The aim of this study, is to evaluate the effectiveness of ultrasound guided injection of botulinum toxin A into the muscles of mastication; the masseter, temporalis and the lateral pterygoid, in a closed reduction approach of condylar and sub-condylar fractures, seeking to shed light on the efficacy and potential advantages of this innovative therapeutic avenue.
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Eligibility Criteria
Inclusion Criteria:
* Having unilateral extra-capsular condylar/ sub-condylar fractures isolated or associated with other fractures.
* Isolated intra-capsular fractures.
* Moderate condylar displacement, JO to 45 degrees or incomplete fractures.
* Reproducible occlusion without drop-back or with dr…
Inclusion Criteria:
* Having unilateral extra-capsular condylar/ sub-condylar fractures isolated or associated with other fractures.
* Isolated intra-capsular fractures.
* Moderate condylar displacement, JO to 45 degrees or incomplete fractures.
* Reproducible occlusion without drop-back or with drop-back that returns to midline on release of posterior force.
* Availability of more than half of the dentition
Exclusion Criteria:
* Bilateral condylar fractures
* Gross condylar displacement\> 45 degrees (severely displaced)
* Anatomic reduction of ramus height 2: 2 mm
* Unstable occlusion (e.g., periodontal disease, less than three teeth per quadrant)
* Patients with severe polytraumas.
* Patients with relative contraindications to BTX injections that may include; pregnancy, lactation, BTX Allergies and presence of infection at the injection site.
* Patients with motor neuron diseases.
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