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Mandibular condyle bone mineral density measurement by quantitative computed tomography: a gender-related difference in correlation to spinal bone mineral density.

We conducted volunteer studies to assess age-related changes of mandibular condyle bone mineral density (BMD) and its correlation to the spinal BMD. Quantitative computed tomography was performed on the condyles and spines (L1-3) of 210 healthy subjects (114 men and 96 women, aged 5-85 years). A separate study was performed on 73 young student subjects (39 men and 34 women, aged 23-25 years). The mandibular condyle BMD showed a decrement rate similar to spinal BMD in men, but in women the decrement rate of the mandibular condyle BMD was lower than that of the L1-3 BMD. On the other hand, correlation coefficients in BMD between the mandibular condyle and spine were similar in women and men. Gender-related differences were found to be dramatic when assessed in the young student group; the mandibular condyle and spinal BMDs were highly correlated in women (r = 0.82, p < 0.0001), but no correlation was found in men (r = 0.22). Taken together, these results suggest that the same regulatory mechanisms exist in the mandibular condyle and spine BMDs. However, aside from the spine BMD, additional undefined factor(s), including mechanical stress from the occlusion, may be involved in maintaining mandibular BMD.

Adolescent↗

Adenocarcinoma metastatic to the mandibular condyle.

Two cases of metastatic lesions presenting in the mandibular condyle as Temporo-Mandibular Joint Pain Dysfunction Syndrome are presented with a discussion on the mechanisms of tumour metastases to bone.

Adenocarcinoma↗

Morphology of the lateral pterygoid muscle associated to the mandibular condyle in the human prenatal stage.

The lateral pterygoid muscle (LPM) inserts at the condyle and the articular disc and plays a central role in mandibular movement via the Temporomandibular Articular Complex. The aim of this study was to examine the association between the morphology of LPM muscular fascicles and the degree of mineralization of the mandibular condyle in the prenatal stage employing structural, ultrastructural and microanalytical evaluation. Sixteen human fetuses at 11-37 weeks of gestation, with no apparent pathology and resulting from spontaneous abortions, were included in the study. Samples from lateral pterygoid muscle and the mandibular condyle were processed for light microscopy and electron microscopy and microanalysis. Desmin immunolabeling (dilution 1: 25 Dako) and alpha sarcomeric actin immunolabeling (dilution 1:50 Dako) employing the avidin-biotin system were used in paraffin embedded samples. Contralateral samples were examine by transmission electron microscopy. Four condyles (at 17-21 weeks of gestation) were used to measure the relative content of calcium and phosphorous employing the X-ray diffraction microanalytical technique. At 11-16 weeks of gestation, the LPM was composed of secondary myotubes associated to satellite cells and nerve fibers. At 18 weeks, the muscle exhibited multiple compact fascicles and the condyle showed a thin, external, subperiostal mineralized layer with few central bone spicules. At 20 weeks, at the site of insertion of the LPM, the bone trabeculae of the condyle contained an electrondense matrix with abundant mineralization nuclei. At 17-21 weeks of gestation no significant variations in the contents of phosphorous and calcium were observed. At 24 weeks, transmission electron calcium and microscopy studies revealed a marked increase in the functional units of the muscle fascicles. Also, at this age muscle fibers exhibited differences in the expression of desmin and alpha sarcomeric actin. At 37 weeks the muscle became multipennate in appearance, exhibiting a more complex organization than younger fetuses. Alpha sarcomeric actin labeling became light with age. This results suggest that between 16 and 22 weeks of gestation the differentiation and maturation process of the muscle fibers precedes and prevails over the development and mineralization process from mandibular condyle. The rudimentary performance of the prenatal LPM would be one of the factors that regulate the process of ossification at the level of the mandibular condyle. The rate of ossification would increase starting from 22 of gestation week.

Actins↗

Osteochondroma of the mandibular condyle: a case report and review of the literature.

Osteochondroma is rarely found in the oral and maxillofacial regions. A rare case of osteochondroma affecting the mandibular condyle of a 46-year-old Japanese woman is reported. Clinical examination revealed facial asymmetry, malocclusion, and a palpable hard mass in the right temporomandibular joint (TMJ). Radiologically, the lesion was visualized as a radiopaque mass in the same region, but no destructive features were evident. Three-dimensional computed tomography was employed for estimating the stereographic extension of the lesion, which seemed to develop from the anterior portion of the condylar neck, and extend to the condylar head. The patient underwent tumor excision and condyloplasty under a clinical diagnosis of benign TMJ tumor. The histopathological diagnosis was osteochondroma of the mandibular condyle, and the lesion consisted of proliferative bony and hyalinized cartilage-like tissues. Moreover, a cartilage cap, a characteristic feature of osteochondroma, was also observed. Thirty-eight cases of osteochondroma of the mandibular condyle described in the English literature, including the present case, were reviewed. The mean patient age was 39.7 years with a peak in the fourth decade, which was older than patients with tumors in the axial skeleton. There was no sexual predominance for tumors in either the mandibular condyle or axial skeleton. The histopathogenesis of this tumor developing in the mandibular condyle was also discussed.

