[Surgical management of fractures of the mandibular condyle].
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Humans↗
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Results for “MANDIBULAR CONDYLE”
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[A new technique for the reduction of the dislocated mandibular condyle].
A case is reported of a 57 year-old woman who suffered a dislocation of the mandibular condyles for 18 months. A new technique is described for the reduction of the mandible. Two screws are fixed in the angles of the jaw and wires are passed extraoraly after connecting them with the screws. Forces can be exercised through these wires.
Bone Screws↗
Fractures of the mandibular condyle. Part 2: results of treatment of 348 patients.
This study was designed to record the results of conservative treatment of condylar fractures and to find out if there were any variables that were predictive of complications. Data were analysed in our computer department. During the period 1984-1996, all patients who presented with a fracture of the mandibular condyle and who attended for control examination one year after treatment were recorded at the end of treatment and one year later. The ability to open the mouth, deviation and occlusion were recorded. After one year 45 of the 348 patients (13%) had minor physical complaints such as reduced ability to open the mouth, deviation, or dysfunction. Ten of them (3%) had pain in the joint or muscles or both. Eight patients (2%) had malocclusion, which in seven could be related to dislocation of the condylar head out of the fossa. Five of the eight patients had had bilateral fractures. We conclude that conservative treatment of condylar fractures is non-traumatic, safe, and reliable and in only a few cases may cause disturbances of function and malocclusion. The risk associated with the latter is greatest with bilateral fractures and dislocation of the condylar head from the fossa.
Adolescent↗
Prevalence of structural bony change in the mandibular condyle.
Estimated on data derived from a longitudinal study of 172 orthodontic subjects, structural bony change in the mandibular condyle occurs in 5% of the individuals documented from childhood to adulthood. The first appearance generally was between 12 and 16 years of age. Differential diagnosis based upon signs and symptoms of CMD registered simultaneously, as proposed in the 1990 guidelines for craniomandibular disorders appeared to be inconsistent. To illustrate how suddenly the process of bony change may proceed, a case report is presented in which a severe change transpired within a 1-year interval in a 13-year-old patient.
Adolescent↗
Closed condylotomy in the treatment of recurrent dislocation of the mandibular condyle.
Twenty-one patients 10-79 years of age were operated on for recurrent dislocation of the mandibular condyle using Kostecka's closed condylotomy method. The procedure alters the condyle position and will indirectly shorten the lateral pterygoid muscle, thus eliminating its pulling power to the condyle, even though it still functions. For the study, a late examination was performed with at least 1 year's follow-up. Seventeen patients were cured after unilateral or bilateral condylotomies, and two patients were asked to undergo a second operation on the opposite side. In normal cases any joint operated on was cured. Two cases suffering from congenital torticollis or disseminated sclerosis were felt to be unsuccessful. One exceptional case resulted in a pseudarthrosis, and was repaired by rib bone cartilage transplant. The method is the simplest and least traumatic when recurrent dislocation of the temporomandibular joint is treated surgically.
Adolescent↗
Differences in biologic response of the mandibular condyle to forward traction or opening of the mandible. An experimental study in the rat.
The effect of different mandibular postures on the growth of the mandible was studied. A total of 60 female Wistar rats were divided into 3 groups, and all the animals were anesthetized for 6 h daily from the age of 30 days onwards. The first group served as controls. The second had the mandible maintained in a protracted position, and the third had the mandible in an open position during the anesthesia. Macroscopic measurements showed the growth of the mandibular condyle to be increased in a posteroinferior direction and also in a superior direction in the animals with the mandible in an open position. The cartilage layer containing collagen type II was significantly thinned, whereas cell proliferation had significantly increased in the posterosuperior region. In association with mandibular protrusion the thickness of the cell layer containing collagen type II had increased, and cell proliferation in the posterosuperior region had significantly decreased. Significant differences in the growth of the condylar process were observed histologically and histochemically between the experimental animals, implying that the most rewarding aspect of the regulation of condylar growth seems to be the possibility to regulate the maturation rate of the cartilage cells.
Adaptation, Physiological↗
Reflected light microscopy of the human mandibular condyle--a study of a post-mortem material.
The surface characteristics of the articulating surfaces of 11 human mandibular condyles removed post-mortem were determined by the use of reflected light dark-field microscopy. Good agreement was obtained between macroscopical grading of degenerative change and appearance as observed by microscopy. Microscopical appearances believed to correspond to normal surface, fibrillation and degenerative changes are described.
Aged↗
The use of ultrasound to determine the position of the mandibular condyle.
