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PubMed2005

Bifid mandibular condyle: CT and MR imaging appearance in two patients: case report and review of the literature.

We describe two cases of a bifid mandibular condyle. The first case is a 48-year-old woman with headaches and a pain and clicking sensation in her right jaw during mastication. The second case is an asymptomatic 17-year-old woman with a history of bilateral microtia and hemifacial microsomia. In both patients, the bifid condyle was first identified by CT and affected the temporomandibular joint. The imaging findings of both patients' bifid mandibular condyles led us to conclude that both patients likely had an abnormal development of the mandibular condyles. We believe that an intervening fibrous or vascular structure may have split the condyle into two heads.

Adolescent↗
PubMed1983

Central luxation or dislocation of the mandibular condyle into the middle cranial fossa. A case report and review of the literature.

This case report concerns a central luxation of the mandibular condyle of an 11-year-old girl. After a fall from a bicycle, the mandibular condyle luxated into the middle cranial fossa. The mandible was "ankylosed" in an ipsilateral latero-occlusion, and the diagnosis was confirmed by temporomandibular joint radiography. Immediate conservative reposition was performed successfully, without any immobilisation. After 18 months follow-up, the temporomandibular joint function was normal and painless despite progressive degenerative changes in the mandibular condyle. The patient's facial appearance proved to be normal.

Child↗
PubMed2002

Bone graft in the shape of human mandibular condyle reconstruction via seeding marrow-derived osteoblasts into porous coral in a nude mice model.

PURPOSE: The purpose of this study was to develop a tissue-engineered bone graft model in the shape of a human mandibular condyle. MATERIALS AND METHODS: Natural coral with a pore size of 150 to 220 microm and porosity of about 36% was molded into the shape of a human mandibular condyle. Culture-expanded rabbit marrow mesenchymal stem cells were induced by recombinant human bone morphogenetic protein-2 (rhBMP2) to improve osteoblastic phenotype. Then marrow-derived osteoblasts were seeded into natural coral at a density of 2 x 10(8)/mL and incubated in vitro for 3 days before implantation. The cell-coral complexes were implanted subcutaneously into the backs of nude mice and incubated in vivo for 2 months before harvesting. Implantation of coral alone acted as control. The specimens were processed for gross inspection, radiographic examination, and histologic and scanning electronic microscopic observation. RESULTS: The results showed that new bone grafts in the shape of a human mandibular condyle were successfully developed 2 months after implantation and maintained the initial shape of the natural coral scaffold. New bone could be observed histologically on the surface and in the pores of natural coral in all specimens in the cell-seeding group (6 of 6), whereas in the control group there was no evidence of osteogenesis process (0 of 4). CONCLUSION: This study suggests the feasibility of using porous coral as scaffold material transplanted with marrow-derived osteoblasts to restore bone graft in the shape of human mandibular condyle and shows the potential of using this method for the reconstruction of bone defects.

Animals↗
PubMed1996

The soft tissue cover of the mandibular condyle: age-related changes in high buoyant density proteoglycans, free tissue water and remodelling activity.

Age-related changes in the relative proportion of high buoyant density proteoglycans of the soft tissue cover of the mandibular condyle of domestic pigs and the chemical composition of these proteoglycans were investigated by biochemical methods. The relative proportion of high buoyant density proteoglycans has been shown to decrease with age, with their chemical composition varying as follows: With age, the relative proportions of protein increased, galactosamine decreased, glucosamine was similar in newborns and juveniles, but clearly increased in adults, galactosamine plus glucosamine decreased. As measured by 1H-NMR-relaxation spectroscopic methods, the concentration of free tissue water of the soft tissue cover of the mandibular condyle decreased with age. Its mobility, however, was greater in newborns than in juveniles, but similar in juveniles and adults. The concentration of free tissue water, but not its mobility, correlated weakly with relative proportions of polyanionic side chains (e.g. chondroitin sulphate plus keratan sulphate chains) of the high buoyant density proteoglycans. By affecting the concentration of free tissue water and in turn of matrix solutes and cellular environments, the high buoyant density proteoglycans of the soft tissue cover of the mandibular condyle seem to be involved in regulation of age-related changes in the adaptive remodelling activity of the mandibular condyle.

Aging↗
PubMed2005

Function impairment and pain after closed treatment of fractures of the mandibular condyle.