Age Factors↗

Tissue-engineered neogenesis of human-shaped mandibular condyle from rat mesenchymal stem cells.

The temporomandibular joint is susceptible to diseases and trauma that may ultimately lead to structural degeneration. Current approaches for replacing degenerated mandibular condyles suffer from deficiencies such as donor site morbidity, immunorejection, implant wear and tear, and pathogen transmission. The hypothesis of this study was that a human-shaped mandibular condyle can be tissue-engineered from rat mesenchymal stem cells (MSCs) encapsulated in a biocompatible polymer. Rat bone marrow MSCs were isolated and induced to differentiate into chondrogenic and osteogenic cells in vitro, and encapsulated in poly(ethylene glycol)-based hydrogel in two stratified layers molded into the shape of a cadaver human mandibular condyle. Eight weeks following in vivo implantation of the bilayered osteochondral constructs in the dorsum of immunodeficient mice, mandibular condyles formed de novo. Microscopic evaluation of the tissue-engineered mandibular condyle demonstrated two stratified layers of histogenesis of cartilaginous and osseous phenotypes. The current approach is being refined for ultimate therapeutic applications.

Animals↗

[Is miniplate osteosynthesis for combined mandibular body and bilateral mandibular condyle fractures adequate?].

Between 1980 and 1993 81 patients with a combined mandibular body and bilateral mandibular condyle fractures underwent open reduction and internal fixation of the mandibular body. The following methods were used: 29 x miniplate osteosynthesis, 28 x maxiplate osteosynthesis, 13 x lag screws, 10 x combinations and once titanium mesh. Reoperations because of occlusal disturbances were necessary in two cases of miniplate fixation, in one case of maxiplate fixation and in one case of lag screw fixation. In 1994 28 patients were reviewed. Posterior crossbite as operative sequela was noted in 2 (out of 14) patients after miniplate osteosynthesis, in 3 (out of 9) patients with maxiplate osteosynthesis, in 1 (out of 4) patients with combined miniplate and lag screw fixation and in 0 (out of 3) cases with lag screws. In cases of oblique mandibular body fractures we recommend the lag screw technique. Maxiplate osteosynthesis is more troublesome and more difficult in comparison with miniplate osteosynthesis. Therefore we recommend the miniplate osteosynthesis for the remaining types of mandibular body fracture and if needed the mandibular condyle.

Adult↗

The influence of compressive loading on growth of cartilage of the mandibular condyle in vitro.

The purpose of this study was to clarify the change in mandibular condyles under compressive loading. An organ-culture system of fetal rat mandibular condyles was used, and mechanical loading was generated by compressing the gas phase within a closed chamber. After the culture period, with compressive loading, type I collagen and fibronectin were observed in the lower half of the hypertrophic chondrocyte layer in the mandibular condyles; in contrast, without compressive loading, there was no such reaction. The size of the condyle was not increased by compressive loading. These results suggest that intermittent compressive loading could induce type I collagen and fibronectin production by chondrocytes.

Animals↗

The effect of epidermal growth factor on the fetal rabbit mandibular condyle and isolated condylar fibroblasts.

The load-bearing surface of the mandibular condyle presents a unique arrangement of tissues consisting of an avascular layer composed largely of collagen bundles. Fibroblasts are interspersed amongst these bundles and are generally agreed to produce the collagen. The mechanisms controlling development of these tissues have not been determined. This study was conducted to explore the role of epidermal growth factor (EGF), which appears to be important in the development of many oral tissue types as well as in the growth and differentiation of the mandibular condyle. Superficial cells of the fibrous zone of the condyle were isolated from fetal rabbit condyles and [(3)H]thymidine incorporation into DNA measured. The application of EGF produced a significant increase in radiolabel incorporation after 2 days compared to 4 days in the controls, suggesting that EGF induced cells to enter S-phase more rapidly. Fetal condyles were also cultured on gelfoam surgical sponges for up to 21 days. Autoradiography of cultured condyles showed that cells of all three zones may potentially replicate, as indicated by incorporation of [(3)H]thymidine. All three regions displayed greater increases in cell numbers in samples exposed to EGF than in control samples. The measurement of zone thickness in condyles cultured on gelfoam sponges with or without EGF showed that this peptide was able to re-establish thickness, bringing it in line with the relation observed when the condyles were isolated initially, particularly of the intermediate zone over a period of 21 days. As very little autoradiographic labelling occurred at this time-point in any of the zones, the increase in thickness must primarily be due to matrix production. It is concluded that EGF is one factor potentially regulating both replication and differentiation in mandibular condyle and its associated cells.

