Moving on after trauma Consequences for the masticatory system of orofacial trauma and condylar fracture

This thesis aims to increase our knowledge of the association between orofacial trauma, specifically condylar fractures, and orofacial pain and dysfunction. The thesis is divided into two parts.
The first part of the thesis centres around condylar fractures and their consequences for the temporomandibular joint (TMJ). Calculations of a Finite Element Model (FEM) imply a sudden drop in balance between the two TMJs with certain amounts of deviation of the fractured part. Outcome of the FEM suggests remodelling in both TMJs after unilateral condylar fracture. As a first step towards implementing value-based healthcare (VBH), costs associated with treatment for condylar fractures were investigated.
The second part of the thesis focuses on the possible association between trauma and temporomandibular disorders (TMD). The systematic review found a robust association between direct orofacial macrotrauma and TMD across various TMD diagnoses and trauma locations, directly after the trauma and on a longer time span, despite other interventions. To further elaborate on this association, an investigation was conducted in a tertiary referral clinic. In this clinic, no association between orofacial trauma and TMD was found.
Predictions in the first part of the thesis clarify the process of load and remodelling within the TMJs. The association between orofacial trauma and TMD emphasizes the importance of interdisciplinary collaboration. Overall, this thesis increases our knowledge of the association between orofacial trauma and TMD. It shows that we move on after trauma.