Idiopathic Condylar Resorption: A Survey and Review of the Literature

Publication date: Available online 19 July 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Lena Alsabban, Felix Jose Amarista, Louis G. Mercuri, Daniel Perez

Abstract

PURPOSE

Idiopathic condylar resorption (ICR) is a relatively uncommon condition. Its diagnosis, etiology and management options are also controversial. Further, it is difficult for one provider to collect a large cohort of ICR patients to develop a statistically significant study of these concerns. Therefore, the purpose of the present study was to survey experienced temporomandibular joint (TMJ) surgeons with ICR cases relative to these concerns, as well as review the management outcomes literature.

MATERIALS AND METHODS

Survey Monkey® (SurveyMonkey.com, LLC Palo Alto, CA) was used to canvas the 88 international TMJ surgeons on the TMJ Concepts (Ventura, CA) InterNetwork, this network connects a group of surgeon across the world that consistently do TMJ surgery, the intent was to provide a global snapshot of the demographic, epidemiologic, diagnostic work-up, and outcomes related to the management of ICR cases.

RESULTS

The surveys from surgeons who did not respond to all 12 questions were not included in the results. After applying the exclusion criteria, complete data on a cohort of 100 patients were obtained and utilized for the study. History of hormonal imbalance was only reported in 10% of the patients; however, 42 of 94 women were reportedly taking BCPs presumably affecting their menstrual cycles. The most common reason for consultation was Class II malocclusion (98% of the patients). Treatment modalities varied and included orthodontics, orthotics, TMJ total joint replacement (TMJ TJR), orthognathic surgery, and disc repositioning.

CONCLUSION

ICR management proved to be controversial amongst the surveyed surgeons, multiple treatment options have been described in the literature including: medical management, orthognathic surgery only, TMJ and orthognathic surgery or total joint prostheses (TJP) reconstruction.

Long-term controlled multi-center clinical studies should be developed to evaluate outcomes with all non-surgical and surgical management options for the ICR patient.

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