BACKGROUND: To determine the prognosis of fractures of the mandibular condyle after closed treatment. METHODS: Patients (n = 144) with a fracture of the mandibular condyle, all treated closed, were included in the study. Fracture types and position of the fracture parts were determined on radiographs. Follow-up was after 12 months in which the average pain, experienced during the last week (visual analog scale, 100 mm), and mandibular functioning were assessed (mandibular function impairment questionnaire (MFIQ)). RESULTS: Data of 116 (81%) patients, 41 women (35%) and 75 men (65%), were available for analysis. Condylar neck fractures were most common (52%). Bilateral fractures were present in 28% of the patients. Pain (visual analog scale score >0) was found in 9% of the patients. Impaired mandibular function was found in 40% (MFIQ >0) and 24% (MFIQ > or =4) of the patients. The most important risk factor for pain was being a woman. The most important risk factors for function impairment were > or =25 years of age and gross displacement of the fracture parts. CONCLUSION: The overall prognosis of mandibular function and pain after closed treatment of condylar fractures is good. The most important risk factor for pain persisting for 1 year after closed treatment of a condylar fracture is being a woman. The most important risk factors for function impairment are an age of > or =25 years and gross displacement of the fracture parts.

Age Factors↗
PubMed1985

Metastatic tumors of the mandibular condyle. Review of the literature and report of a case.

A metastatic tumor involving the mandibular condyle presented symptoms of temporomandibular joint (TMJ) dysfunction. Positive identification of the primary malignant lesion as prostatic adenocarcinoma was accomplished through the use of immunohistochemical stains for prostate-specific antigen and subsequent prostate biopsy. A review of the literature revealed fifteen additional cases of metastatic lesions of the mandibular condyle, seven of which also demonstrated TMJ-related symptoms as the initial manifestation of malignant disease. Such cases represent a diagnostic challenge, both clinically and microscopically. Symptoms of TMJ dysfunction coupled with radiographic evidence of a destructive lesion or pathologic fracture should suggest a possible malignant process indicating the need for biopsy. Subsequent examination of routine sections in combination with the use of selected stains, including immunohistochemistry may be helpful in identification of the primary tumor site.

Adenocarcinoma↗
PubMedDate not supplied

Osteomyelitis of the mandibular condyle secondary to dental extractions.

Although osteomyelitis of the mandibular condyle secondary to dental extraction is scarcely mentioned in the medical and dental literature, we have seen three cases within a two-year period. The first two patients were examined for an eroded condyle three months and 18 months following the extractions. The third patient, who was treated one month after extraction for acute osteomyelitis of the condyle, has done well. All three patients required operations and administration of long-term antibiotics.

Acinetobacter Infections↗
PubMed1976

Light microscopic and ultrastructural observations of the calcifying zone of the mandibular condyle in the rat.

The hypertrophic stage of development of the rat mandibular condyle was investigated in 16 and 26-day-old rats by electron microscopy. Interest was focused on the zone of mineralization and erosion. It was observed that capillaries invaded the lower level of the hypertrophic zone, without any previous chondroclastic resorption of calcified partitions. The partitions surrounding the hypertrophic chondrocytes were not mineralized around their entire circumference at the level of capillary penetration. The capillaries were accompanied by perivascular cells but these showed no similarities to chondroclasts. Multinucleated chondro- or osteoclasts were however present at a lower level of the subchondral area. It is suggested that there are no inherent differences with respect to the pattern of mineralization and erosion between the epiphyseal growth plate and the developing mandibular condyle.

Animals↗
PubMed1989

[Effect of adriamycin on the mandibular condyles of growing rats].

The purpose of the present study was to investigate histologically and ultrastructurally the effect of adriamycin on the mandibular condyles of growing rats. Eighty rats, one day old, were used. The animals of Group 1 (Control Group) were given distilled water once a day for five days by intraperioneal injections, and the animals of Group 2, Group 3 and Group 4 were given 0.6 mg, 0.9 mg and 1.2 mg of adriamycin/kg (total amount: 3 mg/kg, 4.5 mg/kg, 6 mg/kg), respectively, once a day for five days. At 1, 4, 7 and 10 days after the last injection, the left mandibular condyles were examined histologically. At 1 and 4 days, the right mandibular condyles were examined ultrastructurally. 1. Light Microscopic Observation. 1) Group 2. At 1 and 4 days, the condyles did not differ significantly from those of Group 1. At 7 and 10 days, the zone of differentiation decreased in thickness as compared with those of Group 1. 2) Group 3. At 1 and 4 days, the zones of articular surface, proliferation and differentiation showed decreased in cell number and in thickness as compared with those of Group 1. At 7 and 10 days, the zones of articular surface and proliferation showed the recovery, although it was not complete. However, the zone of differentiation still decreased in cell number and in thickness. The zone of hypertrophy showed an increase in thickness. 3) Group 4. At 1 and 4 days, the zones of articular surface, proliferation and differentiation were almost similar in cell number and in thickness to those of Group 3 at 1 and 4 days. There was an irregularity in cell shape in the zone of proliferation. At 7 and 10 days, the zone of proliferation decreased in thickness and the zone of differentiation decreased in cell number and in thickness. The zone of hypertrophy was greatly thinned. 2. Electron Microscopic Observation. 1) Group 1. At 1 day, the zone of articular surface was composed of fibroblasts and collagen fibrils, and the zone of proliferation contained many oval mesenchymal cells. The zone of differentiation consisted of both differentiating chondrocytes and cartilage matrix, and the zone of hypertrophy consisted of both enlarged chondrocytes and cartilage matrix. At 4 days, all zones were similar to those of the condyle of this group at 1 day. 2) Group 4. At 1 day, the zone of articular surface showed decreased number of collagen fibrils.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1993

