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Objectives Mandibular fractures, especially at the parasymphysis and angle, significantly affect the temporomandibular joint (TMJ) due to remodeling. This study assesses changes in condyle volume, morphology, and position after open reduction and internal fixation (ORIF) using 3D analysis methods. Materials and methods A retrospective study evaluated 16 patients (11 males, 5 females; mean age: 33.63 years) with parasymphysis fractures, categorized into isolated (PS-type) and those with angle involvement (A-type). Preoperative and postoperative CBCT scans (minimum 6-month follow-up) were analyzed. Volumetric, linear, and angular changes in the condyle were assessed on the fractured and non-fractured sides. Results Significant postoperative condylar volume increase was observed on both fractured ( p  = 0.0081) and non-fractured sides ( p  = 0.0453). In PS-type fractures, condylar volume ( p  = 0.0156) and height ( p  = 0.0352) significantly increased on the fractured side, with a marked inter-side volumetric difference ( p  = 0.0232). A-type fractures showed a significant increase in sagittal condylar position on the non-fractured side ( p  = 0.0078). No other parameters showed significant change across or within groups. Correlation analyses revealed no significant association between condylar volume change and patient age or follow-up time. Conclusion TMJ remodeling after ORIF varies by fracture type. Isolated parasymphysis fractures caused significant increases in condylar volume and height. Angle fractures involvement showed greater sagittal positional. These results highlight the impact of fracture location and mechanical force distribution on adaptive remodeling.

Aim This study aimed to evaluate radiomorphometric risk factors for mandibular angle fractures (MAFs) by simulating pre-fracture mandibular anatomy using digital reduction techniques on cone beam computed tomography (CBCT) images. Demographic and etiological characteristics were also analyzed to identify factors associated with MAF occurrence. Methods In this retrospective study, 55 patients with mandibular fractures were categorized into two groups: those with mandibular angle fractures (MAF, n  = 20) and those with fractures in other mandibular regions (non-MAF, n  = 35). High-resolution CBCT scans were analyzed following digital fragment realignment using Materialise Mimics 25.0. Radiomorphometric measurements included gonial angle, ramus height, and ramus width. Demographic variables, third molar status, and trauma etiology were evaluated. Statistical analysis was performed using Mann–Whitney U, chi-square, Fisher’s exact, and independent samples t tests, with a significance level of p  < 0.05. Results Patients in the MAF group were significantly younger (median age: 21 vs. 27 years; p  = 0.002) and predominantly male (90%). Third molars were more frequently observed in the MAF group (85%) and were significantly associated with angle fractures ( p  = 0.019). Condylar fractures occurred in 42.9% of the non-MAF group but were absent in the MAF group ( p  < 0.001). Conclusion CBCT combined with digital reduction improves anatomical assessment and standardization in fracture evaluation. Younger age, male gender, and the presence of third molars were significantly associated with MAFs. Third molars may represent a modifiable risk factor for mandibular angle fractures and should be considered carefully in clinical prevention strategies.