A randomized, single blind study of 20 patients examined the accuracy of ultrasound in establishing the position of the mandibular condyle in relation to the glenoid fossa. The sonographic technique is described. The temporomandibular joint was imaged sonographically with the patients in an open- and a closed-mouth position as a model for condylar sag and proper condylar seating, respectively, during mandibular ramus osteotomy procedures. One radiologist identified condylar position correctly in 38 of 40 still ultrasound images, with a sensitivity and a specificity of 95%. During real time ultrasound examination, it is possible to visualize varying degrees of condylar movement in relation to the glenoid fossa. The results of this study support the potential use of ultrasound as an adjunct to mandibular orthognathic surgery.
Adult↗
In vivo effects of tunicamycin on chondrocytes of rat mandibular condyles as revealed by lectin cytochemistry.
The in vivo effects of tunicamycin on the glycosylation of proteoglycans and link protein in rat mandibular condylar chondrocytes were studied by ultrastructural lectin histochemistry. The binding of wheat-germ agglutinin was shown by using anti-lectin antibody followed by protein A-gold complex. In normal rats, wheat-germ agglutinin labeling was restricted to trans cisternae and vacuoles of the Golgi complex, whereas it was observed in neither the cis region of the Golgi complex nor in the rough endoplasmic reticulum. By 3 h after the drug administration, wheat-germ agglutinin binding sites on the disorganized Golgi vacuoles were dramatically reduced in number. At 6 h after the drug administration, the lectin binding sites on the Golgi vacuoles were restored. These results demonstrate that the in vivo use of tunicamycin in combination with histochemical analysis using lectin probes is of significant value for the study of protein glycosylation in chondrocytes of the rat mandibular condyle.
Animals↗
Adaptation and remodeling of the mandibular condyle following vertical ramus osteotomy in dogs.
This experiment investigated the effects of vertical ramus osteotomy (VRO) on normal mandibular condyles and those altered surgically to simulate trauma to the articular surface. Four dogs that received unilateral vertical ramus osteotomy to reposition the condyle downward and forward responded with progressive remodeling of the articular cartilage. A second group of four dogs that had grooves cut into the articular surfaces of both condyles showed more rapid healing on the side receiving VRO. In a third group (n = 4), vertical ramus osteotomy appeared to protect the articular cartilage from regressive remodeling after extraction of the molar teeth and prevent decreased vertical dimension of occlusion. The articular cartilage on the side with the vertical ramus osteotomy remained healthy, while the untreated side developed a narrower joint space and showed histologic evidence of thinning and degeneration of the fibrocartilage and increased density of the subchondral bone.
Adaptation, Physiological↗
[A PROBLEM OF HYPERPLASIA OF THE MANDIBULAR CONDYLE].
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Humans↗
Hyperplasia of the mandibular condyle. A historical review of important early cases with a presentation and analysis of twelve patients.
Thirteen patients with condylar hyperplasia have been examined and twelve operated upon in a nine year period ending December 1979. A further eight patients with facial asymmetry, considered to be the sequelae of condylar hyperplasia, had extra condylar osteotomies carried out. As no specimens are available for histopathological examination, they have been excluded from the series. There appears to be a similarity between the histological findings of osteochondromata of the mandibular condyle and coronoid processes, active condylar hyperplasia and the changes noticed in the region of the costo-chondral junction of the acromegalic rib.
Adolescent↗
Mandibular condyle osteochondroma. Review of the literature and report of a misdiagnosed case.
Temporomandibular disorders can usually be diagnosed on the basis of a thorough history and a comprehensive examination of the patient. Additional diagnostic tests, such as imaging of the temporomandibular joint (TMJ) area, are mandatory and must be flawless in case of atypical findings. The aim of this report is to illustrate pitfalls in clinical reasoning and in imaging procedures in the diagnosis of temporomandibular pain and dysfunction. A case report of a patient with osteocartilaginous exostosis of the mandibular condyle, which was erroneously diagnosed and treated as an internal derangement of the TMJ for half a year, is presented.
Adult↗
Transcranial oblique lateral radiography to verify the position of the mandibular condyles with the use of functional appliances.
By means of standardized transcranial oblique lateral (TOL) radiographs, the position of the mandibular condyles in the glenoid fossae of 14 patients with Class II division 1 malocclusion was studied at the beginning of treatment with or without functional appliances placed in position, and also at the end of treatment. A significant increase in the distance between the upper point of the condyle and the glenoid fossa was found when the appliance was worn for the first time. This displacement was found to disappear at the end of the treatment even when the appliance was placed in position.
Activator Appliances↗
Intraoral myotomy of the lateral pterygoid muscle for treatment of recurrent dislocation of the mandibular condyle.
