• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.11.1-11.6
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• 2019

Background: Botulinum toxin injection on the masticatory muscle induces the osteopenic condition on the ipsilateral condyle. Bisphosphonate suppresses bone resorption and is used to treat osteopenic or osteoporotic condition. This study aimed to evaluate the effect of bisphosphonate administration on prevention of condylar resorption and botulinum toxin A-induced disuse osteopenia in rats. Results: The volume of the condyle and bone volume/tissue volume (BV/TV, %) showed a strong tendency towards statistical significance (p = 0.052 and 0.058). Trabecular thickness (Tb.Th, mm) and trabecular number (Tb.N, 1/mm) were significantly smaller in the Botox group than in the other groups (p < 0.05). The volume of the condyle and BV/TV in the bisphosphonate 100 and bisphosphonate 200 groups showed similar values when compared with the control group. Conclusion: Bisphosphonate administration after botulinum toxin A injection in the masticatory muscles appears to prevent condyle resorption and botulinum toxin-induced disuse osteopenia in rats.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권4호
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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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• 제32권1호
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• pp.69-79
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• 2007

하악과두 흡수(condylar resorption)는 하악과두 용해라고도 하며 과두형태변화와 크기 감소가 점진적으로 또는 갑작스럽게 일어나는 것으로 정의할 수 있다. 원인은 잘 알려져 있지 않지만 류머티스 관절염, 전신성 홍반성 낭창, 스테로이드 복용(usage), 교정치료, 악교정 수술후 일어나는 과두흡수(secondary condylar resorption)와 특별한 원인 없이 일어나는 특발성 과두흡수(primary condylar resortion)로 나눌 수 있다. 이러한 하악과두 흡수가 발생하는 경우에는 골소실로 인해 이환측 과두에서 후방 지지의 갑작스런 상실이 초래된다. 이로인해 하악이 변위될수 있으며 교합변화, 개방교합과 같은 교합변화와 하악의 후퇴가 나타날 수 있다. 이에 저자는 하악과두 흡수가 일어난 증례를 보고하며 과두흡수와 관련된 인자, 병리기전, 환자관리에 대해 고찰하고자 한다.

• 대한치과교정학회지
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• 제20권2호
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• pp.363-379
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• 1990

The purpose of this study was to evaluate the effects of the mandibular retractive force on the mandibular condyle of growing dog. The experimental animals were six mongrel dogs of two-month old. Their deciduous dentition were completed. Two of them was used as control group, and experimental group was composed of remaining four. Head band and chin cup were made of cotton tape, and hooks are fabricated on the chin cup and had band for closed coil. Mandibular retractive force was 100g/side and chin cap appliance was used for 14 hours/day during night. Experimental group were sacrificed at 2, 4, 6, 8 weeks from beginning of the experiment. Right TMJ was prepared for histologic study and left TMJ was examined grossly for disc, fossa, and condyle. The conclusions are: 1. Two-month old control animal showed active cartilaginous growth on the mandibular condyle, therefore showed thick proliferative and hypertrophic zones. Remodeling process in the condyle head was observed in which there were bone resorption on the anterior surface and bone apposition on the posterior surface. 2. Four-month old control animal showed marked reduction of hypertrophic zone but the condylar bone remodeling was more pronounced. 3. In experimental group, there are marked reduction of hypertrophic zone at 4 weeks from beginning of experiment, and hypertrophic zone disappeared at posterior-superior portion of condyle in 6-week experimental animal. 8 week experimental animal showed slight recovery of hypertrophic zone. 4. In experimental group, bone deposition was increased at anterior surface of condyle, and bone resorption was increased at posterior surface of condyle. 5. In control group, the glenoid fossa and surrounding bone showed mainly bone apposition. But experimental group showed bone resorption at anterior surface of articular eminence and increased bone apposition at posterior surface of postglenoid spine. 6. No marked traumatic change was seen but 4 weeks and 8 weeks experimental animal showed flattening of posterior surperior condylar surface. Bone marrow of condyle showed minute focal bleeding in 2 weeks and 4 weeks experimental animal, and congestion and depression of hematopoietic bone marrow during all experimental period.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권5호
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• pp.442-446
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• 2001

