• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권1호
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• pp.82-88
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• 2005

Treatment methods of mandibular condylar fracture were conservative and surgical method. Surgical method of mandibular high condylar fracture was very difficult because approach and internal fixation of small size fracture fragment were difficult. So there is a tendency to select conservative method over surgical method for guiding a stable occlusion and avoiding TMJ disorder and growth disturbance, minimizing pain and deviation during function. But, in case of mandibular high condylar fracture patient who has no biting teeth on posterior teeth area, guiding a stable occlusion and conservative functional treatment were very difficult. In this case, patient was 62years old male. He had fracture of mandibular symphysis, right mandibular body, left mandibular high condyle. We treated the patient for mandibular symphysis and right mandibular body fracture area with surgical method. But left mandibular high condylar fracture area was difficult to treat with surgical method. So we selected a conservative functional method on left mandibular high condylar fracture area. We intended recovery of vertical dimension and stable occlusion with implantation of immediate provisional implant on maxillar and mandibular posterior teeth area, and temporary crown. And then patient did mandibular functional movement and his mandibular function was recoverd.

• 대한치과교정학회지
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• 제23권3호
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• pp.427-445
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• 1993

The ankylosis of temporomandibular joint occured by several causes directly developes TM joint disfunction, In cases with prolonged condylar ankylosis, especially at growing age the condylar ankylosis evokes malfunction of growth center area, and then developes the abnormal facial morphology and malocclusion. Therefore it must be cured. Almost authors have agreed to the necessity of surgical correction of the TMJ anylosis. but they did not decide the one surgical method to get the best result. The Tx. method suggested by many authors are the using interposition after resection of condyle to remain a lever of 3rd class in Mn. kinetics, the autogenous condylar graft and the alloplastic condylar graft. Some authors have got the satisfied results only with the condylectomy of the involved TMJ. This study also operated only the detachment of fibrous adhesion on ankylosed condylar side and then established occlusion in the case with the unilateral TMJ ankylosis and fibrous joint adhesion and facial asymmetry evoked after the fracture of condylar head at early age. This study got a improved mouth opening and a stable postsurgical result after 1 year. Also, this study reviewed many author's study about the chanracteristics, etiology, diagnosis and Tx. method for the ankylosis of TMJ.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권5호
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• pp.267-276
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• 2022

Objectives: Recently a modified high-submandibular approach (HSMA) has been introduced for treatment of condylar fracture. This approach involves an incision line close to the mandibular angle and transmasseteric transection, leading to a low incidence of facial palsy and allowing good visualization of the condyle area, especially the condylar neck and subcondyle positions. This study reports several cases managed with this modified HSMA technique for treating condylar fractures. Materials and Methods: Six cases of condylar fractures treated with modified HSMA technique were reviewed. Results: Three unilateral subcondylar fracture, 1 bilateral subcondylar fracture, 1 unilateral condylar neck fracture, 1 unlateral simultaneous condylar neck and subcondylar fracture cases were reviewed. All the cases were successfully treated without any major complication. Conclusion: Reduction, fixation, and osteosynthesis of condylar fractures via the modified HSMA technique enabled effective and stable treatment outcomes. Therefore, the described approach can be used especially for subcondylar and condylar neck fractures with minimal complications.

• Imaging Science in Dentistry
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• 제46권1호
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• pp.25-31
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• 2016

Purpose: This study was performed to evaluate condylar surface changes and remodeling after orthognathic surgery using three-dimensional computed tomography (3D CT) imaging, including comparisons between the right and left sides and between the sexes. Materials and Methods: Forty patients (20 males and 20 females) who underwent multi-detector CT examinations before and after surgery were selected. Three-dimensional images comprising thousands of points on the condylar surface were obtained before and after surgery. For the quantitative assessment of condylar surface changes, point-to-point (preoperative-to-postoperative) distances were calculated using 3D processing software. These point-to-point distances were converted to a color map. In order to evaluate the types of condylar remodeling, the condylar head was divided into six areas (anteromedial, anteromiddle, anterolateral, posteromedial, posteromiddle, and posterolateral areas) and each area was classified into three types of condylar remodeling (bone formation, no change, and bone resorption) based on the color map. Additionally, comparative analyses were performed between the right and left sides and according to sex. Results: The mean of the average point-to-point distances on condylar surface was $0.11{\pm}0.03mm$. Bone resorption occurred more frequently than other types of condylar remodeling, especially in the lateral areas. However, bone formation in the anteromedial area was particularly prominent. No significant difference was found between the right and left condyles, but condylar surface changes in males were significantly larger than in females. Conclusion: This study revealed that condylar remodeling exhibited a tendency towards bone resorption, especially in the lateral areas. Condylar surface changes occurred, but were small.

