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Histological and microradiographical studies of human mandibular condyle.

Twenty-one clinically normal human mandibular condyles were examined by histologic and microradiographic methods obtaining some measurements. The histologic structures of condyle were quite different between the child group and other aged groups. The difference in the surface articular zone composed of the fibrous tissue was not so great in all age groups, while there was quite a difference in the structure in the remaining zones. It was clearly demonstrated by microradiogram that the osteons of the subarticular bone plate were more prominent in aging. Abnormal structures of the condyle were revealed in some individuals of the adult and old age groups, which were assumed probably to be the reactive remodelling against the functional changes of the temporomandibular joint.

Adolescent↗

Formation of a mandibular condyle in vitro by tissue engineering.

PURPOSE: Mandibular reconstructive procedures often produce significant donor site morbidity. Recently, the use of minimally invasive techniques has been reported for mandibular reconstruction with decreased morbidity at the primary operative site. To date, these techniques have not addressed the graft donor site. We hypothesize that tissue-engineering techniques may be used to fabricate bone and thereby eliminate donor site morbidity. METHODS: Porcine mesenchymal stem cells (pMSCs) were isolated from the bone marrow of 3 Yucatan minipigs and grown in standard culture flasks. When they became near-confluent, cells were detached and replated with the addition of osteogenic supplements. A model of a porcine mandibular condyle was made and used to fabricate porous polymer scaffolds from biodegradable poly DL-lactic-co-glycolic acid (PLGA). Differentiated osteoblasts were transferred to the PLGA scaffold and cultured for 6 weeks in a rotational oxygen-permeable bioreactor system. The cultured constructs, consisting of scaffold and cells, were evaluated by gross, radiologic, and histologic examinations. RESULTS: The engineered constructs were white and hard and had a shape that closely resembled that of the model condyle. Plain radiographs demonstrated that the radiodensity of the construct was between that of the normal condyle and that of control scaffolds. Histologically, bone was observed on the entire surface of the PLGA scaffolds with an average thickness of 0.03 mm. Bone was not observed in the control scaffolds. CONCLUSION: In this pilot study, autologous tissue-engineered bone constructs were successfully made by combining biodegradable polymers and pMSCs.

Alkaline Phosphatase↗

Grape seed proanthocyanidins extract promotes bone formation in rat's mandibular condyle.

We studied the effect of dietary supplementation with grape seed proanthocyanidins extract (GSPE) 3 mg added in 100 g high-calcium diet with a calcium content of 1697 mg 100 g(-1) on mandibular condyle bone debility, which was induced by a low-calcium diet. Forty Wistar male rats, 5 week old, were randomly divided into control (Co), low-calcium diet (LC), low-calcium/high-calcium diet (LCH), and low-calcium/high-calcium with supplementary GSPE diet (LCHG) groups for 6 wk. Bone formation of the mandibular condyle was measured using peripheral quantitative computed tomography (pQCT). Significant differences were not seen among the four groups for body weight, measured weekly. The LCHG group scored significantly higher in cortical bone density, total bone cross-sectional area, cortical bone cross-sectional area, cortical bone mineral content, total bone density, total bone mineral content, and in the stress-strain index to the reference axis x when compared with the LCH group. We concluded that a high-calcium diet combined with GSPE supplementation is more effective in reversing mandibular condyle bone debility in rats than is a low-calcium diet, standard diet, or high-calcium diet alone.

Anatomy, Cross-Sectional↗

The effect of altered functional forces on the expression of bone-matrix proteins in developing mouse mandibular condyle.

