Abstract
BackgroundBifid mandibular condyle (BMC) constitutes an extremely rare disorder characterized by a duplication of the head of the mandibular condyle. Its prevalence ranges from 0.31% to 1.82% in the published literature.ObjectivesThe primary objective was to describe the main etiological, clinical and radiological characteristics of patients with BMCs and the existent treatment options. The secondary objective was to simultaneously include the characteristics of two new cases of BMC.Material and MethodsAn electronic search in Pubmed (MEDLINE), Scopus and The Cochrane Library was carried out by two independent reviewers until April 2018. Prospective or retrospective cohort studies, case series and case reports describing clinical and/or radiological characteristics of patients with BMC were included. Registered variables were demographic, etiological factors, diagnostic exam, clinical characteristics and treatment options. The results from the articles selected were organized in a Table along with the characteristics of two new cases of BMC provided by the authors.ResultsFrom a total of 431 articles found in the initial search, 68 articles were finally included. This systematic review included 216 patients and 270 BMC with an average age of 30.6 (SD=14.7) years and a women:men ratio of 1.4:1. Mediolateral condylar orientation was the most prevalent position (80.1%). Among cases with known etiology, 40.8% of cases had a history of traumatism, while 55.9% did not present any relevant medical background. Half of the symptomatic cases had history of trauma. The most common symptoms were hypomobility (22.7%), arthralgia (18.1%), articular noise (17.2%) and ankylosis (17.6%). Active monitoring and manufacturing an occlusal splint were the most frequent treatment options.ConclusionsBMC may have congenital or traumatic etiology. Hypomobility and arthralgia are the most frequent symptoms and treatment options are often conservative. Key words:Bifid mandibular condyle, trifid condyle, tetrafid condyle, condylar orientation, ankyloses.
Highlights
Bifid mandibular condyle (BMC) constitutes an extremely rare disorder characterized by a duplication of the head of the mandibular condyle [1,2,3]
While a great majority of BMCs have coincidentally been diagnosed with a panoramic radiography (PAN) during a routine exam [1,12,14,19,26,27,28,29,30,31], computed tomography (CT) is considered to be the test of choice for an appropriate diagnosis [13,16,18,30,32]
The results from the articles selected were organized in a Table along with the characteristics of two new cases of BMC provided by the authors
Summary
Bifid mandibular condyle (BMC) constitutes an extremely rare disorder characterized by a duplication of the head of the mandibular condyle [1,2,3]. The actual prevalence of BMC is controversial as it widely ranges from 0.31% to 1.82% among previously published studies [4,5,6] This disorder is considered to be a developmental abnormality it has been related to infection, trauma, condylar fractures or condylectomy [7,8,9,10,11,12,13,14,15,16]. The primary objective of this systematic review was to describe the main etiological, clinical and radiological characteristics of patients with BMCs, and the existent treatment options. Objectives: The primary objective was to describe the main etiological, clinical and radiological characteristics of patients with BMCs and the existent treatment options. Active monitoring and manufacturing an occlusal splint were the most frequent treatment options
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