Condylectomy and Costochondral Graft Reconstruction for Treatment of Active Idiopathic Condylar Resorption

Abstract

The purpose of this study was to evaluate the outcomes in patients with active bilateral idiopathic condylar resorption treated by condylectomy and costochondral graft (CCG) reconstruction. This was a retrospective evaluation of 15 consecutive patients treated at Massachusetts General Hospital from 1999 to 2004 who had: 1) active bilateral idiopathic condylar resorption confirmed by clinical examination, plain radiographs, and technetium-99 bone scan; 2) adequate documentation; and 3) a minimum of 12 months follow-up. Patients with an identifiable cause of condylar resorption such as rheumatoid or degenerative arthritis, trauma, or steroid use, or who had less than 12 months follow-up were excluded. Preoperative, immediate postoperative, 6-month, 12-month, and latest follow-up clinical examinations, lateral cephalograms, and panoramic radiographs were used to evaluate the outcomes. Inferior alveolar and marginal mandibular nerve function, jaw motion, and occlusion were evaluated by history and physical examination. All patients underwent bilateral condylectomy and CCG reconstruction. There were 13 female and 2 male patients with a mean age of 24 years. Mean follow-up was 34 months (range, 12 to 84). Preoperatively, all patients had Class II malocclusion: mean overjet 6.2 mm and mean anterior open bite -2.65 mm. At latest postoperative follow-up, all patients showed Class I occlusion with no anterior open bite, a stable and reproducible occlusion, and a normal range of TMJ motion with a mean maximal incisal opening of 39 mm. The results of this study indicate that a stable and satisfactory outcome is achievable in patients with active idiopathic condylar resorption treated by condylectomy and CCG reconstruction.