review.

Informed Consent

Not applicable as this is a systematic review.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pathak, R., Kale, T.P., Kotrashetti, S.M. et al. Interventions for the Management of Mandibular Coronoid Process Fractures: A Systematic Review. J. Maxillofac. Oral Surg. 22, 433–441 (2023). https://doi.org/10.1007/s12663-022-01824-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12663-022-01824-0

Keywords

Search

Navigation