It often results in a posterior, rotational growth pattern of the mandible, deficient vertical posterior mandibular development, and retrognathic profiles often requiring. Twentytwo adolescent patients diagnosed with aicr and anterior temporomandibular disc displacement were compared to untreated. Aicr is one of the most common tmj conditions seen in teenage females 8. Twentytwo adolescent patients diagnosed with aicr and anterior temporomandibular disc displacement were compared to. After growth completion, as the condyle resorbs, the occlusion becomes progressively class ii, with or without open bite. Progressive condylar resorption pcr of the temporomandibular joint tmj occurs mostly in adolescent female individuals, who are likely to request orthodontic treatment. The heading sequence of the mesh terms used orthognathic surgery mesh and condylar resorption or progressive condylar. In patients with the condition of uncertain etiology that is commonly referred to as idiopathic condylar resorption, the condyles of the mandible partially resorb, thereby causing a loss of condylar height with secondary alterations of the maxillofacial morphology, occlusion, and head and neck function. On the other hand, condylar resorption cr is defined as a progressive change in condylar configuration followed by a decrease in mass. This disorder is nine times more likely to be present in females than males, and is more common among teenagers. The condyles undergo resorption and the bone loss results in facial, bite and airway changes. A comprehensive treatment approach for idiopathic condylar.
This prospective study selected 21 patients who underwent orthognathic surgery for bite correction. Idiopathic condylar resorption icr is a specific condition that affects the jaw joints temporomandibular joints or tmjs and most commonly occurs in teenage girls. The mitek minianchor technique is applicable to cases of disc displacement of various etiologies, including adolescent internal condylar resorption aicr 15, 16. Upon orthognathic mandibular advancement surgery the adjacent soft tissues can displace the distal bone segment and increase the load on the temporomandibular joint causing loss of its integrity. Validation of a novel imaging approach using multislice ct. Study selection included preexisting cbct condylar. It sometimes has been referred to as cheerleaders syndrome, because it frequently occurs in teenage girls participating in sports activities which, through minor or major. Pathophysiology and pharmacologic control of osseous mandibular condylar resorption. Idiopathic condylar resorption of the temporomandibular joint. This article presents the diagnostic criteria for idiopathic condylar resorption and a new treatment protocol for management of this pathologic condition.
Surgical treatment of adolescent internal condylar resorption. Condylar resorption can be aggressive months or slow years. Ku jk 2017 orthognathic surgery for patients with idiopathic condylar resorption. The condyles are knobs of bone which protrude from the sides of the jaw bone to form hinge joints with the skull, one on each side of the head. Pdf idiopathic condylar resorption icr, alternatively called progressive condylar resorption, is an uncommon aggressive form of. Rm philips, wh bellresorption of mandibular condyles after sagittal ramus split osteotomy.
Townes and panoramic radiographs, taken at several intervals, were used to quantify the displacement of the condylar process fractures. Anterior open bite due to idiopathic condylar resorption during. Condylar resorption causes and treatment bauer smiles. Surgical orthodontic treatment of acquired openbite attributed to. Condylar bony changes in patients with temporomandibular. The heading sequence of the mesh terms used orthognathic surgery mesh. Facial imbalance receding chin, smaller airway snoring, apnea and bite disturb. Idiopathic condylar resorption icr, which is alternatively called progressive condylar resorption pcr, is an uncommon aggressive form of degenerative disease of the temporomandibular joint tmj. Pain symptoms will worsen if the resorption of the jawbone goes untreated. This hormonally mediated condition is initiated as the adolescent enters the pubertal growth phase age of onset between 11 to 15 years. The aim of this study was to better understand how surgical repositioning and stabilization of anteriorly displaced articular discs using the mitek minianchor technique affects condylar growth in growing patients with adolescent internal condylar resorption aicr. During growth, condylar resorption may decrease the projection of the mandible and be unrecognized as the source of a class ii malocclusion.