Bifid mandibular condyle resulting from a sagittal fracture of the condylar head.

Sagittal or vertical fractures of the mandibular condyle and chip fractures of the medial part of the condylar head are very rare entities and their identification is difficult with conventional radiographs. We report a case of a unilateral bifid mandibular condyle which resulted following a sagittal condylar fracture. This was associated with a chip fracture of the medial part of the condylar head on the contralateral side. These types of condylar fracture do not require any surgical treatment, but early mobilization is indicated.

Exostoses↗
PubMed1981

[Mandibular condyle tumors (author's transl)].

The must frequently observed mandibular condyle tumors are benign in nature, followed by metastases; primary malignant tumors are very rarely encountered, following a review of the clinical and radiographic characteristics of all types of tumors that occur, three cases of condylar metastases are described. Treatment of primary tumors is exclusively surgical, that of secondary lesions being palliative because of the often poor prognosis related to the primary tumor.

Diagnosis, Differential↗
PubMed2006

Dislocation of the mandibular condyle into the middle cranial fossa.

Dislocation of the mandibular condyle into the middle cranial fossa is an uncommon event. A case report is presented based on a patient (32-year-old female) who sustained a traumatic left condyle fracture with superior dislocation into the middle cranial fossa due to a high-speed car accident. The diagnosis was done four months after trauma. Via a preauricular approach, left condylectomy and transposition of temporal muscle flap was performed. Postoperatively, the patient stayed for two weeks with intermaxillary fixation and four months of physical therapy.

Accidents, Traffic↗
PubMed2002

Management of traumatic dislocation of the mandibular condyle into the middle cranial fossa.

Dislocation of the mandibular condyle into the middle cranial fossa is a rare complication of facial trauma that can have neurological and life-threatening implications. This article discusses the anatomic features that predispose patients to this type of injury, as well as the clinical features and mechanism of injury for this rare type of condylar deformity, to help practitioners recognize this easily overlooked injury and avoid disastrous complications. The article summarizes previously published case reports of this rare complication of condylar trauma and presents a case for which initial diagnosis and a management protocol are described.

Bicycling↗
PubMed1996

Anatomic and directional variation in the mechanical properties of the mandibular condyle in pigs.

Stereologic studies of trabecular architecture suggest that the pig mandibular condyle is strongest when loaded supero-inferiorly, and that stress is concentrated in the antero-inferior region (Teng and Herring, 1995). To test these hypotheses, we investigated the uni-axial mechanical properties of 22 pig mandibular condyles in three loading directions at a mean strain rate of 0.14 (+/- 0.12)% s-1. A total of 91 rectangular beam specimens (averaging 9.0 mm x 6.0 mm x 5.0 mm) was tested. For each specimen, 5 or 6 non-destructive tests were performed before compressive failure. Strain in both longitudinal and transverse directions was measured by foil strain gauges on the central part of the specimen. Data were normalized at a strain rate of 0.1% s-1, specimen length of 9 mm, and cross-sectional area of 30.25 mm2. Generally, modulus of elasticity (E) and ultimate stress (sigma u) in the anterior regions of the condyle were greater than those in the posterior. E, sigma u, and Poisson's ratio (upsilon) were significantly different among the test directions, but ultimate strain (epsilon u) was not. The highest values of E (4.04 GPa), sigma u (14.97 MPa), and rho (0.81 g/cm3) were seen in the anterior inferior/middle region under supero-inferior loading. The lowest values (0.94 GPa for E, 2.38 MPa for sigma u, and 0.52 g/cm3 for rho) were found in the inferior/posterior region in medio-lateral loading. Although the mechanical properties of the condyle vary depending upon location, these results verify that the condyle is strongest and stiffest under compressive loads in the supero-inferior direction, and that the anterior-inferior region is particularly strong and stiff.