Analysis of Variance↗

Cranial bone graft to reconstruct the mandibular condyle in Macaca mulatta.

PURPOSE: The purpose of this study was to evaluate the efficacy of cranial bone grafts to reconstruct the mandibular condyle in a nonhuman primate model. MATERIALS AND METHODS: The right mandibular condyle was resected in eight female, adult, nongrowing monkeys (Macaca mulatta) and the mandible was reconstructed with autogenous, full-thickness cranial bone harvested from the frontal area of the skull and stabilized with rigid fixation. Joint function, facial symmetry, and occlusion were evaluated preoperatively and over the course of 1 year postoperatively. The height of the bone graft was measured intraoperatively and at 1 year postoperatively. RESULTS: Seven monkeys survived for 1 year. The animals' weights were stable postoperatively. There were no statistically significant changes in maximal incisal opening or lateral excursion, as well as no statistically significant changes in facial symmetry or occlusion. On average, the total decrease in height of the graft was 0.7 +/- 0.9 mm (P = .07). CONCLUSION: After reconstruction of the mandibular condyle in Macaca mulatta, full-thickness cranial bone grafts provided a functional joint that resisted resorption. Cranial bone may therefore provide a suitable alternative to other autologous or alloplastic graft materials for reconstruction of the human mandibular condyle in nongrowing patients.

Analysis of Variance↗

Osteochondroma of the mandibular condyle. A case report.

Osteochondroma of the mandibular condyle is extremely rare and may cause signs and symptoms like those seen in patients with temporomandibular joint dysfunction. Differentiation between osteochondroma and condylar hyperplasia is not possible on histologic grounds alone, but the radiographic and intraoperative findings together are usually sufficient to establish a definite diagnosis.

Adult↗

Osteoma of the mandibular condyle: report of a case with 5-year follow-up.

Osteomas of the mandibular condyle are rare. An unusual case of an osteoma occurring in the mandibular condyle of a 22-year-old man with mandibular deviation and malocclusion is reported; this represents the 14th documented case in the English language literature. The tumor was resected with condylectomy. Postoperatively, mandibular deviation was minimized.

Adult↗

[Osteochondroma of the mandibular condyle. Apropos of a case].

The authors report a case of mandibular condyle osteochondroma on a 33 years-old woman, similar to osteocartilaginous exostosis of the long bones. The lesion was revealed by a facial asymmetry and a change of the occlusion. The diagnosis was performed on the computed-tomography examination and histopathology. The removal of the lesion has conserved the condyle without recurrence after 20 months following-up. The authors remind the uncommonly location of osteochondroma in the facial skeleton and discuss the histogenesis of this lesion in its mandibular condyle site.

Adult↗

Assessment of patients treated for intracapsular fractures of the mandibular condyle by closed techniques.

PURPOSE: The goals to study different lines of intracapsular fractures of the mandibular condyle and to evaluate their influence on the prognosis after closed treatment. PATIENTS AND METHODS: Clinical, radiologic, and axiographic follow-up of 40 patients with 50 intracapsular fractures of the mandibular condyle was carried out after closed treatment. The examinations were performed an average of 22 weeks after treatment. Three types of intracapsular fractures were distinguished: type A, or fractures through the medial condylar pole; type B, or fractures through the lateral condylar pole with loss of vertical height of mandibular ramus, and type M, multiple fragments, comminuted fractures. RESULTS: Moderate to serious dysfunction was observed in 33% of the cases. Radiologic examination of fracture types B and M revealed a reduction in the height of the mandibular ramus of up to 13% compared with the contralateral side. These 2 fracture types also resulted in the most prominent deformations of the condylar head. Axiography revealed irregular excursions and a limitation of condylar movement in comminuted fractures of up to 74% compared with the nonfractured side. CONCLUSION: Lesions to the osseodiscoligamentous complex of the temporomandibular joint caused by intracapsular fractures of the mandibular condyle can be severe. The poor functional and radiologic results encountered in the fracture types B and M showed the limitations of closed functional treatment.