Remodeling of the condyle and temporal fossa with destruction of condylar cartilage and subchondral bone leads to postsurgical condylar resorption, with arthralgia and functional limitations. Idiopathic condylar resorption icr presents diagnostic. In terms of etiology and clinical presentation, aicr is a distinct tmj pathology that differs. Oct 14, 2012 idiopathic condylar resorption in teenage girls most common tmd in adolescent 9f. B the same condyle 1 year after treatment with orthodontics and surgical mandibular advancement. Idiopathic condylar resorption icr can cause open bite in affected individuals. The radiological signs of cr are similar to juvenile osteoarthritis and osteoarthrosis. Condylar resorption, also called idiopathic condylar resorption, icr, and condylysis, is a temporomandibular joint disorder in which one or both of the mandibular condyles are broken down in a bone resorption process. Condylar changes in patients with idiopathic condylar. Idiopathic condylar resorption icr is a temporomandibular joint tmj condition characterized by condylar deformation leading to idiopathic loss of condylar height.
Bilateral idiopathic condylar resorption of the temporomandibular joints. Progressive condylar resorption, also known as idiopathic condylar resorption, is an uncommon, aggressive, degenerative disease of the temporomandibular joint tmj seen mostly in adolescent girls. Idiopathic condylar resorption icr is a progressive condition that affects the jaw joints. The 2 yellow lines indicate that a major tmj pathosis, such as progressive condylar resorption pcr1, pcr2, results in a greater growth deficit than did the minor insult. Condylar resorption in orthognathic patients after mandibular. Left alone, resorption could badly damage the bone and surgery may be needed. If condylar resorption is still active, replacement of the joint with an autologous costochondral graft or total alloplastic temporomandibular joint replacement prosthesis is possible 25, 4045. Osseous condylar resorption that occurs without obvious cause is termed idiopathic condylar resorption icr. Idiopathic condylar resorption public group facebook.
The average office will likely see 02 cases in a career. Progressive condylar resorption is a process that involves the temporoman dibular joint tmj. Idiopathic condylar resorption in teenage girls most common tmd in adolescent 9f. Surgical treatment of adolescent internal condylar resorption aicr. Orthognathic surgery for patients with idiopathic condylar. Orthognathic surgery versus temporomandibular total joint replacement.
There are a number of icrpcr patients who present with one of the following problems, who are best treated with synthetic total joint replacement. Condylar resorption and arthrosis of the joint dgkfo. Condylar degeneration and diseaseslocal and systemic etiologies. Idiopathic condylar resorption and arthrosis of the joints. Pathophysiology and pharmacologic control of osseous mandibular condylar resorption, letters to the editor. Orthodontics typically encounter icr at a rate of 1 care per 5000. Idiopathic condylar resorption is a poorly understood progressive disease that affects the tmj and that can result in malocclusion, facial disfigurement, tmj dysfunction, and pain. Risk factors in the initiation of condylar resorption. We report the successful treatment of a 38yearold woman with bilateral idiopathic condylar resorption and anterior open bite. They can be among the most challenging of orthodontic patients to successfully treat, especially if orthognathic surgery is involved in the treatment process.
Feb 17, 2017 idiopathic condylar resorption icr is a welldocumented but poorly understood progressive disease that affects the temporomandibular joint tmj. The patients whose condylar process fractures were treated by closed. Wed like to understand how you use our websites in order to improve them. Idiopathic condylar resorption and its impact on orthodontic treatment by almuzian. Condylar resorption following orthognathic surgery is affected by various surgical and nonsurgical factors, and its incidence rate has been reported to vary from 1 to 31%. Apos trends in orthodontics orthodontic camouflage via. It is also often met in literature under the following terms. Pcr1 occurring at an earlier age than pcr2 results in a greater growth deficit because the tmjs and both jaws had a shorter growth period before the process was interrupted.