Analysis of Variance↗
PubMed2000

The three-dimensional cancellous bone architecture of the human mandibular condyle.

In the present study, we tested the hypothesis that the cancellous bone of the mandibular condyle is inhomogeneous and anisotropic. For this purpose, 11 mandibular condyles from embalmed human cadavers were scanned in a micro-CT system. Within each condyle, 9 volumes of interest were selected from different mediolateral and supero-inferior regions. Several bone parameters were calculated to describe the morphology. It appeared that the cancellous bone of the condyle could be approximated by parallel plates. These plates were almost vertically oriented at an angle of 17 degrees relative to the sagittal plane, i.e., perpendicular to the condylar axis. In the superior regions of the condyle, the cancellous bone had the largest bone volume fraction (0.19), associated with the thickest trabeculae (0.11 mm), and the highest trabecular number (1.72 mm(-1)). The lowest bone volume fraction (0.15) was found more inferiorly. The degree of anisotropy increased from superior to inferior across the condyle. No mediolateral differences in bone morphology were found, but superiorly central regions contained more bone than peripheral regions. The plate-like trabeculae could indicate that the condyle is optimally adapted to sustain loads from all directions in a plane perpendicular to the condylar axis. The high bone mass and lower anisotropy in the superior regions could enable the condyle to sustain multiple load directions. Toward the collum, the trabeculae are more aligned. This could point to stresses acting predominantly in one direction.

Aged↗
PubMed1996

Expression of extracellular matrix in human mandibular condyle.

OBJECTIVE: The age-related expression of the extracellular matrices in human mandibular condyle was examined. STUDY DESIGN: The distribution patterns of types I to V collagens, laminin, fibronectin, fibronectin receptor, and transforming growth factor beta in 34 human mandibular condyles dissected from autopsy specimens were studied by immunohistochemical procedure with special attention on the age-related changes. RESULTS: Type I collagen was detected in the full layer of the condylar cartilage, and a stronger immunoreaction was delineated in the articular and cartilage zone. Types II and III collagen were mainly localized in the fibrocartilage zone. Type IV collagen and laminin were detected not only in the basement membrane of the blood vessels but also in the degenerated lesion where the expression of transforming growth factor beta was also detected. Immunostaining of type V collagen and fibronectin was noted in the perichondrocytic area, whereas that of fibronectin receptor was seen in the chondrocytes. In materials from younger cadavers types I, II, IV and V collagens, fibronectin, its receptor, and laminin showed stronger expression in the degenerative lesions than in the normal portions. In the sections from cadavers over the seventh decade, the immunoreaction of extracellular matrices was weak compared with the younger materials, and no increased reaction of extracellular matrices in the degenerative lesions was detected. In addition, severe osteoarthrosis was frequently seen in the older materials in macroscopic findings. CONCLUSION: These results suggest that the expression of extracellular matrices thus seems to be closely related to aging and degenerative changes in the condyle.

Adolescent↗
PubMed2002

Comparison of panoramic radiography and panoramic digital subtraction radiography in the detection of simulated osteophytic lesions of the mandibular condyle.

OBJECTIVE: The aim of this study was to compare panoramic temporomandibular joint radiography, unenhanced and color-enhanced digital-subtraction radiography with respect to detectability of simulated osteophytic lesions of the mandibular condyle. METHODS: Three dry human skulls with no obvious temporomandibular joint pathology were selected. Four sizes of bone chips were placed on the anterior aspect of the condyle at medial, central, and lateral locations. Panoramic radiographs were made with and without the chips in place. These paired radiographs were digitized, and unenhanced and color-enhanced digital-subtraction images of the original panoramic images were obtained. Eight observers evaluated 72 randomized images of each modality for the presence or absence of simulated osteophytic lesions of the mandibular condyle, grading the images on a 100-point scale. RESULTS: A(z) values for overall diagnostic accuracy of the three imaging modalities were 0.5376 for panoramic radiography, 0.7861 for unenhanced digital subtraction radiography, and 0.7923 for color-enhanced digital-subtraction radiography. Digital-subtraction radiography improved the detection accuracy of the original panoramic films. CONCLUSION: Panoramic radiographs were significantly less accurate in the detection of simulated osteophytic lesions of the mandibular condyle than the two digital-subtraction techniques.

Analysis of Variance↗