Purpose : This study evaluated clinical and radiographic results after open reduction and lag-screw fixation of mandibular condyle fractures. Patients and Methods : 26 patients had been treated by lag-screw fixation for madibular condyle fracures via submandibular approach and follow up for over 6 months. The lag-screw used in this study was designed by Eckelt. Results : Radiographically, resorption of the condyle head found in 4 cases (15%) and minimal displacement of the condyle head was found in 3 cases (12%). Post-operative infection were not found in all cases. Clinically, All patiens had a stable occlusion and normal mouth opening (over 40mm). TMD problems with crepitus or some discomfort encountered in 4 patients but tolerable to the patients. Conclusion : Lag screw fixation can be a good option especially high level condylar fractures, however this procedure must be used in cautiously because of slipping of the fragments and possible to resorption of the fragments.

• Imaging Science in Dentistry
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• 제34권2호
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• pp.81-89
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• 2004

Purpose: To investigate the histopathological changes in the temporomandibular joint in streptozotocin-induced diabetic rat following irradiation. Materials and Methods : Sprague-Dawley rats weighing about 250 gm were divided into three groups: control, diabetic, and diabetic-irradiated groups. Diabetes mellitus was induced in the rats by injecting streptozotocin. Rats in the control group were injected with citrate buffer only. After 5 days, the head and neck region of the rats in diabetic-irradiated group were irradiated with single absorbed dose of 10 Gy. The rats were killed at 1, 3, 7, 14, 21, and 28 days after irradiation. The specimen including the temporomandibular joint were sectioned and observed using a histopathological method. Results : In the diabetic group, severe bone resorption in the mandibular condyle was observed throughout the period of experiment. Necrosis of bone marrow and trabeculae was observed at 28 days after diabetic state. Atrophy and fibrosis in the retrodisca] tissue was gradually progressed during the time of the experiment. In the diabetic-irradiated group, severe bone resorption in the mandibular condyle was observed during the early experimental phases, but regeneration of bone marrow was initiated at ]4 days after diabetic state and irradiation. A]so, calcification of abnormal trabeculae was observed at 28 days after diabetic state and irradiation. The retrodisca] tissue was degenerated in the early experimental phases, but it had been gradually regenerated during the experimental time. Conclusion: This experiment suggests that bone resorption and degeneration in the mandibular condyle are caused by the induction of diabetes, and abnormal bone formation is induced after irradiation in diabetic state.

• 치과방사선
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• 제23권1호
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• pp.27-44
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• 1993

This study was performed to investigate the changes of mandibular condyle by low calcium diet and the effects of irradiation on the bone in osteoporotic state. In order to carry out this experiment, 80 seven-week old Sprague-Dawley strain rats weighing about 150 gm were selected and equally divided into one experimental group of 40 rats and one control group with the remainder. The experimental group and the control group were then subdivided into two group and exposed to irradiation. The two irradiation groups received a single dose of 20 Gy on the jaw area only and irradiated with a cobalt-60 teletherapy unit. The rats in the control and experimental groups were serially terminated by fours on the 3rd, the 7th, the 14th, and the 21st day after irradiation. After termination, both sides of the dead rats mandibular condyle were removed and fixed with 10% neutral formalin. The bone mineral density of mandibular condyle was measured by use of dual energy X-ray bone densitometer(model DDX-alpha, Lunn Corp., U. S. A.). The mandibular condyle was radiographed with Hitex HA-80(Hitex Co., Japan). Thereafter, the obtained radiographs were observed, and the mandibular condyle was further decalcified and embedded in paraffin as the general method. The specimen sectioned and stained with hematoxylin-eosin, PAS and Rabbit Anti-Human Tumor Necrosis Factor-a observed by a light microscope. The obtained results were as follows: 1. In the non-irradiated group with the low calcium diet, the bone mineral density of the condyle was markedly decreased after 14 days, and decrease the number of trabeculae of the condyle and resorption of the calcified cartilaginous zone were observed after 3 days. On microscopic observations, the number nd size of trabeculae were decreased after 7 days of experiment. 2. In the irradiated group with the low calcium diet, the bone mineral density of the condyle was markedly decreased after 14 days and resorption of the calcified cartilaginous zone and decrease the number and coarse of the trabeculae of the condyle were observed. These findings were extended rather than in non-irradiated group with low calcium diet. On microscopic observations, many osteoclasts were detected and the number and size of trabeculae were somewhat decreased after 7 days. Also there was degenerative changes of tissues of bone marrow on the 14th day but that condition was restored on the 21st day of experiment. 3. In the irradiated group with normal diet, the bone mineral density of the condyle was somewhat decreased with times and degree of decrease of the number of trabeculae was somewhat larger than in the non-irradiated group with normal diet. On microscopic observations, the tissues of bone marrow were atrophic and degenerative changes but that condition was restored on the 21st day of experiment. 4. In immunocytochemical findings, in the irradiated and non-irradiated groups with low calcium diet, negative or partial positive response to TNF was observed, but positive response in the normal diet groups.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권6호
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• pp.521-528
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• 2010

