Surgical treatment of adolescent internal condylar resorption (AICR) with articular disc repositioning and orthognathic surgery in the growing patient--a pilot study.

Trevor P Bodine,Eustaquio Araujo,Donald R Oliver,Peter H Buschang,Larry M Wolford

doi:10.1186/s40510-015-0115-8

Trevor P Bodine, Eustaquio Araujo + Show 3 more

Open Access

https://doi.org/10.1186/s40510-015-0115-8

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Journal: Progress in Orthodontics	Publication Date: Jan 18, 2016
Citations: 16	License type: CC BY 4.0

Affiliation: Baylor University, Texas A&M University

Abstract

BackgroundThe aim of this study was to better understand how surgical repositioning and stabilization of anteriorly displaced articular discs using the Mitek mini-anchor technique affects condylar growth in growing patients with adolescent internal condylar resorption (AICR).MethodsTwenty-two adolescent patients diagnosed with AICR and anterior temporomandibular disc displacement were compared to untreated control subjects without AICR matched for age, sex, and Angle classification. Pre-surgical (T1 and T2) and post-surgical (T3 and T4) mandibular tracings were superimposed on natural stable structures to evaluate the horizontal, vertical, and total changes in the position of condylion.ResultsThe treated group showed an overall decrease in condylar height pre-surgically and statistically significant changes in condylar growth direction between the pre- and post-surgical observation periods. Pre-surgically, the treated group showed significantly more posterior condylar growth than the control group; they also showed inferior condylar growth, while the controls showed superior growth. Controls and patients in the treated group showed no significant differences in condylar growth post-surgically.ConclusionsAdolescent patients diagnosed with AICR and anterior disc displacement treated with mandibular ramus and maxillary osteotomies, along with Mitek anchors to reposition internally deranged discs, showed post-surgical normalization of condylar growth.

Highlights

The aim of this study was to better understand how surgical repositioning and stabilization of anteriorly displaced articular discs using the Mitek mini-anchor technique affects condylar growth in growing patients with adolescent internal condylar resorption (AICR)
The aim of this current study was to assess pre- and post-surgical growth of the condyle in patients with AICR treated with the Mitek mini-anchor system. The study evaluates both the pre-surgical and post-surgical changes that occur to determine whether the condylar growth of the condyle can be altered. Patient sample This retrospective study pertains to 22 female adolescent patients diagnosed with AICR who had undergone bilateral temporomandibular articular disc repositioning surgery using the Mitek mini-anchor technique to stabilize and retain the disc position
Treated subjects The 18 treated patients with pre-surgical records showed a decrease in vertical condylar height (0.7 mm/year) and posterior condylar growth (0.5 mm/year)

Summary

Introduction

The aim of this study was to better understand how surgical repositioning and stabilization of anteriorly displaced articular discs using the Mitek mini-anchor technique affects condylar growth in growing patients with adolescent internal condylar resorption (AICR). Temporomandibular joint dysfunction (TMD) is often a complaint of orthodontic patients. Anterior displacement of the articular disc is the most commonly occurring joint dysfunction, affecting nearly 40 % of the general population [1]. While many treatment modalities have been devised to alleviate the symptoms of temporomandibular joint (TMJ) dysfunction [6,7,8,9], few therapies correct the pathological process. One treatment modality for the correction of an anteriorly displaced disc utilizes the Mitek mini-anchor technique [10,11,12]. Concerns exist due to the possible effects of surgical manipulation on condylar growth

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