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PubMed1987

Are you overlooking fractures of the mandibular condyle?

Fractures of mandibular condyle may be overlooked because attention is often focused on readily apparent soft tissue injury such as lacerations and abrasions. Clinical and radiographic signs are often subtle, but the injuries caused by rapid deceleration and listed in Table 2 will serve to alert the pediatrician to the possibility of such fractures. All children in these circumstances should be carefully examined for dental occlusion and the preauricular area palpated to help formulate a clinical diagnosis. Additional evidence is gained from the finding of deviation or limitation of the jaw upon opening or edema in the preauricular area. If any of these yield abnormal findings, a good quality series of mandibular radiographs will be needed to confirm the diagnosis. Overlooking a condylar fracture may commit a child to unsightly facial asymmetry, marked malocclusion, or ankylosis requiring invasive surgery for correction. Consultation with an oral and maxillofacial surgeon or other interested specialist should be sought while the patient is still in the emergency room.

Accidents↗
PubMed1978

Histochemical and radiologic studies of the human fetal mandibular condyle.

Histochemical investigations on the mandibular condyle were performed on 72 human embryos and fetuses of crown-rump lengths (CRL) ranging from 26 to 186 mm, representing skeletal maturity indices expressed in CNO values (CNO = composite number of ossified bones in the hand and foot) ranging from 0-0 to 19-12. The development of the mandibular condyle is described according to morphology and to histochemical reactions for glycosaminoglucuronglycans, collagen, glycogen, alkaline and acid phosphatase, and nonspecific AS esterase. The development is described for (1) the bony component of the mandibular condyle, (2) the condylar cartilage, and (3) the fibrous cover of the mandibular condyle. For each tissue component, maturation steps are set up and included in the total evaluation of the condylar maturity stages. The developmental sequence set up on the basis of the morphologic and histochemical findings was followed by all condyles investigated. From this it may be presumed that the developmental sequence in human mandibular condylar components is constant during the former half of the prenatal period. The material available did not justify a description of skeletal development in the mandibular condyle as a function of fetal size, CRL, or skeletal maturity in the hand and foot.

Alkaline Phosphatase↗
PubMed1980

Scanning electron microscopic and radiographic correlation of articular surface and supporting bone of the mandibular condyle.

Specimens of mandibular condyle from human cadavers were employed for scanning electron microscopic and radiographic observations of the articulating surface and underlying bone. Smooth articular surface supported by smooth bone was most frequently observed. Craters and depressions in the articular surface were associated with resorption of underlying bone. Lateral radiographs proved to be of limited value in detecting defects of this type.

Adult↗
PubMed1997

Bifid mandibular condyle.

The bifid mandibular condyle remains a relatively uncommon entity although the number of reports continues to accumulate, usually as incidental radiographic findings. It would appear that it may arise in at least two different ways, traumatically and developmentally. A case is presented of a unilateral bifid condyle in a young female. From the radiological examination, including CT, the left condyle was seen to be divided medio-laterally by a groove located on the anterior aspect. A history of trauma was inconclusive and no link was apparent with respect to the patient's medical history. Since the patient's original complaint improved with the management of her oral symptoms and the provision of new dentures, no other treatment of the joint was indicated. The case is discussed in connection with the relevant literature.

Adult↗
PubMed2003

Endoscopic mandibular condyle fracture repair.

Treatment of mandibular condyle fractures remains a controversial issue. Arguments center on the relative merits of open versus closed treatment. In the past decisions were largely based on philosophy, anecdotal experience, and retrospective case series with short follow-up. Well-designed studies have now begun to appear in the literature and suggest improved results after open, anatomic reduction and fixation. Many surgeons are still hesitant about liberally applying the open approach due to the resultant facial scarring and the risk of facial nerve injury. Developments in endoscopic technology have recently been applied to facial fracture repair. The endoscopic approach to mandibular condyle fracture repair reduces the risk of facial nerve injury, and dramatically reduces facial scarring, compared with standard open approaches. We feel that the reduced morbidity of the endoscopic approach may allow the benefits of anatomic reduction and rigid fixation to be offered to a larger proportion of patients with mandibular condyle fractures. Technical and technological advances are expected to aid in the dispersal of these techniques in the future.