Adolescent↗

[Comparative experimental study between longitudinal fracture and transverse fracture of mandibular condyle].

OBJECTIVE: To evaluate the secondary effect of childhood miniature pig longitudinal fracture and transverse fracture of mandibular condyle to Temporomandibular Joint (TMJ). METHODS: Longitudinal and transverse fractures on condyle of 14 childhood miniature pigs were created respectively. After 3 and 6 months the TMJs were studied macroscopically and microscopically. RESULTS: The transverse fracture of mandibular condyle brought about TMJ adaptive changes. There was no adhesion between disc and condyle. The longitudinal fracture led usually to bifid condyle deformity and adhesion between disc and condyle. Many fibroblasts and chondrocytes were seen in the adhesion between disc and condyle. Blood vessels and fatty degeneration appeared in the articular disc. CONCLUSION: Two different types of childhood condylar fractures are apparently different in the aspects of secondary lesions on TMJ. It suggests that an evident correlation between mandibular condyle longitudinal fracture and TMJ ankylosis.

Animals↗

Osteochondroma of the mandibular condyle: report of a case and review of the literature.

Osteochondromas rarely affect the mandibular condyle. An unusual case of an osteochondroma occurring in the left mandibular condyle in a 40-year-old man who presented with mandibular deviation and malocclusion is reported; this represents the 37th documented case in the English-language literature. The tumor was resected through condylectomy. Four-year follow-up assessments revealed satisfactory function and occlusion, without evidence of recurrence of the tumor.

Adult↗

Expression of superficial zone protein in mandibular condyle cartilage.

OBJECTIVE: Superficial zone protein (SZP) has been shown to function in the boundary lubrication of articular cartilages of the extremities. However, the expression of SZP has not been clarified in mandibular cartilage which is a tissue that includes a thick fibrous layer on the surface. This study was conducted to clarify the distribution of SZP on the mandibular condyle and the regulatory effects of humoral factors on the expression in both explants and fibroblasts derived from mandibular condyle. METHODS: The distribution of SZP was determined in bovine mandibular condyle cartilage, and the effects of interleukin-1beta (IL-1beta) and transforming growth factor-beta (TGF-beta) on SZP expression were examined in condyle explants and fibroblasts derived from the fibrous zone of condyle cartilage. RESULTS: SZP was highly distributed in the superficial zone of intact condyle cartilage. The SZP expression was up-regulated by TGF-beta in both explants and cultured fibroblasts, whereas the expression was slightly down-regulated by IL-1beta. A significant increase in accumulation of SZP protein was also observed in the culture medium of the fibroblasts treated with TGF-beta. CONCLUSIONS: These results suggest that SZP plays an important role in boundary lubrication of mandible condylar cartilage, is synthesized locally within the condyle itself, and exhibits differential regulation by cell mediators relevant to mandibular condyle repairing and pathologies.

Animals↗

Myxoma of the mandibular condyle. A case report and review of the literature.

Myxoma of the mandibular condyle is extremely rare and may cause signs and symptoms like those seen in patients with temporomandibular joint dysfunction (TMD). The histogenesis, histologic profile, and management of myxoma of the jaws remain controversial. We report a case of myxoma involving the mandibular condyle appearing as TMD, and we review the literature to highlight current controversies surrounding this lesion.

Diagnosis, Differential↗

Detection and significance of the characteristic magnetic resonance signals of mandibular condyles in children.

OBJECTIVE: We sought to determine the magnetic resonance imaging (MRI) characteristics of mandibular condyles in still-growing children. In addition, we also evaluated the significance of the double-contour-like structure and the conversion from red to yellow marrow characteristic of this age. METHODS: The MRI characteristics of mandibular condyles were determined by means of fast spin-echo intermediate-weighted images in subjects 9 to 14 years old. In 1 subject who developed temporomandibular joint-related clinical symptoms 1 year later, MRI was re-performed at that time. RESULTS: With the use of MRI, a total of 17 double-contour-like structures were detected in 42 temporomandibular joints of 9- to 14-year-olds, but neither 50 healthy joints of youths nor adults. In terms of bone marrow signal changes, the turning point was found to be 11 years old. In 1 subject, the double-contour-like structures were not visible on the MR images obtained 1 year after the first examination. CONCLUSION: The double-contour-like structure and the periods of conversion from red to yellow marrow may be able to be used as part of the criteria for the staging of mandibular condyle development in children.

Adolescent↗