Signs, Symptoms, and Morphological Features of Idiopathic Condylar Resorption in Orthodontic Patients: A Survey-Based Study.

Akihiko Iwasa,Eiji Tanaka

doi:10.3390/jcm11061552

Abstract

Background: Idiopathic condylar resorption (ICR) is an aggressive degenerative disease of the temporomandibular joint that is most frequently observed in teenage girls. However, no specific cause of ICR has been identified. To explore the specific causes of the onset and progression of ICR, we performed a survey-based study on ICR in orthodontic patients and described its subjective symptoms, clinical signs, and condylar morphological features. Methods: A total of 1735 participants were recruited from 2193 orthodontic patients. For each participant, subjective symptoms and clinical signs of temporomandibular disorders (TMDs) were evaluated through clinical examination and a questionnaire. Furthermore, three-dimensional computed tomography (CT) was performed to diagnose ICR. Results: Among the 1735 patients evaluated, ICR was present in two male and ten female patients. All 12 patients had maxillary protrusion and an anterior open bite. Four patients with ICR underwent orthodontic treatment. Based on CT findings, patients with ICR had significantly different condylar sizes and shapes from patients with TMDs alone. Conclusions: The coexistence of intrinsic and extrinsic factors, such as sex-hormone imbalance and a history of orthodontic treatment, might lead to the onset of ICR. We suggest that growing patients suspected of having ICR should undergo CT evaluation because CT findings may precede clinical symptoms and signs.

Highlights

The temporomandibular joint (TMJ) permits large relative movements between the temporal bone and mandibular condyle [1]
Among the various types of malocclusion, crowding, maxillary protrusion, and mandibular prognathism were observed in 32.0%, 27.1%, and 14.7% of orthodontic patients with temporomandibular disorders (TMDs), respectively
The most common symptom was clicking; self-reported and clinically assessed joint sounds were noted in 45.1% and 58.0% of orthodontic patients with TMDs, respectively (Table 3)

Summary

Introduction

The temporomandibular joint (TMJ) permits large relative movements between the temporal bone and mandibular condyle [1]. The mandibular condyle rapidly elongates toward the temporal bone [3]. This elongation is mostly dependent on appositional growth at its apex, where chondrogenitor cells in the polymorphic cell layer differentiate into chondrocytes, which are incorporated into the underlying condylar cartilaginous tissue during chondrogenesis [4]. To explore the specific causes of the onset and progression of ICR, we performed a survey-based study on ICR in orthodontic patients and described its subjective symptoms, clinical signs, and condylar morphological features. We suggest that growing patients suspected of having ICR should undergo CT evaluation because CT findings may precede clinical symptoms and signs

Methods

Results

Discussion

Conclusion