Mechanical forces are known to have an effect on bone formation, maintenance and remodelling, and there is evidence that the development of the mandibular condyle in the rat is influenced by the consistency of the diet. Here a mouse model was used to investigate the relation between food, condylar development and the expression of bone sialoprotein (BSP), osteopontin (OPN), osteocalcin (OC) and type 1 collagen (COL I). Twenty-four 19-day-old male mice were randomly divided into three groups. Groups 1 and 2 were fed hard pellets and soft powdered food, respectively, for 2 weeks. Group 3 mice were fed soft food for 1 week followed by a week of hard pellets. Incisors of mice in groups 2 and 3 were trimmed twice a week to reduce occlusal forces. After killing the animals, mandibular condyles were collected for RNA extraction, in situ hybridization and immunohistochemical analyses. Histological sections showed that the condyles of mice in group 2 were underdeveloped, with a thinner layer of cartilage and fewer bone trabeculae. Northern hybridization of total RNA of the condyle from mice in this soft-food group also exhibited a significant decrease in the amounts of BSP, OPN, OC and COL I, representing 79%, 75%, 77% and 79% respectively, of that from mice fed hard food. In situ hybridization of these bone-matrix proteins demonstrated signals in bone-forming cells and BSP mRNA was also seen in the hypertrophic cartilage cells in the developing condyle. Immunohistochemical study demonstrated an obvious difference in the intensity of staining, especially for BSP. Results from group 3 were similar to those from group 1. The observed decrease in bone matrix-protein expression confirms that the consistency of the diet affects the development of the mouse mandibular condyle and that a soft diet diminishes the rate of bone formation.

Animals↗

Eosinophilic granuloma of the mandibular condyle. Case report.

A case of eosinophilic granuloma of the mandibular condyle in a 38-year-old woman is reported. Clinically, the lesion presented as a malignant process with pathological fracture. The problems related to radiographic and histological diagnosis are discussed.

Adult↗

Osteochondroma of the mandibular condyle: report of case.

A case of osteochondroma of the mandibular condyle has been presented. The facial and occlusal deformities produced by the tumor are described. After the surgical treatment and concomitant orthodontic treatment, satisfactory occlusion and facial contour were established.

Adult↗

Deafness and cholesteatoma complicating fracture of the mandibular condyle.

A case of posterior fracture-dislocation of the mandibular condyle which resulted in conductive deafness and cholesteatoma is presented. Initial management by condylectomy improved auditory canal patency but failed to prevent the development of cholesteatoma, necessitating mastoid surgery. Although major complications following fractures of the condyle are not common the need to consider the possibility of damage to the ear in such fractures is emphasised.

Adult↗

Radiographic structural findings in the mandibular condyles of young individuals receiving orthodontic treatment.

Radiographic findings in mandibular condyles were studied from the pre- and post-treatment panoramic radiographs of 625 orthodontic patients. The subjects' mean age was 11 years at the start and 14 years at the end of active orthodontic treatment. Radiographic condylar findings were seen in 14 (2%) subjects before treatment and in 54 subjects (9%) after treatment (p < 0.001). In age-related controls (n = 783) condylar findings were seen in 3% (p < 0.001). The condylar finding was 'flattening only' in half of the patients and in one-third of the controls with condylar findings. Activator treatment was associated with condylar findings (p < 0.05). Condylar findings increased with age in the orthodontically treated subjects (p < 0.05) but not in the unselected population controls. This may mean that condyles become more sensitive with age in children. Increase with age may be partly due to the radiographic interpretation, since minor condylar findings are difficult to observe in young children, and partly due to differences in treatment modalities and the duration of treatment.

Activator Appliances↗

Surgical treatment of osteochondroma of the mandibular condyle in the adult. A 5-year follow-up.

Five adult patients with temporomandibular joint (TMJ) pain and impaired mandibular function and with clinical and radiographic features of unilateral osteochondroma of the mandibular condyle was included in a 5-year prospective follow-up study. All patients were surgically treated with condylectomy and reshaping of the condylar neck which was then positioned underneath the preserved TMJ disk. The yearly follow-up evaluations comprised measurements of maximum interincisal opening and protrusive movements, assessments of occlusion and TMJ pain as well as tomographic interpretation of recurrent growth. No patient showed recurrence of growth at the 5-year follow-up and mandibular function and occlusion was normalized in all patients. The results indicate that this conservative surgical approach can be recommended for treatment of osteochondroma of the mandibular condyle.

