The Effectiveness of Guided Botulinum Toxin "A" Injection to the Masticatory Muscles in the Management of Condylar and Subcondylar Fractures

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.