Mandibular Condylectomy Research Articles

Computer‐assisted removal of an ectopic tooth from the mandibular fossa through a mandibular condylectomy approach in a Comptois gelding

SummaryA 3‐year‐old Comptois gelding with a history of chronic fistulation at the base of the right ear was referred for the treatment of a unilateral ectopic tooth in the right temporal region. Cone‐beam computed tomography (CBCT) confirmed the presence of an ectopic tooth in the right mandibular fossa. The ectopic tooth was associated with a draining tract running through the zygomatic process of the right temporal bone. A total mandibular condylectomy provided a direct approach to the ectopic tooth, which was subsequently successfully removed. Long‐term follow‐up confirmed a satisfactory outcome despite the need for repeated debridement and persistence of a small draining tract 15 months postoperatively. Computer‐assisted surgery (CAS) provided precise anatomical intraoperative orientation for the condylectomy and subsequent removal of the ectopic tooth close to the calvarium. The use of CAS greatly facilitated surgery and minimised the risks of important collateral damage.

Long-Term Outcome of Horses Undergoing Unilateral Mandibular Condylectomy and Meniscectomy for Temporomandibular Joint Disease.

BackgroundThere are no reports describing the long-term outcome of sport horses undergoing unilateral mandibular condylectomy with meniscectomy (UMC) for treatment for severe temporomandibular joint (TMJ) disease (TMD). Whether horses undergoing UMC require a specialized diet, can return to riding with a bit, or return to intended function after surgery is unknown.ObjectiveTo determine the long-term outcome of horses undergoing UMC for treatment of severe TMD.Study DesignA multi-institutional, retrospective study.MethodsMedical records obtained from seven equine referral hospitals of horses with severe TMD that underwent UMC were reviewed. Details regarding the presenting complaints, results of clinical examination, findings of diagnostic imaging, surgical technique, and outcome (including long-term follow-up with an owner questionnaire) were recorded.ResultsEleven horses fit the inclusion criteria. Three had severe idiopathic osteoarthritis, and eight had confirmed septic osteoarthritis of the TMJ. The most common post-operative complications were drainage and peri-incisional swelling (n = 5). One horse developed a hematoma at the surgical site because the facial artery was inadvertently transected during the approach, causing the condylectomy to be postponed. All horses were discharged alive from the hospital, and 10 returned to their previous or intended use. All had complete resolution of clinical signs of TMD. One mare was retired from athletic use due to her genetic value as a broodmare. One horse was euthanized 2 years after UMC due to progressively worsening of clinical signs of temporohyoid osteoarthropathy (THO), which were not present before surgery. When available, owner satisfaction of the results of the procedure was excellent.Main LimitationsSample size; multiple institutions; owner bias.ConclusionsUnilateral mandibular condylectomy should not be considered a salvage procedure. Horses treated for severe TMD by UMC can return to their previous or intended level of athletic performance and do not require a specialized diet.

Precise Intraoral Condylectomy With the Guide of Three-Dimensional Printed Template in a Mandibular Condylar Hyperplasia Patient.

This study aimed to introduce an innovative method for mandibular condylectomy. A customized three-dimensional (3D) printed template is used to perform precise condylectomy in an intraoral approach. Condylectomy combined with orthognathic surgery was used for the treatment of facial asymmetry secondary to unilateral condylar hyperplasia. The customized 3D printed osteotomy guide was placed with an intraoral approach under endoscopy, in order to perform a precise condylectomy. With the customized 3D printed template, the condylectomy was performed more precisely, and the conventional extraoral incision was avoided. The osteotomy line was accurately transferred from the virtual surgical plan to the real surgery, which assured the precise resection. The intraoral approach combined with a 3D printed template provides a novel solution to perform the condylectomy precisely.

Temporomandibular Joint Prostheses: Optimal Materials for the Optimal Stomatognathic System Performance-Preliminary Study.

