| Condylar resorption | |
|---|---|
| Other names | Idiopathic condylar resorption |
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| An anatomical diagram of the condyloid process. | |
| Specialty | Orthopedic |
Condylar resorption, also called idiopathic condylar resorption, ICR, and condylysis, is a temporomandibular joint disorder in which one or both of the mandibular condyles are broken down in a bone resorption process. This disorder is nine times more likely to be present in females than males, and is more common among teenagers. [1]
Symptoms that may be associated with condylar resorption are both aesthetic and functional. These include:
The cause of condylar resorption is unknown, but there are theories. Because condylar resorption is much more likely to occur in young females, hormonal mediation may be involved. Strain on the temporomandibular joint from orthodontics or orthognathic surgery may be related to the condition. Reactive arthritis, rheumatoid arthritis, and psoriatic arthritis are other possible causes. [2]
A diagnosis of condylar resorption can be made following clinical evaluation and imaging, often cone beam computed tomography, and less frequently single-photon emission computed tomography and positron emission tomography. [3]
Treatment of condylar resorption is controversial. Orthodontics can address malocclusion without surgery, but this is often unstable or compensatory, and fails to address the aesthetic impacts of condylar degeneration. Orthognathic surgery in conjunction with orthodontics may be done to reconstruct and stabilize the condyles and disc of the temporomandibular joint. However, this does not address the underlying etiology of the disease. Meta-analysis shows that 46-100% of idiopathic condylar resorption cases treated with orthognathic surgery experience some degree of relapse. [4] Adverse effects of this approach also include pain, nerve damage, and loss of sensation due to the location of the inferior alveolar nerve.
Anti-inflammatory medication can be used to slow the resorption process. Arthrocentesis, and arthroscopic surgery are also sometimes used to treat disc displacement and other symptoms. [2]
The condition can only be fully addressed with total removal of the diseased condyles. The condyles are replaced with a temporomandibular joint total joint replacement (TJR) device, often in conjunction with orthodontics and orthognathic surgery. The device restores lost ramus height, providing a stable occlusion.
Temporomandibular joint dysfunction is an umbrella term covering pain and dysfunction of the muscles of mastication and the temporomandibular joints. The most important feature is pain, followed by restricted mandibular movement, and noises from the temporomandibular joints (TMJ) during jaw movement. Although TMD is not life-threatening, it can be detrimental to quality of life; this is because the symptoms can become chronic and difficult to manage.
Bruxism is excessive teeth grinding or jaw clenching. It is an oral parafunctional activity; i.e., it is unrelated to normal function such as eating or talking. Bruxism is a common behavior; reports of prevalence range from 8% to 31% in the general population. Several symptoms are commonly associated with bruxism, including hypersensitive teeth, aching jaw muscles, headaches, tooth wear, and damage to dental restorations. Symptoms may be minimal, without patient awareness of the condition. If nothing is done, after a while many teeth start wearing down until the whole tooth is gone.
In anatomy, the temporomandibular joints (TMJ) are the two joints connecting the jawbone to the skull. It is a bilateral synovial articulation between the temporal bone of the skull above and the mandible below; it is from these bones that its name is derived. This joint is unique in that it is a bilateral joint that functions as one unit. Since the TMJ is connected to the mandible, the right and left joints must function together and therefore are not independent of each other.
Trismus, commonly called lockjaw, is reduced opening of the jaws. It may be caused by spasm of the muscles of mastication or a variety of other causes. Temporary trismus occurs much more frequently than permanent trismus. It is known to interfere with eating, speaking, and maintaining proper oral hygiene. This interference, specifically with the patient's ability to swallow properly, results in an increased risk of aspiration. In some instances, trismus presents with altered facial appearance. The condition may be distressing and painful for the patient. Examination and treatments requiring access to the oral cavity can be limited, or in some cases impossible, due to the nature of the condition itself.
Orthognathic surgery ; also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and lower face related to structure, growth, airway issues including sleep apnea, TMJ disorders, malocclusion problems primarily arising from skeletal disharmonies, other orthodontic dental bite problems that cannot be easily treated with braces, as well as the broad range of facial imbalances, disharmonies, asymmetries and malproportions where correction can be considered to improve facial aesthetics and self esteem.
In orthodontics, a malocclusion is a misalignment or incorrect relation between the teeth of the upper and lower dental arches when they approach each other as the jaws close. The English-language term dates from 1864; Edward Angle (1855-1930), the "father of modern orthodontics", popularised it. The word "malocclusion" derives from occlusion, and refers to the manner in which opposing teeth meet.
Hemifacial microsomia (HFM) is a congenital disorder that affects the development of the lower half of the face, most commonly the ears, the mouth and the mandible. It usually occurs on one side of the face, but both sides are sometimes affected. If severe, it may result in difficulties in breathing due to obstruction of the trachea—sometimes even requiring a tracheotomy. With an incidence in the range of 1:3500 to 1:4500, it is the second most common birth defect of the face, after cleft lip and cleft palate. HFM shares many similarities with Treacher Collins syndrome.
The following outline is provided as an overview of and topical guide to dentistry and oral health:
Occlusion, in a dental context, means simply the contact between teeth. More technically, it is the relationship between the maxillary (upper) and mandibular (lower) teeth when they approach each other, as occurs during chewing or at rest.
Mandibular fracture, also known as fracture of the jaw, is a break through the mandibular bone. In about 60% of cases the break occurs in two places. It may result in a decreased ability to fully open the mouth. Often the teeth will not feel properly aligned or there may be bleeding of the gums. Mandibular fractures occur most commonly among males in their 30s.
A jaw abnormality is a disorder in the formation, shape and/or size of the jaw. In general abnormalities arise within the jaw when there is a disturbance or fault in the fusion of the mandibular processes. The mandible in particular has the most differential typical growth anomalies than any other bone in the human skeleton. This is due to variants in the complex symmetrical growth pattern which formulates the mandible.
Dislocations occur when two bones that originally met at the joint detach. Dislocations should not be confused with Subluxation. Subluxation is when the joint is still partially attached to the bone.
In anatomy, the mandible, lower jaw or jawbone is the largest, strongest and lowest bone in the human facial skeleton. It forms the lower jaw and holds the lower teeth in place. The mandible sits beneath the maxilla. It is the only movable bone of the skull. It is connected to the temporal bone by the temporomandibular joint.
Dr. Joseph J Marbach DDS was a leader in the field of facial pain. He was a chaired professor at University of Medicine and Dentistry of New Jersey. Marbach was born in Paterson, New Jersey to immigrant parents. He was educated at Drew University, Madison, New Jersey and University of Pennsylvania where he received his degree in dentistry.
Dentomandibular sensorimotor dysfunction (DMSD) is a medical condition involving the mandible, upper three cervical (neck) vertebrae, and the surrounding muscle and nerve areas.
Tooth ankylosis is the pathological fusion between alveolar bone and the cementum of teeth, which is a rare phenomenon in the deciduous dentition and even more uncommon in permanent teeth. Ankylosis occurs when partial root resorption is followed by repair with either cementum or dentine that unites the tooth root with the alveolar bone, usually after trauma. However, root resorption does not necessarily lead to tooth ankylosis and the causes of tooth ankylosis remain uncertain to a large extent. However, it is evident that the incident rate of ankylosis in deciduous teeth is much higher than that of permanent teeth.
Open bite is a type of orthodontic malocclusion which has been estimated to occur in 0.6% of the people in the United States. This type of malocclusion has no vertical overlap or contact between the anterior incisors. The prevalence varies between different populations, for instance, occurring with 16% in Black people and 4% in white people. The term "open bite" was coined by Carevelli in 1842.
Condylar hyperplasia is over-enlargement of the mandible bone in the skull. It was first described by Robert Adams in 1836 who related it to the overdevelopment of mandible. In humans, mandibular bone has two condyles which are known as growth centers of the mandible. When growth at the condyle exceeds its normal time span, it is referred to as condylar hyperplasia. The most common form of condylar hyperplasia is unilateral condylar hyperplasia where one condyle overgrows the other condyle leading to facial asymmetry. Hugo Obwegeser et al. classified condylar hyperplasia into two categories: hemimandibular hyperplasia and hemimandibular elongation. It is estimated that about 30% of people with facial asymmetry express condylar hyperplasia.
Condylar hypoplasia is known as underdevelopment of the mandibular condyle. Congenitally (primary) caused condylar hypoplasia leads to underdeveloped condyle at birth. Hypoplasia of mandible can be diagnosed during birth, in comparison to the hyperplasia which is only diagnosed later in growth of an individual.
Posselt's envelope of motion or Posselt's envelope of movement refers to the range of motion of the lower jaw bone, or mandible.