Progressive condylar resorption pcr synonyms pcr of the tmj is also known by the terms idiopathic condylar resorption and condylysis. In the 1980s, conventional transcranial and infracranial radiographs were used to evaluate the position of the condyle in the fossa. Evaluation of condylar resorption before and after. Previously identified by the term idiopathic condylar resorption, it is a degenerative condition that strikes the condylar head with arthriticlike presentation and leads to pain and. Idiopathic condylar resorption diagnosis, pathophysiology, treatment and orthodontic considerations. Pdf idiopathic condylar resorption icr is a condition with no known cause, which manifests as progressive. Progressive condylar resorption pcr is a pathological process that primarily afflicts early through late adolescent females, but can present in males as well. The reported incidence of condylar resorption after orthognathic surgery ranges from 1% to 31% depending on the defined criteria and various surgical and nonsurgical risk factors. Although it is prudent to not treat patients with icr until active. Cbct creates a 3d xray to let us see the degradation of the condyle. Progressive condylar resorption pcr or idiopathic condylar resorption icr. Open access publications 51762 freely accessible full text publications. Request pdf risk factors in the initiation of condylar resorption progressive condylar resorption is a process that involves the temporomandibular joint tmj and the occlusion. Condylar resorption is a condition that affects the bone of the lower jaw.
May 08, 2020 condylar resorption is a condition that affects the bone of the lower jaw. Adolescent internal condylar resorption acir cases 3 and 4. Management of condylar resorption before, during, and after. If you notice symptoms of condylar resorption, cone beam computed tomography cbct is used to diagnose the condition. Malpositioned condyles during osteotomy can cause remodeling of the condyles, but can also initiate condylar resorption cr. Condylar degeneration and diseaseslocal and systemic. She had incompetent lips, a gummy smile, increased lower facial height, high mandibular plane angle, skeletal and dental class ii malocclusion with mild mandibular crowding, increased overjet, and mandibular midline deviation to the right. Baylor university medical center 3409 worth street, suite 400 dallas, tx 75246 2148289115. Jan 18, 2016 the aim of this study was to better understand how surgical repositioning and stabilization of anteriorly displaced articular discs using the mitek minianchor technique affects condylar growth in growing patients with adolescent internal condylar resorption aicr. The temporomandibular joint condyle is susceptible to developing a variety of problems, ranging from simple osteoarthrosis to severe condylar resorption. The most frequent condylar bony change observed was sclerosis 3 joints, 30. This article will focus on issues related to the etiology of these conditions. It is usually encountered in adolescent and young females, although it has also been observed in males. It is fortunately very rare, since it can be very damaging.
The condition most often occurs in teenage girls, but can occur at any age, although rarely over the age of 40 years. Tuinzing, dmd, phd vrije universiteit hospital, amsterdam, the netherlands condylar resorption and condylar atrophy have been iden tified as a problem and this has led to many publications in the last decade. Adolescent internal condylar resorption aicr larry m. This item appears in the following collections academic publications 176810 academic output radboud university. Diagnosis and management of condylar resorption sciencedirect. Pdf idiopathic condylar resorption icr, alternatively called progressive condylar resorption, is an uncommon aggressive form of degenerative disease. Condylar resorption is degenerative condition seen mostly in adolescent and young women.
Risk factors in the initiation of condylar resorption squarespace. This article discusses the cause, appropriate diagnostic evaluation, and management of progressive condylar resorption. Surgical management of idiopathic condylar resorption. Condylar resorption also known as condylysis is an event rarely seen in normal orthodontic practice, but when it occurs, it is a very unhappy occurrence and. Idiopathic condylar resorption icr is a welldocumented but poorly understood progressive disease that affects the temporomandibular joint tmj. Idiopathic condylar resorption and its impact on orthodontic treatmen. A surgeon proposed a condylar shave designed to reshape the eroded condyle. In terms of etiology and clinical presentation, aicr is a distinct tmj pathology that differs from other conditions causing condylar resorption. Icr may result in malocclusion, facial disfigurement, tmj dysfunction, and pain. Surgical management of idiopathic condylar resorption oral and. Idiopathic condylar resorption icr, also known as idiopathic condylysis or condylar atrophy, which is known to predominantly affect females aged 1535 years, results in maxillofacial morphological features such as decrease in mandibular ramus height, loss of overall posterior facial height, mandibular retropositioning and resultant class ii with or without anterior open.
88 629 171 35 1372 557 39 318 284 116 1506 1185 1541 1619 427 42 217 1289 1580 111 360 6 1383 1077 984 1634 471 1147 1344 284 106 673 820 174 1110 1096 1345 676 105 324 302 455