Contraindications↗
PubMed1996

Lesions of the mandibular condyle in juvenile chronic arthritis.

A total of 371 serial dental panoramic radiographs from 71 children with juvenile chronic arthritis (JCA) were examined to determine the presence and extent of radiographically detectable condylar abnormalities. The series included 12 children with so called 'bird face' deformity and 55 in whom facial growth was judged to be normal. By the age of 15 years, 27 patients (38 per cent), showed lesions of the TMJ, of which 14 (55 per cent) were bilateral. Of those cases with unilateral destruction, the left condyle was affected nine times more frequently than the right. All of the children with 'bird face' deformity had condylar abnormality, but these facial characteristics should not be considered pathognomonic of juvenile chronic arthritis. Moderate to severe condylar abnormality was detectable in 10.9 per cent of children with normal facial growth, and where condylar destruction is present it can often be established as early as 8 years. Systemic corticosteroids appear to have little or no effect on the condyle or mandibular growth.

Adolescent↗
PubMedDate not supplied

[A case of osteochondroma of the mandibular condyle].

A case of mandibular condyle osteochondroma is reported, special attention being paid to radiographic aspects and to the functional changes brought on by this neoplasia. Surgical and meta-operative treatment to correct residual latero-deviation and occlusal relations are described.

Adult↗
PubMed1990

Primary bone cyst of the mandibular condyle.

Cysts of the mandibular condyle are rare and their diagnosis and treatment can be difficult. A case in a young girl is described where the histology was that of a solitary bone cyst but the presentation and behaviour more closely resembled an aneurysmal bone cyst.

Bone Cysts↗
PubMed1996

Functional reconstruction in a case of osteoblastoma of the mandibular condyle.

Resection of the mandibular condyle inevitably leads to functional impairment even in cases of reconstruction with prosthesis or autogenous bone graft. Loss of function is caused by the loss of action of the lateral pterygoid muscle. Therefore, preservation and fixation of this muscle to a transplant should be performed whenever possible. A case of osteoblastoma of the condylar head and neck with functional reconstruction after ablative surgery is presented.

Adult↗
PubMed1995

[Treatment of fractures of the mandibular condyle].

The current treatment of mandibular condyle fractures still remains unclear. The choice between surgical and conservative treatment is difficult in current clinical practice. Every possible treatments are here presented to give the oral and maxillofacial surgeon a better knowledge about what to do in presence of a mandibular condyle fracture.

Adolescent↗
PubMed1998

Gross anatomic and scanning electron microscopic studies on the mandibular condyles of the human cadavers.

The mandibular condyles of 30 cadavers were examined bilaterally. The greatest medial-lateral lengths and greatest anterior-posterior widths of these condyles were measured with a millimeter caliper. The mean size of the greatest medial-lateral length of the superior surface of the condyle between males and females was significantly different. On the other hand, the mean size of the greatest anterior-posterior width of this surface between males and females was not significant. In gross anatomic examination, 28 of the 60 condyles (46.6%) had a convex articulating surface without having any surface irregularities. However, 32 of the 60 condyles (53.4%) demonstrated irregular articular surfaces with characteristic flattening and eburnation. Half of these surface irregularities were found in the lateral part and a few of them were located in the medial part and superior surface of the condyles. Short, irregular undulations, surface depressions and sharply demarcated microcraters were observed in the SEM examination of mandibular condyles having macroscopic abnormalities. These osseous abnormalities were present in the mandibular condyles of people, who were over the age of 50 years and they were very prominent especially in the ones who were completely edentulous. Therefore remodeling of the articular surface might occur in response to alteration of functional forces within the joints of these aged individuals.

Adult↗
PubMed2006

Bifid mandibular condyle: a rare disorder.

Bifid mandibular condyle is a rare disorder and little is known about the etiology and pathogenesis. We reported a patient with left bifid mandibular condyle with a history of trauma. There was no limitation of mouth opening but the patient was complaining of pain while chewing. Underdeveloped lateral head of the bifid condyle was excised at the level of condylar neck under general anesthesia. The patient healed without any problem. Microscopic evaluation of the excised condyle supported a congenital etiology. Although most cases of the bifid condyle discovered by chance it should be recognized and treated by plastic surgeons interested in craniomaxillofacial surgery.