This article describes an intraoral procedure for myotomy of the lateral pterygoid muscle as treatment of recurrent dislocation of the mandibular condyle and five treated cases are presented. In none of the cases were anatomic structures damaged, and none of the patients has developed recurrence. The main effect of this treatment is ascribed to scarring anterior to the joint capsule, limiting excursion of the condyle. Although the follow-up is limited, the results seem promising.
Adolescent↗
A follow-up study of radiographic findings in the mandibular condyles of orthodontically treated patients and associations with TMD.
Our earlier studies have shown that some radiographic structural findings in the mandibular condyles are more common in orthodontically treated populations than in normal populations. To test the hypothesis that these findings are stable, we studied condylar findings in panoramic radiographs longitudinally in 39 subjects and in 39 sex- and age-matched controls. The subjects had condylar findings at the end of orthodontic treatment at about 15 years of age; no such findings were seen in the controls. The subjects and controls were re-examined radiographically about 12 years after the posttreatment radiographic examination. We also tested the hypothesis that radiographic condylar findings are associated with temporomandibular disorders (TMD). No statistically significant differences were found between subjects and controls in terms of reported subjective TMD symptoms. Clinically, the subjects had temporomandibular joint (TMJ) crepitation significantly more frequently (27%) than controls (8%) (p < 0.05). Crepitation correlated with some reported symptoms and clinical signs, suggesting that osteoarthrosis might have been an important etiological factor for TMD in the present subjects. At the follow-up examination, radiographic condylar findings were seen in 25 subjects and in four controls (p < 0.001). The condylar findings varied greatly between the time of orthodontic treatment and follow-up in the subjects. The findings had become more severe in 49% of the subjects, more often in females than in males (p < 0.05), whereas in 28% of the subjects the condylar findings had disappeared. Although the radiographic findings after orthodontic treatment fluctuated with age, in most adolescents with changes in their condyles, these findings remained constant or became more severe.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Curvature analysis of the mandibular condyle.
OBJECTIVE: To determine whether curvature analysis on high resolution CT images can be used as a tool for evaluation of mandibular condyle morphology. METHODS: Curvature analysis was performed on reconstructed oblique coronal CT images of 634 normal condyles from 317 patients (144 men and 173 women; age range 4-89 years) with inner or middle ear disease. The condyles were scanned with 1 mm collimation using helical CT. The CT images were analysed manually on a personal computer. RESULTS: The condyle CT images could be categorized into five curvature profile patterns: (1) bi-peak; (2) no peak; (3) tri-peak; (4) bi-peak with an intervening bottom above the base line (bi-peak with a col); and (5) bi-peak with an intervening negative phase. A separate evaluation using computer graphic condyle models indicated that these curvature patterns corresponded to flat (bi-peak), round (no peak), convex (bi-peak with a col), concave (bi-peak with a negative phase) and angled (tri-peak) contours of the condyle's superior surface. The curvature profiles were identical between bilateral condyles in 40% (126/317) of the patients. Gender-related differences in the incidence of the curvature profiles were also found, the bi-peak with a col profile being more frequently observed in women and the bi-peak with a negative phase profile being observed more frequently in men. CONCLUSION: Curvature analysis on CT images depicts condyle morphology effectively and may be an adjunctive tool for condyle morphometry.
Adolescent↗
An ultrastructural study of cartilage resorption at the site of initial endochondral bone formation in the fetal mouse mandibular condyle.
An ultrastructural study was undertaken on cartilage resorption at the site of initial endochondral bone formation in the mouse mandibular condyle on d 16 of pregnancy. After resorbing the bone collar, the osteoclasts extended their cell processes into the cartilage matrix and made contact with hypertrophic chondrocytes. By means of cell processes or vacuolar structures, these osteoclasts entrapped the calcified cartilage matrices, cell debris, and the degraded uncalcified cartilage matrices. In particular, since the calcified cartilage matrices were sometimes seen to be disrupted within the osteoclastic vacuolar structures, they were probably disposed of by the osteoclasts. Invading endothelial cells giving rise to capillaries also directly surrounded the degraded uncalcified cartilage matrices and small deposits of cell debris. In addition, hypertrophic chondrocytes that had attached to or were in the process of attaching to the invading osteoclasts often enclosed the small calcified cartilage matrices. Other cell types that have often been reported in other regions of cartilage resorption were not seen at the site of initial endochondral bone formation in this study. Our findings in relation to cartilage resorption may therefore represent unique features of the site of initial endochondral bone formation site. We consider that the manner of cartilage resorption is likely to vary by site, age, and species.
Animals↗