Functional orthodontic rehabilitation and craniofacial growth in pediatric mandibular condylar fractures: a narrative review

Background/Objectives: Pediatric mandibular condylar fractures require management that accounts for ongoing craniofacial growth and temporomandibular joint (TMJ) function. This narrative review summarizes contemporary evidence on age- and displacement-sensitive decision-making, functional and orthodontic rehabilitation, imaging, and long-term growth surveillance. Methods: A structured narrative search of PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library was conducted for English-language human studies published from January 2021 through June 2026, supplemented by citation searching for foundational publications. Results: Management ranges from expectant observation and functional appliance therapy to brief closed stabilization and open reduction with internal fixation (ORIF). Predominantly retrospective and heterogeneous evidence suggests that timely restoration of comfortable mandibular mobility is associated with favorable functional recovery and substantial remodeling potential in many growing patients, although outcomes depend on age, fracture morphology, functional loading, and remaining growth. ORIF may be appropriate for selected severe fractures when acceptable function and occlusion cannot be restored by less invasive measures. Conclusions: Management should integrate skeletal maturity, fracture level and displacement, laterality, occlusal disturbance, mandibular mobility, cooperation, and remaining growth. Across treatment modalities, avoidance of unnecessary prolonged immobilization, structured functional rehabilitation, and longitudinal orthodontic and craniofacial surveillance are important clinical priorities.