• Journal of Oral Medicine and Pain
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• v.32 no.1
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• pp.69-79
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• 2007

Condylar resroption, or condylysis can be defined as progressive alteration of condylar shape and decrease in mass. Although the cause is unknown, condylar resorption has been assocated with rheumatoid arthritis, systemic sclerosis, systemic erythematous, steroid usage, orthodontic treatment and orthognathic surgery. In most case, however, there is no identifiable precipitating event. Hence the term is idiopathic condylar resorption. With condylar resorption, the bone loss is resulting in a loss of posterior support in the involved condyle and the mandible can then shift. As a result, the most patients exhibit occlusal change, openbite, retrognathism, and a decrease in posterior face height. This article reports cases of condylar resorption. And the author will review factors capable of changes of condyle, pathogensis and management of conylar resorption.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.4
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• pp.359-369
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• 2008

Purpose: Fractures of the mandibular condyle accounts for 15% to 30% of all the mandibular fractures and lots of complications are reported. Among these complications, condylar resorption is the most important one to be taken into account. The purpose of this study is evaluating condylar resorption pattern in relation to extracorporeal fixation technique. Patients & methods: Thirty four patients with 42 mandibular condylar fractures were retrospectively examined with an average follow-up of 18.5 months (6-66 months). Male/female ratio is 27 males (7 bilateral cases) and 7 females (1 bilateral case). Applicated surgical techniques were extracorporeal fixation via submandibular approach and extracorporeal fixation via intraoral approach. We compared radiographic views of post-operative periods with that of most long term follow up in 34 operated sites respectively. Result: There were 2 generalized condylar resorption sites and 3 partial resorption sites with clinical implications. Others (29 joints) showed good healing or satisfactory adaptive state of temporomandibular joints clinically. Radiologically, signs of partial condylar resorption and/or osteoarthrosis were diagnosed in 11 patients. But, 8 out of the 11 patients didn't show significant clinical symptoms, which means successful adaptive remodeling of the surgically located condylar head. Conclusion: From the above results, intentional ramal osteotomy, temporary detachment of the fractured condyle and extracorporeal fixation technique seems to be effective and useful in those cases of condylar fractures in which reduction of the dislocated condyle is very difficult or virtually impossible.

• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.337-346
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• 2006

Aims: The present study investigated the relationship between condylar resorption and craniofacial skeleton types(especially vertical relationships), the differences of craniofacial skeleton types between with open bite group and without open bite group, and the associations of anterior disc dislocation with or without reduction to condylar resorption with MRI. Patients selection and methods: Clinical examination, magnetic resonance imaging (MRI), panorama, lateral transcranial and lateral cephalometric radiographs in 34 patients with condylar resorption were used to investigate this relationship. Results and Conclusions: Patients with the following specific facial morphologic characteristics appear to be most susceptible to condylar resorption: (1) females were predominant, (2) patients' age ranged from 12 to 50 years old with a strong predominance for 2nd and 3rd decades, (3) patients had high mandibular plane angle and high gonial angle, (4) patients had decreased vertical height of the ramus, (5) patients had generally significant antegonial notch, (6) patients had predominance of Class I occlusal relationship with or without open bite but mandible was retruded as mean ANB 5.54 degrees, (7) condylar resorption rarely occurs in lower mandibular plane angle facial types, (8) although no statistically significant difference was found, the open bite group had a tendency more hyperdivergent skeletal pattern than the non open bite group, and (9) imaging demonstrates from small resorbing condyles to idiopathic condylar resorption and TMJ articular disc dislocations. Thus, morphologic features of patients with vertical discrepancies may represent a risk factor for the development of condylar resorption.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.1
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• pp.30-36
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• 2014

There are many treatment options in management of mandibular condylar neck fractures. Closed reduction is the most conservative treatment; however, achievement of anatomic reduction is difficult, and there are some risks of mandibular functional impairment. Open anatomic reduction and internal fixation have some advantages; therefore, many oral and maxillofacial surgeons have attempted to achieve anatomic reduction through the open approach and extracorporeal reduction and fixation. However, when using this method, there is some risk of resorption of the fractured mandibular condylar head. Therefore, we designed a modified extracorporeal reduction technique, without detaching the lateral pterygoid muscle in order to maintain the blood supply to the fractured mandibular condylar head. We believe that this minor modification may minimize the risk of resorption of the fractured mandibular condylar head. In this article, we introduce this technique in detail, and report on two cases.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.5
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• pp.343-350
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• 2017

The aim of this study is to introduce a surgical technique that can maintain blood supply to prevent condylar resorption in the extracorporeal reduction of condylar fracture. Neither the medial pterygoid muscle on the ramal bone nor the lateral pterygoid muscle on the condylar fragment was detached after vertical ramal osteotomy. Thus, reduction was performed in the intracorporeal state. Therefore, blood supply was expected to be maintained to the fragments of both the condylar and ramal bones. On postoperative radiographs, the anatomical outline of the fractured condyle was well restored, and the occlusion was stable. In the unilateral case, there were no signs of mandibular condylar resorption until postoperative 3 weeks. In the 2 bilateral cases, condylar displacements with plate fractures and screw loosening were observed at postoperative 1 month or 5 months, but radiodensity at the displaced fracture site increased during the follow-up period. Finally, complete remodeling of the condylar fragments with restored anatomic appearance was observed on 8-month or 2-year follow-up radiographs. All cases exhibited good healing aspects with no signs or symptoms of mandibular condylar dysfunction during the postoperative remodeling period after intracorporeal reduction of condylar fracture.