Adult↗

A technique for control of the condylar head during open reduction of the fractured mandibular condyle.

Open reduction of fractures of the neck of the mandibular condyle may be technically difficult. Control of the proximal fragment may be achieved by insertion of a Moule pin into the condylar neck. This facilitates retrieval of the condylar head and alignment of the bone fragments which are essential components of the technique. Accurate anatomical reduction and stabilisation of the fracture simplifies the technique of miniature plate fixation.

Adult↗

[Fracture of the glenoid fossa without condylar dislocation and with intact mandibular condyle. Report of a case].

The osteomuscular structure of the cranium presents peculiar anatomic characteristics that aim to preserve the noble organs that are housed inside or are adjacent to them. This is also true of the condylar region which protects the cranial cavity from forces transmitted to the glenoid cavity by the condyle in traumatism to the facial region and above all the genial symphysis. These factors act as "force breakers" to prevent the condyle penetrating the middle cranial fossa. Of these the most important is the presence of a line of minor resistance at the level of the condyle neck which is often the site of a protective fracture. However, the dislocation of the condyle in the middle cranial fossa is an occurrence that is reported in the literature, albeit very rarely; the fracture of the glenoid fossa with an intact mandibular condyle and without evident dislocation of the latter is even more rare. The paper reports the case of a 22-year-old male patient who was injured in the submental area leading to loss of conscience. CT revealed that the left mandibular condyle was intact whereas there was a comminuted fracture of the roof of the glenoid fossa and two fractures at the mandibular level. The patient also presented left otoliquorrhea. The glenoid fracture was not complete and therefore the mandibular condyle did not show evident dislocation nor was it necessary to resort to surgical or non-surgical treatment. After the reduction and restraint of the two mandibular fractures, occlusion was correct and the position of the left condyle was appropriate following X-ray control, even if the glenoid cavity was partially fractured. Otoliquorrhea resolved spontaneously after about three days and did not require any treatment. The case described here, which was recontrolled after some time, presented excellent functional results demonstrating that conservative treatment of the glenoid cavity fracture was the correct therapeutic choice.

Adult↗

Growth stimulation of mandibular condyles and femoral heads of newborn rats by IGF-I.

Primary and secondary cartilage differ in embryonic origin and are generally considered to have a different mode of growth. However, few experimental studies exist that directly compare the two types of cartilage and their growth regulation. The regulation of cartilage growth is a complex mechanism involving growth factors like insulin-like growth factor-I (IGF-I). The purpose of this study was to compare the growth of mandibular condyles of 4-day-old rats with that of femoral heads in vitro and to analyze the effects of IGF-I. Explants were cultured for up to 2 weeks with 0, 5, and 25 ng/ml IGF-1. Both, 5 and 25 ng/ml IGF-I significantly stimulated growth of the mandibular condyles while only 25 ng/ml IGF-I stimulated growth of the femoral heads. IGF-I increased glycosaminoglycan synthesis of both condylar and femoral cartilage. However, only the DNA synthesis of the mandibular condyles was significantly increased by IGF-I while that of the femoral heads was not affected. It is concluded that IGF-I stimulates growth of both secondary condylar cartilage and primary femoral cartilage. The mandibular condyle appears to be more sensitive to IGF-I than the femoral head, which may partly be due to the different developmental stage.

Animals↗

[Tumors of the mandibular condyle (author's transl)].

Three cases of tumors of the mandibular condyle are reported. One patient had metastases from a cutaneous melanoblastoma, another a benign osteochondroma, and the third a plasmocytosarcoma revealing the presence of Kahler disease. The authors emphasize the rare nature of these lesions, in spite of the technical advances made in the radiological and surgical exploration of the temporomandibular joint, and also the large variety of histological types reported in the literature. They discuss the main diagnostic features, especially in isolated lesions in patients with no relevant past history, and stress the importance of surgical biopsy. Therapy varies from surgical treatment in benign tumors, the prognosis being excellent, to usually palliative therapy in malignant lesions.