The aim of this study was to quantitatively evaluate alloplastic Temporomandibular Joint (TMJ) Prostheses against other treatment modalities regarding the jaw kinematics. Six patients with Temporomandibular Joint Prostheses, four with mandibular ramus Patient-Specific Implant (PSI) with condylar head preservation, and four after mandibular condylectomy were evaluated by the means of axiography (Cadiax Compact 2), which is the noninvasive three-dimensional study of condylar movements. The patients were also evaluated clinically for the mandibular movements. The study revealed that the significant movement limitations occurred bilaterally in patients fitted with TMJ prosthesis. For the protrusion movement, the vector length of the movement (L) for the TMJ prosthesis was 0.31 vs. 3.01 mm for the PSI (Kruskal–Wallis chi-squared = 9.1667, df = 2, p-value = 0.01022, post hoc Dunn p-value = 0.015) and for the laterotrusion to the operated side, the length of the vector (L) was 0.66 vs. 3.35 mm, respectively. Statistically significant differences between groups were most frequent for the laterotrusion to the unoperated side. The study shows that a further development on TMJ Prostheses geometry and materials is needed.

Microbiological investigation of the mandibular condyle in patients with advanced osteoarthritis of the temporomandibular joint

PurposeThe aim of this study was to investigate the presence of bacteria in samples of the temporomandibular joint taken from patients suffering from advanced osteoarthritis of the temporomandibular joint (TMJ). Materials and methods25 fresh mandibular condyle samples were taken from 17 consecutive patients undergoing mandibular condylectomy (8 bilateral) for advanced TMJ osteoarthritis (Dimitroulis Category 5 joints). The joint samples were stained and cultured for the presence of microorganisms following a standardised joint culture protocol. ResultsNo evidence of bacteria was found on staining or solid culture mediums. Late growth (day 12) of commensal skin organisms (P. Acnes, S. Epidermitis, S. Capitis) were identified in enriched broth samples in 5 joint samples. No statistically significant associations were noted between positive broth samples and age or previous joint intervention (p > 0.05) ConclusionsWithin the limitations of this study, we have failed to identify meaningful bacterial growth in tissues (i.e. condylar head) of the TMJ that would suggest a contributory bacterial pathogenesis for arthritis of the TMJ.

Is there New Condylar Formation after Unilateral Partial Mandibular Condylectomy?

Facial asymmetry related to unilateral condylar hyperplasia is one of the facial deformities diseases, usually treated with TMJ surgery. The aim of this review is to define if condylar reparation is possible after partial resection of the condylar head and establish the conditions. We realized a search in Pubmed Central, Science Citation Index, Elsevier Science Direct Complete, Highwire Press, Springer Standard Collection, to find the studies realized in condylar reparation after condylectomy in humans and animals. The results showed poor information for both, human and animal model research. The information shows that condylar reparation is possible after condyelectomy, demonstrating similar morphology with the normal non-operated condyles. Functional load, age and surgery presented relation with condylar reparation.

Mandibular condylectomy in a standing horse for treatment for osteoarthritis of the temporomandibular joint

SummaryAn Irish Sport Horse mare presented for evaluation and treatment of inability to masticate effectively with subsequent severe weight loss. A slowly expanding, firm, nonpainful mass was noted at the left temporomandibular joint. Radiographic examination revealed extensive osteoarthritic changes of this joint. Due to the age and debilitated condition of the horse, along with financial constraints on the owner's behalf, the decision was made to perform a mandibular condylectomy as a standing procedure using sedation and local and regional anaesthesia techniques. The mare tolerated the procedure very well and post operatively improved significantly.

Mandibular condylectomy with osteoarthrectomy and temporalis muscle transfer

Objectives: The aim of the present study was to evaluate the success rate and postoperative complication rate following surgical treatment of patients with severe temporomandibular joint chronic arthritis and ankylosis using mandibular condylectomy with osteoarthrectomy and temporalis muscle transfer.

Partial mandibular condylectomy and temporal bone resection for chronic, destructive, septic arthritis of the temporomandibular joint in a horse

See also Clinical Commentary by Carmalt

Pathology Quiz Case 2

A N 89-YEAR-OLD WOMAN PRESENTED WITH a rapidly progressive mass in the right parotid gland that extended into the middle cranial fossa. She denied constitutional symptoms, weight loss, and problems with speech, swallowing, or respiration. Her medical history was remarkable for liposarcoma of the right arm that had been treated with surgical resection 2 years earlier. Physical examination revealed a 3-cm fullness in the right preauricular area. There was no trismus, cranial nerve deficits, or neck lymphadenopathy. Computed tomography (CT) demonstrated a 4.0 3.0 2.7-cm mass with smooth, erosive changes of the temporomandibular joint (TMJ) and skull base with flocculent calcifications (Figure 1). The mass demonstrated inhomogeneous contrast enhancement on postcontrast T1-weighted magnetic resonance images (MRIs) (Figure2). Fine-needle aspiration (FNA) revealed abundant chondroid-appearing material with associated degeneration, changes consistent with a low-grade chondroid neoplasm. The patient underwent resection of the infratemporal fossa mass by way of a right parotidectomy with facial nerve dissection, mandibular condylectomy, and wide resection of the middle fossa cranial base and associated dura. Intraoperative frozen section showed atypical chondrocytes that were suggestive of a low-grade chondroid malignant neoplasm. Gross pathologic inspection revealed a white, friable, gritty mass. On microscopic examination, several areas showed atypical chondrocytes with occasional binucleated chondrocytes, which were interpreted as chondroid metaplasia (Figure 3, arrows). The mass was also surrounded by multinucleated giant cells (Figure 3, arrowheads). The mass demonstrated needleand rhomboid-shaped basophilic crystals that displayed positive birefringence on polarized microscopy (Figure 4). What is your diagnosis?

Mandibular condylectomy with osteoarthrectomy with and without transfer of the temporalis muscle

Twenty-two patients with chronic arthritis and ankylosis of the temporomandibular joint (TMJ) were treated by resection of the condyle with osteoarthrectomy and interposition with a temporalis muscle flap. We compared them with 14 patients who were treated by condylectomy and osteoarthrectomy alone. All patients were evaluated prospectively. Most patients had had a previous operation on the disc. Variables investigated before and after operation were pain during mandibular movements (using a visual analogue score (VAS) of 1–10) and impaired mandibular function such as chewing and biting off (also using a VAS of 1–10). Maximum interincisal opening was measured with a ruler. Both groups of patients showed significant improvements in all the variables evaluated. Using the predefined success criteria, both methods showed good success rates with few complications. The patients treated by interposition of the temporalis muscle tended to do better, but not significantly so. Both methods induced occlusal changes and some needed dental treatment postoperatively.

Aetiology of bifid condyle

Free AccessLetter to the editorAetiology of bifid condyleP P JajuP P JajuSearch for more papers by this authorPublished Online:28 Jan 2014https://doi.org/10.1259/dmfr/32282722SectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail AboutIn reference to the article “The frequency of bifid mandibular condyle in a Turkish patient population” published in Dentomaxillofacial Radiology,1 I wish to congratulate the authors for an informative study. Bifid mandibular condyle is a rare abnormality of unknown aetiology. The authors took great effort in mentioning multiple aetiologies of bifid condyle, for example, endocrine disturbances, exposure to teratogens, nutritional deficiencies, infection, radiation, trauma and genetic induced. In addition to the numerous aetiological factors described in the article I wish to elaborate some theories not mentioned.Poswillo et al2 suggested that it occurs as a result of changes in the position or form of the disc, leading to the formation of intraarticular septa across the joint space. This, in turn, influences the pattern of condylar regeneration. Post fracture healing and remodelling of the mandibular condyle, if they involve lateral and medial fragments, have also been linked to the development of ankylosis or bifid mandibular condyle. Szentpetery et al3 stated that the site of fracture and, most probably, its relation to the insertion of the lateral pterygoid muscle may determine future development of a normal or bifid condyle. Gundlach et al4 experimentally induced bifid condyles in animals by injecting teratogenic substances such as, N-methyl-N-nitrosourea and formhydroxamic acid in different concentrations at various stages of pregnancy. In addition, some reports of bifid mandibular condyle have established a relationship between the origin of the condition and the glenoid fossa. In developmental bifid mandibular condyle there is a separate glenoid fossa for each of the two parts, while in traumatic bifid mandibular condyle there is only one glenoid fossa.5 I hope these further possible explanations of the various theories adds to our knowledge of bifid condyle.References1 Miloglu O , Yalcin E , Buyukkurt MC , Yilmaz AB , Harorli A . The frequency of bifid mandibular condyle in a Turkish patient population. Dentomaxillofac Radiol 2010;39:42–46. Link ISI, Google Scholar2 Poswillo DE . Late effects of mandibular condylectomy. Oral Surg Oral Med Oral Patho 1972;33:500–512. Crossref Medline ISI, Google Scholar3 Szentpetery A , Kocsis G , Marcsik A . The problem of the bifid mandibular condyle. J Oral Maxillofac Surg 1990;48:1254–1257. Crossref Medline ISI, Google Scholar4 Gundlach KK . Formhydroxamic acid-induced malformations of the temporo-mandibular joint. J Oral Maxillofac Surg 1983;11:121–123. Google Scholar5 Stadnicki G . Congenital double condyle of the mandible causing temporomandibular joint ankylosis: report of case. J Oral Surg 1971;29:208–211. Medline, Google Scholar Previous article FiguresReferencesRelatedDetailsCited byMultiheaded mandibular condyles26 July 2022 | Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie, Vol. 46Bifid condyle secondary to traumatic condylar fractureJournal of Oral and Maxillofacial Surgery, Medicine, and Pathology, Vol. 26, No. 4Nontraumatic Bilateral Bifid Condyle and Intermittent Joint Lock: A Case Report and Literature ReviewJournal of Oral and Maxillofacial Surgery, Vol. 69, No. 8 Volume 39, Issue 4May 2010Pages: 191-256 2010 The British Institute of Radiology History Published onlineJanuary 28,2014 Metrics Download PDF

Modified trans-oral approach for mandibular condylectomy

Different approaches to the mandibular condyle have been described. In this paper, a modified trans-oral technique to access the mandibular condyle is described and illustrated. This technique was used in a small group of patients; the clinical outcomes are promising. The technique can be used in various temporomandibular joint (TMJ) operations, such as condylar resection, high condylectomy or tumor removal. It provides adequate intra-oral surgical access to the mandibular condyle and avoids complications from extra-oral approaches to the TMJ.

Mandibular Condylectomy and Meniscectomy for the Treatment of Septic Temporomandibular Joint Arthritis in a Horse

To report use of mandibular condylectomy for treatment of advanced degenerative joint disease of the temporomandibular joint (TMJ) caused by sepsis. Clinical case report. Two-year-old Noriker filly. Computed tomography (CT) was used to confirm advanced degenerative joint disease of the left TMJ and for follow-up after mandibular condylectomy and removal of necrotic meniscus. Painful swelling (3 weeks duration) with drainage located just caudal to the left lateral canthus of the eye was associated with atrophy of the left masseter muscle, masticatory problems, and inappetence. There was incisor malocclusion with a 1.4 cm resting lateral mandibular deviation to the right and inability to open the mouth more than a few centimeters. Left mandibular condylectomy combined with meniscectomy and thorough debridement of the septic left TMJ resulted in resolution of clinical signs and complete return of function. Streptococcus zooepidemicus, intermediately resistant to penicillin and subsequently to enrofloxacin, was isolated from the wound. Regeneration of a mandibular "pseudocondyle" was evident on CT at 4 months. At 4 months and 1 year the filly had maximal mouth opening >10 cm and no malocclusion. Mandibular condylectomy can be used to facilitate management of septic TMJ arthritis. There was no radiologic or clinical evidence of TMJ ankylosis >1 year after meniscal removal. Mandibular condylectomy, including meniscectomy, is an acceptable treatment option for advanced TMJ septic arthritis and allowed return of normal masticatory function.

Regeneration of mandibular condyle following unilateral condylectomy in canines

The purpose of this experimental study was to investigate regeneration of the mandibular condyle after unilateral condylectomy in canines. Five 2-year-old beagle dogs underwent unilateral mandibular condylectomy and were sacrificed either immediately postoperatively (n=1) or 3 months later (n=4). Temporomandibular joints were examined radiologically and histologically, and sides were compared. All joints showed postoperative regeneration of the condylar head. Maximum regeneration of the condyle occurred medially, where most bone of the glenoid fossa was present, rather than laterally. From an anteroposterior perspective, regeneration of the condylar head was more favourable anteriorly, facing the inferior slope of the glenoid fossa. Regenerated articular cartilage was irregular. Articular discs displayed central thickening compared with unoperated joints. The bone of the glenoid fossa was normal. Unilateral mandibular condylectomy in canines resulted in a certain degree of condylar regeneration during a 3-month postoperative period, with some irregular articular cartilage formation.

Endoscopic mandibular condylectomy and reconstruction: early clinical results

Purpose The purpose of this study was to evaluate early outcomes in patients who underwent endoscopic condylectomy and costochondral graft reconstruction (CCG) of the ramus/condyle unit (RCU). Patients and methods A retrospective evaluation of 10 consecutive patients who underwent endoscopic condylectomy and CCG (n = 17 sides) for the treatment of idiopathic condylar resorption (n = 7), degenerative joint disease (n = 1), and malunion of a fractured condyle (n = 2) was completed. Patients were included who had 1) adequate documentation after endoscopic condylectomy and CCG reconstruction and 2) a minimum of 6-months follow-up. Patients with inadequate documentation or follow-up were excluded. The surgical technique included a 1.5-cm incision inferior to the mandibular angle. Blunt dissection was carried to the masseter muscle, which was incised using needle point electrocautery. An optical cavity was created for insertion of a Hopkins (Karl Storz, Culver City, CA) endoscope. The resection and reconstruction were carried out with endoscopic instrumentation. Preoperative (T0), postoperative (T1), and follow-up (T2) clinical examinations, lateral cephalograms, and panoramic radiographs were used to evaluate the outcomes. Results In all 10 cases, condylectomy and CCG reconstruction (n = 17 sides) were successfully performed using the endoscopic approach. The mean follow-up period was 17 months (range, 8 to 38 months). All submandibular scars were aesthetically satisfactory, and there were no facial, inferior alveolar, or lingual nerve injuries. No other intraoperative or postoperative complications occurred. Postoperative RCU length, mandibular position, and correction of the occlusion were documented using lateral cephalometric and panoramic radiographs. Conclusion The results of this study indicate that endoscopic condylectomy and CCG reconstruction produce satisfactory clinical outcomes without significant morbidity. Long-term follow-up studies are in progress.

Endoscopic condylectomy and reconstruction

Purpose: The benefits of minimally invasive surgery have been well documented. The purpose of this paper is to present early results in a series of patients who had endoscopic mandibular condylectomy and reconstruction with costochondral grafts.

Unilateral mandibular condylectomy in lambs

The purpose of this experimental study was to investigate the degree of regeneration of the mandibular condyle after unilateral condylectomy in 10-week-old lambs. The lambs were killed three months after the operation, and the joints examined radiologically and histologically. Scoring systems were used to assess the radiological changes and histological regeneration of the condyle. All joints showed regeneration of the condylar head postoperatively. The maximum degree of regeneration occurred on the medial side rather than the central or lateral areas. There was a significant correlation among the medial, central, and lateral planes (P<0.05). The reformed articular cartilage was irregular and thin (P<0.01), and the disc was thick in the central plane (P<0.01) compared with the control joints. The temporal bone was normal. This study shows that unilateral condylectomy in the growing period results in some condylar regeneration particularly on the medial side and reformation of some irregular and thin articular cartilage.

Bilateral Mandibular Condylectomy in a Cat

A six year old cat with a chronically luxating jaw was treated by bilateral condylectomy. The etiology of the chronic luxation was unilateral temporomandibular joint dysplasia.

Excision arthroplasty as a treatment for temporomandibular dysplasia

ABSTRACTThree cases of temporomandibular dysplasia are reported. Crepitus and pain were associated with manipulation of the lower jaw and in two cases there were episodes of open‐mouth jaw‐locking. Jaw‐locking in these two cases was not associated with displacement of the coronoid process of the mandible and impingement on the zygomatic arch. Excision arthroplasty of the temporomandibular joint (mandibular condylectomy) was successful in preventing open‐mouth jaw‐locking and in curing temporomandibular joint pain.