• 대한치과교정학회지
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• 제27권1호
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• pp.105-117
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• 1997

본 연구는 기능적 교합장애에 의한 하악골 측방편위가 하악골의 성장에 미치는 영향과 교합장애 제거후 나타나는 하악골의 성장양상을 알아 보기 위하여 생후 4주령의 웅성 백서에서 상악우측, 하악좌측 절치를 2주 및 4주간 절단한 실험군과 4주간 절치절단을 시행하고 2주간 절단을 중지한 실험군에서 하악골계측 및 과두연골의 조직학적 변화를 관찰하여 다음과 같은 결론을 얻었다. 1. 실험 2주군에서 좌측의 하악골장경, 과두장경, 하악골고경, 과두단면적은 우측및 정상군에 비해 작은 경향을 보였고 우측의 하악골장경, 과두단면적은 정상군에 비해 작았다. 2. 실험 4주군에서는 좌측 과두단면적이 우측에 비해 작았으나 좌측 하악골의 빠른 적응성 변화로 좌,우측 하악골장경은 유사하였다. 그러나 정상군에 비해서는 하악골장경, 과두단면적이 여전히 작은 경향을 보였다. 3. 절치절단 중지 후 2주경과한 실험 6주군에서는 기능이 정상화됨에 따라 좌측과 우측이 동일한 성장을 보이나 정상군에 비해서는 여전히 하악골장경이 짧았다. 4. 시상면에서 실험 2주군의 좌측 과두연골은 우측및 정상군에 비해 연골층의 증식이 전반적으로 억제된 소견을 보이며 우측 또한 정상군에 비해 성장이 억제되었다. 그러나 실험 4주군, 6주에서는 정상군과 유사한 소견이 관찰되었다. 5. 두연골층체적은 전 실험기간 동안에 실험군의 좌,우측간, 그리고 실험군과 정상군의 동측간 비교시 유의성있는 차이를 관찰할 수 없었다. 이상에서 성장기 백서에 편측 절치절단을 시행한 경우, 시상면에서는 절단측의 하악골및 과두의 성장이 억제되는 효과를 관찰할 수 있었으며 또한 빠른 시일내에 적응하여 좌,우측 하악골은 유사한 성장변화를 일으킴을 알 수 있었다. 그러나 과두연골체적변화는 실험군 좌, 우측및 정상군에서 전 실험기간동안에 유사한 양상이 관찰됨을 미루어 보아 전체적인 과두연골의 성장은 억제되지 않았음을 알 수 있었고 과두연골의 성장은 다방면으로 일어남을 인지할 수 있었다.

• 대한치과보철학회지
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• 제17권1호
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• pp.35-46
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• 1979

A number of experimental studies have been carried out in order to clarify the question as to how temporomandibular joint adapt to the changes of mandibular movement and occlusal equilibration. Recently, the studies on the interrelations between anatomical structure of temporomandibular joint and the state of occlusion have been actively performed in dentistry particularly in prosthodontic field. Author performed extraction of unilateral mandibular molars in 30 mature male rats, and observed histological changes of temporomandibular joint through the light microscope. Following results were obtained. 1. The loss of unilateral teeth gave rise to the changes in the location of condylar head, that is, interior displacement of condylar head in the extraction side and upper displacement in the non-extraction side. 2. Articular disk was compressed by the interior surface of condylar head, resulting in its extension below the condylar neck in the extraction side, and the histological arrangement of the compressed area showed irregular feature. 3. The extension of articular disk below the condylar neck was accompanied with the contraction of muscle fibers which were originated from the articular disk. 4. The cartilage layer of articular fossa to the exterior of the extraction side showed hypertropy. 5. Early in the experiment, the inernal extremity of condylar head of extract ion side showed bone resorption, and cartilage layer of condylar head showed hypertropy. At 12 weeks after experiment, the condylar surface showed flattened, and the cartilage layer of condylar head was replaced by the compact bone. 6. The articular disk showed the formation of pannus in the extraction side as well as in the non-extraction side. 7. The occlusal disturbance due to unilateral missing teeth has brought about the non-inflammatory retrogressive change and osteoarthrotic change late in the experiment.

• 대한치과교정학회지
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• 제50권2호
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• pp.86-97
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• 2020

Objective: To propose a three-dimensional (3D) method for evaluating temporomandibular joint (TMJ) changes during Twin-block treatment. Methods: Seventeen patients with Class II division 1 malocclusion treated using Twin-block and nine untreated patients with a similar malocclusion were included in this research. We collected their cone beam computed tomography (CBCT) data from before and 8 months after treatment. Segmentations were constructed using ITK-SNAP. Condylar volume and superficial area were measured using 3D Slicer. The 3D landmarks were identified on CBCT images by using Dolphin software to assess the condylar positional relationship. 3D models of the mandible and glenoid fossa of the patients were constructed and registered via voxel-based superimposition using 3D Slicer. Thereafter, skeletal changes could be visualized using 3DMeshMetric in any direction of the superimposition on a color-coded map. All the superimpositions were measured using the same scale on the distance color-coded map, in which red color represents overgrowth and blue color represents resorption. Results: Significant differences were observed in condylar volume, superficial area, and condylar position in both groups after 8 months. Compared with the control group (CG), the Twin-block group exhibited more obvious condyle-fossa modifications and joint positional changes. Moreover, on the color-coded map, more obvious condyle-fossa modifications could be observed in the posterior and superior directions in the Twin-block group than in the CG. Conclusions: We successfully established a 3D method for measuring and evaluating TMJ changes caused by Twin-block treatment. The treatment produced a larger condylar size and caused condylar positional changes.

• Imaging Science in Dentistry
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• 제49권3호
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• pp.251-256
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• 2019

Jugular bulb diverticulum is an irregular extension of the jugular bulb into the temporal bone that may be symptomatic or asymptomatic. The jugular bulb has rarely been reported to extend into the occipital condyle; such extension is termed a condylar jugular diverticulum and is characterized as a defect in the occipital condyle contiguous with the jugular bulb. This report details 3 cases of condylar jugular diverticulum. Extension of the jugular bulb into the ipsilateral occipital condyle was noted as an incidental finding on cone-beam computed tomographic (CBCT) images of 3 patients. All 3 patients were asymptomatic, and this finding was unrelated to the initial area of interest. CBCT use is becoming ubiquitous in dentistry, as it allows 3-dimensional evaluation, unlike conventional radiography. Proper interpretation of the entire CBCT is essential, and recognition of the indicators of condylar jugular diverticulum may prevent misdiagnosis of this rare entity.

• 치과방사선
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• 제25권2호
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• pp.569-578
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• 1995

Condylar hyperplasia is a self-limiting condition characterized by a slowly progressing, enlargement of the mandible that results in facial asymmetry and a crossbite malocclusion. The facial asymmetry, open bite or crossbite, and radiographic evidence of an enlarged condyle confirm the diagnosis of condylar hyperplasia. The etiology of the condition is unknown. This condition usually first becomes apparent during the second decade of life, when one condyle continues to grow while the other is no longer active. Radiographically, the condyle may appear enlarged or the neck of the condyle maybe elongated or both may occur, Sometimes, however, no radiographically demonstrable condylar abnormality will be noted. Surgical correction with subcondylar osteotomy is the treatment of choice. We have observed two cases of condylar hyperplasia occurred in the left mandibular condyle of 24-year-old and 35-year-old women. We obtained that two cases were shown the followed results; 1. Clinically, both cases was unilaterally developed on C/C area, with temporomandibular disorders and pain, facial asymetry and malocclusion. 2. Radiographically, hyperplastic mass confined to the condyle. 3. Histopathologically, these cases shown increased hypertrophic region in parts, and lamellated bone with irregular trabeculae.

• 치과방사선
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• 제13권1호
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• pp.7-15
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• 1983

The purpose of this study was to investigate the radiographic images of the condylar head in clinically normal subjects and the TMJ patients using standardized projection technique. 45 subjects who have not clinical evidence of TMJ problems and 96 patients who have the clinical evidence of TMJ problems were evaluated, but the patients who had fracture, trauma and tumor on TMJ area were discluded in this study. For the evaluation of radiographic images, the author has observed the condylar head positions in closed mouth and 2.54㎝ open mouth position taken by the standardized transcranial oblique lateral projection technique. The results were as follows: 1. In closed mouth position, the crest of condylar head took relatively posterior position to the deepest point of the glenoid fossa in 8.9 % of the normals and in 26.6% of TMJ patients. 2. In 2.54㎝ open mouth position, condylar head took relatively posterior position to the articular eminence in 2.2% of TMJ patients and 39.6% of the normals. 3. In open mouth position, the horizontal distance from the deepest point of the glenoid fossa to the condyla head was 13.96㎜ in the normals and 10.68㎜ in TMJ patients. 4. The distance of true movement of condyalr head was 13.49㎜ in the normals and l0.27㎜ in TMJ patients. 5. The deviation of mandible in TMJ patients was slightly greater than that of the normals.