• The Journal of the Korean dental association
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• v.48 no.5
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• pp.379-390
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• 2010

The aim of this study was to investigate clinical and cephalometric characteristics of patients with anterior open bite and mandibular condylar resorption. Total of 45 subjects were recruited from the patients who visited the Department of Oral Medicine, Kyungpook National University Hospital in 2006 for treatment of temporomandibular dysfunction. After taking patient's history concerning temporomandibular joint dysfunction, clinical examination was performed and panoramic, transcranial, and lateral cephalometric radiographs were obtained. The cephalometric data were compared to those of normal Korean population. The results were as follow: 1. Clinical characteristics 1) Female was 4.6 time more prevalent than male, and 82.2% of the subjects were in second and third decade. 2) Angle's Class I occlusal type was 51%, Class II was 29%, and Class III was 20%. 3) The mean value of the overjet and overbite were 3.2mm and -1.1mm, respectively. 4) Most of the patients had parafunctional oral habits. 2. Cephalometric characteristics 1) SNA showed no significant difference between condyle resorption and normal group. However, in female resorption group, SNB was lesser and ANB was greater than those in normal group. 2) SN-GoMe and FMA increased in resorption group. 3) Palatal plane angle did not show significant difference between resorption and normal group. 4) Total posterior facial height was significantly smaller and total anterior facial height showed no significant increase as compared with those of the normal group. 5) Mandibular body length did not show any significant difference between resorption and normal group.

• Journal of Oral Medicine and Pain
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• v.34 no.1
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• pp.91-102
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• 2009

Condylar resorption, or condylysis can be defined as progressive alteration of condylar shape and decrease in mass. Condylar resorption is a poorly understood progressive disease that affects the TMJ and that can result in malocclusion, facial disfigurement, TMJ dysfunction, and pain. The aim of this study was to investigate clinical assessment and cephalometric characteristics in 224 patients with condylar resorption, who visited in the Department of Oral Medicine Kyungpook National University Hospital at 2006, by use of panorama, transcranial view and lateral cephalometric radiograph. The results were as follows; 1. Clinical assessment 1) Total number of patients who visited with chief complaints of TMD were 2419 and 224 (9.3%) among them revealed the condylar resorption, Among patients group with condylar resorption, female was 183 and male was 41, females were predominant. 2) Patient's age ranged from 12 to 70 and mean age was 30.6 years old with a strong predominance for 10s and 20s. Distribution of a showed as follows; 10s was 26.3%, 20s was 34,8%, 30s was 13.8%, 40s was 11.2%, 50s was 7.1%, 60s was 6.3% and 70s was 0.4%. 3) Most of the patients had parafunctional habit. 4) The case of showing the pain in condylar resorption was 145, the case of not showing the pain was 79. 5) Treatment duration of the patients was relatively short. 2. Cephalometric Characteristics 1) ANB which means the retruding of the mandible increased significantly than normal group. The ANB of female was lager than male group as the means of ANB were 5.05 in female and 3.57 in male, 2) SN-GoMe and FMA increased in resorption patients, but FH-PP did not show any significant difference. The FMA of female was lager than male group as the means were 31.69 in female and 30.44 in male. 3) Total posterior facial height was significantly smaller and total anterior facial height showed no significant increase as compared with those of the normal group. Condylar resorption was predominant in young female which was caused by more vertical facial pattern in female than male and increase of parafunctional habit in young age. It was thought that the patients who have a risk factor increasing the compressive stress at condyle caused by obliquely inclined masseter and medial pterygoid show high prevalence of condylar resorption.

• Imaging Science in Dentistry
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• v.46 no.1
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.2
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• pp.162-167
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• 2010

This is a case report about patient who had suffered from degenerative joint disease and treated by TMJ reconstruction with condylar prosthesis. The patient visited Korea University An-am hospital on 2007 complaining symptom about both TMJ pain, mouth opening limitation and open bite. From CT view there was severe resorption of both condylar head, therefore condylar prosthesis reconstruction was planned. After 3D RP model analysis for preparation, the patient was operated under general anesthesia for condylar prosthesis reconstruction and the symptom was alleviated. (increased mouth opening, reduced anterior open bite, full mouth occlusal contact achieved) Follow up was carried out monthly, but after this, patient refused follow up. After 26 months from the operation, the patient revisited for anterior open bite. In clinical evaluation, occlusal contact was remained, but anterior open bite was relapsed. From cephalometry analysis, severe resorption of glenoid fossa was found. Therefore, Autogenous disc reconstruction with alloplastic material was planned on August 2009. After another surgery, condylar prosthesis was regained its normal position in glenoid fossa, and occlusion was recovered properly.

• The korean journal of orthodontics
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• v.46 no.6
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• pp.395-408
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• 2016

We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR.