Modified condylotomy for chronic nonreducing disk dislocations.

Abstract

OBJECTIVES: To retrospectively evaluate the modified condylotomy procedure for patients with chronic nonreducing disk dislocations of the temporomandibular joint. STUDY DESIGNS: Sixty-three patients underwent 78 modified condylotomies on temporomandibular joints that had chronic nonreducing disk dislocations and that were previously treated unsuccessfully with nonsurgical modalities. Patients were asked to evaluate their pain, headaches, bite, and success rate postoperatively. Comparisons of patients' preoperative and postoperative maximum incisal opening were also made. Transpharyngeal and transcranial radiographs were compared to determine condylar changes. RESULTS: Ninety-four percent felt that their pain was better, one patient (2%) said that his pain was the same, and two patients (4%) felt that their pain was worse. Eighty percent considered their headaches were better, and one patient (2%) considered them worse. Seventy-eight percent said that their bite was the same or better, and 22% said it was worse. Three patients underwent a second surgery. Progressive condylar remodeling occurred in 81%, and regressive condylar remodeling occurred in 6%. The maximum incisal opening change was overall a positive change; 35% had a significant positive change, and 10% had a significant negative change. CONCLUSION: This retrospective study shows that the modified condylotomy should be considered as a surgical alternative in treating patients with chronic nonreducing disk dislocations that have been unsuccessfully treated nonsurgically.