Purpose: Anatomical reduction of the fractured condylar process is an important prerequisite for re-establishing function. The authors reported about effectiveness of transoral approach for mandibular subcondyle fracture using trochar device in cases that the fracture line is below the reference line, the perpendicular line of the longitudinal axis of condylar process passing the lowest point of sigmoid notch. As a serial study, we report the open reduction via preauricular approach for mandibular condyle fracture, in cases that the fracture line is above the reference line. Patients and Methods: Sixteen condylar fractures of 15 adult patients were divided two groups and treated by open reduction via preauricular approach (8 cases) or by closed reduction (8 cases). The degree of maximal mouth opening, occlusion, anatomical reduction, condylar resorption and complications were assessed and evaluated for the two groups. Results: The open reduction of condyle via preauricular approach leads to good results without permanent complications. Anatomical reduction of open reduction group and maximal mouth opening range of the closed reduction group is significantly better than the other group. No significant differences were found in the condylar resorption and the occlusion. Conclusion: The preauricular approach was useful to reduce and fix the condylar fragment, in cases that the fracture line is above the reference line.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권2호
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• pp.76-82
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• 2014

Objectives: The aim of this study is to report the results of extracorporeal fixation in patients with mandibular condylar fractures and compare them with the clinical results of conservative treatment. Materials and Methods: The medical records of 92 patients (73 male [M] : 19 female [F], age 13-69 years, mean 33.1 years) treated for condylar fractures at the Department of Oral and Maxillofacial Surgery in Sun Dental Hospital (Daejeon, Korea) from 2007 to 2012 were reviewed. Patients were divided into three groups: group A (23 patients; M : F=18 : 5, age 21-69 years, mean 32.6 years), treated with extracorporeal fixation; group B (30 patients; M : F=24 : 6, age 16-57 years, mean 21.1 years), treated by conventional open reduction; and group C (39 patients; M : F=31 : 8, age 16-63 years, mean 34.4 years), treated with the conservative method ('closed' reduction). Clinical and radiographic findings were evaluated and analyzed statistically. Results: Occurrence of postoperative condylar resorption correlated with certain locations and types of fracture. In this study, patients in group A (treated with extracorporeal fixation) did not demonstrate significant postoperative complications such as malocclusion, mandibular hypomobility, temporomandibular disorder, or complete resorption of condyle fragments. Conclusion: In superiorly located mandibular condyle fractures, exact reconstruction of condylar structure with the conventional open reduction technique can be difficult due to the limited surgical and visual fields. In such cases, extracorporeal fixation of the condyle using vertical ramus osteotomy may be a better choice of treatment because it results in anatomically accurate reconstruction and low risk of complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권3호
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• pp.378-387
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• 1996

We performed costochondral grafting in mmandibular reconstruction including condyle replacement in 5 patients which have 4 cases of ameloblastoma, 1 case of resorption of left condyle due to osteomyelitis. We harvested the 6 th costochondral cartilage of unaffected side. No specific complications were appeared with unexpected fracture of costochondral junction and infection of operation site, These patients show 30-45mm at month opening, near normal of affected side, near normal or normal of unaffected side at lateral excursion. Postoperative coureses was uneventful with improved cosmetic and functional results. Our report is indicated that the costochondral graft is satisfactory to reconstruct mandibular defect including condyle replacement, especially in growing patients.