Child↗
PubMed2006

Bifid mandibular condyle: a case report.

The bifid mandibular condyle is a rare anomaly. A variety of causes are implicated with its development such as developmental origin and trauma. Because of the lack of epidemiological data, there is little information about the real incidence of this malformation. The purpose of this paper is to report a case of bifid mandibular condyle in a 20-year-old woman who referred to a private radiological clinic for routine dental examination. A panoramic radiography incidentally revealed a discrete modification of the left mandibular condyle. Magnetic resonance imaging (MRI) was taken and confirmed the diagnostic proposed.

Adult↗
PubMed1990

The problem of the bifid mandibular condyle.

In a survey of 1,882 prehistoric and historic skulls with 2,077 condyles, 7 double (bifid) mandibular condyles were found. One mandible with bilaterally bifid condyles is presented in detail. Possible causes and consequences of the anomaly are discussed. It is assumed that bifid mandibular condyles with anteroposteriorly situated heads are caused by early childhood fractures, whereas those with mediolaterally situated heads are caused by the persistence of connective tissue septa.

Animals↗
PubMed1999

Experimental study of sagittal fracture of the mandibular condyle.

OBJECTIVE: To observe the healing of sagittal fracture of the mandibular condyle (SFMC) and its effect on the temporomandibular joint in immature miniature pigs. METHODS: Twenty-seven immature miniature pigs were randomly chosen and divided into three groups. Twelve immature miniature pigs underwent sagittal fracture of the mandible condyle; 12 underwent transverse fracture, and 3 were maintained as a normal control. Three-phase scintigraphy, computed tomography (CT) imaging, and histological tests were conducted at 3 weeks, 6 weeks, 12 weeks, and 24 weeks. RESULTS: The data showed the value of the time-activity curve of blood-flow image increased and blood-flow arriving time was postponed after condylar fracture. The alpha/beta ratio was the highest at 2 weeks after SFMC. The count of blood-pool image and static image were higher than nonfractured sides. Peaks were seen at 2 weeks postfracture. Disc and condyle adhesion was found in all sagittal fractures of the mandibular condyle and bifid mandibular condyle was formed. Adhesive tissues between condyle and disc were fibro-connective tissues, which connected the disc directly to cartilage or bone tissue. A large number of fibroblasts and sparse chondrocytes were seen in the adhesive tissue. Blood vessels and adipose cells were seen in the disc, whereas there were no distinguishable changes in transverse fracture. CONCLUSION: Bifid mandibular condyle was found in most SFMC in childhood. The mechanism of bifid condyle deformity is related to secondary injuries to the disc, adhesions between the condyle and disc, and displacement of the medial split fragment. The age when SFMC occurs is an important factor in bifid condyle formation.

Animals↗
PubMed2003

Mandibular condyle movement during mastication of foods.

This study evaluated the mandibular condyle displacement on the working side while masticating certain foods with different textures. For referencing the mandibular condyle movement, the range of voluntary border movement of the mandibular condyle was determined based on the analysis of the sagittal, left lateral and right lateral border motion using Posselt's figure. The test foods consisted of cheese, peanuts, and beef jerky. During mastication of cheese and peanuts, the amount of displacement of the mandibular condyle in all directions was within the range of border movement. Significant posterior and superior shifts of the mandibular condyle were observed during mastication of beef jerky, compared with the findings obtained during border movement. Accordingly, it is suggested that prolonged mastication of hard fibrous foods, may stimulate the temporomandibular joint structure and mandibular dysfunction patients should limit their intake of such foods.

Adult↗
PubMed1985

Histopathology of the mandibular condyle.

Histological sections of mandibular condyles surgically removed from 40 female and 12 male patients who failed to respond to conservative management of temporomandibular joint related problems were examined. The proliferation, intermediate and cartilage zones were frequently either partly or completely absent in older subjects confirming previously held views of the functional significance of these zones. There was no obvious sex differences in the histological appearance of the condyle and evidence of inflammatory change was rarely seen.

Adolescent↗