Adult↗

Clinical and computed tomographic findings in costochondral grafts replacing the mandibular condyle.

PURPOSE: The aim of this study was to evaluate by computed tomography (CT) and clinically the structure and function of costochondral grafts (CCG) used to replace the mandibular condyles. MATERIAL AND METHODS: CT and clinical examination were performed in 11 patients with CCGs (9 female, 2 male; mean age at surgery, 25 years; range, 9 to 44 years) approximately 4.5 years after surgery (range, 5 months to 10.5 years). One mandibular condyle was replaced in six patients and two in five patients. RESULTS: Facial asymmetry was observed in two cases and palpation tenderness of the TMJs or clicking and crepitation were found in 10 of 16 operated TMJs. In three cases coronal CT scans showed the graft to be situated laterally in the mandibular fossa, and lateral overgrowth of the graft was seen in three cases. In two cases, coronal CT slices showed that a new fossa had developed. In most cases translatory movement of the graft was minimal. The graft was either partially or almost completely mineralized, especially in cases with longer follow-up. CONCLUSIONS: Most of the patients in this study seemed to have benefitted from replacement of the deformed mandibular condyle with a CCG as estimated by improved range of mandibular movements and decreased symptoms. There were some problems related to unpredictable growth and location of the graft, as well as restricted movement of the replaced condyle. In the future, care should be taken to ensure proper postoperative functional therapy and to examine the role of cartilage thickness on future growth in young patients.

Adolescent↗

Intrusion of the mandibular condyle into the middle cranial fossa: case report and review of the literature.

OBJECTIVES: To describe a case of mandibular condyle intrusion into the middle cranial fossa in a young child and to systematically review the literature pertaining to this condition. STUDY DESIGN: The diagnostic procedures comprised clinical examination, health history, and both magnetic resonance imaging and computerized tomography. A systematic review of the literature from PubMed, Medline, and Web of Science databases from 1960 to 2005 was made and a total of 55 cases in 51 references were found, of which 36 were described in detail. CONCLUSIONS: Prompt diagnosis of mandibular condyle intrusion into the middle cranial fossa is essential to minimize complications. Advanced imaging modalities of computed tomography and magnetic resonance imaging are indicated.

Accidents, Traffic↗

[Mandibular condyle metastasis : report of three cases (author's transl)].

Three cases of mandibular condyle metastasis of particular interest are reported: -- In two out of the three cases they were detected early enough for the primary tumour to be diagnosed; -- they all presented with articular symptoms; -- all three were treated surgically by excision of the condyles. Diagnosis was confirmed by histological examination, a rare event when mandibular metastasis are concerned, these usually being diagnosed after the primary tumour and then irradiated without histological proof. Primary tumours were respectively bronchial, pancreatic, and mammary.

Adenocarcinoma↗

Bromodeoxyuridine immunohistochemistry for evaluating age-related changes in the rat mandibular condyle decalcified by intravenous infusion.

Age-related changes in cell proliferation kinetics of the mandibular condyle were studied in Sprague-Dawley rats using bromodeoxyuridine (BrdUrd) immunohistochemistry in decalcified, paraffin-embedded tissues. Intraperitoneal injection of 40 mg/kg BrdUrd was given 1 hr before animal sacrifice. Continuous perfusion of EDTA solution via the left ventricle shortened the decalcification time. Immunohistochemical staining was performed with monoclonal anti-BrdUrd antibody. BrdUrd labeled cells, i.e., the S-phase cells, were clearly visible with well-preserved cytological detail. Their nuclei exhibited homogeneously stained granules. The labeling index in the intermediate zone of the condyle decreased with increasing age of the animals. This method is useful for evaluating physiological and pathological changes of the rat mandibular condyle as well as other bones and joints.

Aging↗