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Nobrega MTC, Almeida FT, Friesen R, Davis C, Major PW. Idiopathic condylar resorption in adolescents: A scoping review. J Oral Rehabil 2024; 51:1610-1620. [PMID: 38685690 DOI: 10.1111/joor.13704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 03/18/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Idiopathic condylar resorption (ICR), also known as progressive condylar resorption, is poorly understood, particularly in adolescent patients. Therefore, this scoping review aims to summarize the available literature on the prevalence, aetiology, pathogenesis, diagnostic process, treatment and/or any outcome regarding ICR in adolescent individuals. METHODS This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and its extension for scoping reviews (PRISMA-ScR), as well as Joanna Briggs Institute studies. The search strategy was defined adopting a core search structure for each source, and the search was performed on MEDLINE, EMBASE, Cochrane Library, Web of Science, Scopus and Google Scholar. After duplicate removal, two independent reviewers screened abstracts, followed by complete articles, to achieve the definition of included studies. Data collection was performed, and the extracted data were organized in tabular form, along with a narrative summary of main findings that aligns with the objective of this review. RESULTS Six observational studies were included in this review. Three studies focused on signs and symptoms, one on prevalence and signs and symptoms, one on treatment and one on disease pathogenesis. CONCLUSION This scoping review revealed inadequate published research regarding prevalence, aetiology, early diagnosis, pathogenesis and treatment of ICR in adolescents.
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Affiliation(s)
| | - Fabiana T Almeida
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Reid Friesen
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Clayton Davis
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Paul W Major
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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2
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Lee WE, Chen YJ, Yu SJ, Wang YC, Shih TTF. Evaluation of body composition and bone mineral density in patients with and without idiopathic condylar resorption of temporomandibular disorders by dual energy X-ray absorptiometry. J Dent Sci 2024; 19:1469-1476. [PMID: 39035307 PMCID: PMC11259649 DOI: 10.1016/j.jds.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/13/2024] [Indexed: 07/23/2024] Open
Abstract
Background/purpose The impact of temporomandibular joint (TMJ) osseous destruction on bone mineral density (BMD) remains unclear due to controversial findings. Besides, no previous study has explored the relationship between idiopathic condylar resorption (ICR) and body composition. This study aimed to investigate the relationship between ICR and BMD or body composition. Materials and methods Between July 2018 and August 2022, patients evaluated by an experienced dentist and diagnosed with temporomandibular disorders (TMDs) were referred to our center. They were recruited while they received the magnetic resonance image (MRI) examination, BMD and body composition completely. Patients were further categorized into TMDs with or without ICR groups according to MRI findings. One-way analysis of variance was used to compare the variables of BMD and body composition in the two groups. Results In total, 67 patients were included in the analysis, with 42 categorized as TMDs with ICR and 25 as TMDs without ICR. Patients with ICR had a significantly higher lean mass percentage and lower fat mass percentage; lower android/gynoid fat ratio, and visceral adipose tissue area than those without ICR (P < 0.05). Besides, patients above age 30 with ICR had lower Z scores (P = 0.017) compared with subjects without ICR. Conclusion TMDs patients with ICR show a relationship with body composition and affect the lean and fat mass distribution, especially android/gynoid fat ratio. The pathophysiological mechanism remains unclear. Further researches to investigate teeth binding, malocclusion and dietary habits are important to understand the association of ICR, BMD and body composition.
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Affiliation(s)
- Wei-En Lee
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
| | - Yunn-Jy Chen
- Department of Dentistry, School of Dentistry, National Taiwan University and Hospital, Taipei, Taiwan
| | - Sheau-Jing Yu
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Chen Wang
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
| | - Tiffany Ting-Fang Shih
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
- Department of Radiology, College of Medicine, National Taiwan University, Taipei, Taiwan
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Valladares-Neto J, Acioli GMR, Teodoro AB, Evangelista K, Furquim BD', Silva MAG. Conservative and minimally invasive approaches to control idiopathic condylar resorption: a scoping review. Int J Oral Maxillofac Surg 2023; 52:1188-1196. [PMID: 37271625 DOI: 10.1016/j.ijom.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 06/06/2023]
Abstract
Idiopathic condylar resorption (ICR) is an uncommon disease with multiple names that challenges orthodontic and surgical treatments. The aim of this study was to investigate the existing conservative and minimally invasive approaches to controlling ICR. A scoping literature review was conducted. Inclusion criteria were young patients with degenerative joint disease based on the Research Diagnostic Criteria for Temporomandibular Disorders or Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocols, or ICR based on the DC/TMD expanded taxonomy protocol. Six electronic databases and the grey literature were searched, without restriction on year or language. Two reviewers independently performed the study selection and data extraction. Ten studies were selected from the 13,953 records identified. The total sample size was 424 patients; the female-to-male ratio was 7:1 and the mean age of the patients was 25.7 years. The main primary outcomes were pain, mandibular dysfunction, and condylar resorption. There is no guarantee of definitive success in the early management of ICR, despite the promising approaches studied, and there is no specific protocol to be followed. Therefore, close post-surgical follow-up is still required. This study highlights the need to standardize the nomenclature and diagnostic criteria, and assess the status of condylar activity/severity in future research.
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Affiliation(s)
- J Valladares-Neto
- Department of Orthodontics, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil.
| | - G M R Acioli
- Postgraduate Program in Dentistry, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - A B Teodoro
- Postgraduate Program in Dentistry, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - K Evangelista
- Department of Orthodontics, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - M A G Silva
- Department of Stomatology, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
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Riechmann M, Schmidt C, Ahlers MO, Feurer I, Kleinheinz J, Kolk A, Pautke C, Schön A, Teschke M, Toferer A, Lux CJ, Kirschneck C, Krombach GA, Ottl P, Vieth U, Stengel J, Völker C, Neff A. Controversial Aspects of Diagnostics and Therapy of Idiopathic Condylar Resorption: An Analysis of Evidence- and Consensus-Based Recommendations Based on an Interdisciplinary Guideline Project. J Clin Med 2023; 12:4946. [PMID: 37568349 PMCID: PMC10419428 DOI: 10.3390/jcm12154946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
Idiopathic condylar resorption (ICR), though a rare event, is associated with severe detrimental sequelae for the patient. To date, the etiology remains unknown, and treatment strategies are highly controversial. Therefore, the aim of this study is to present an analysis of the consensus- and evidence-based approach to ICR by a German interdisciplinary guideline project of the AWMF (Association of the Scientific Medical Societies in Germany). Following a systematic literature search, including 56 (out of an initial 97) publications, with a predominantly low level of evidence (LoE), two independent working groups (oral and maxillofacial surgery and interdisciplinary, respectively) voted on a draft comprising 25 recommendations in a standardized anonymized and blinded Delphi procedure. While the results of the votes were relatively homogeneous, the interdisciplinary phase required a significantly higher number of rounds (p < 0.001). Most of the controversial recommendations were related to initial imaging (with consensus on CT/CBCT as the current diagnostic standard for imaging), pharmacotherapy (no recommendation due to lack of evidence), discopexy (no recommendation possible due to low LoE) and timing of orthognathic surgery (with consensus on two-staged procedures after invasive TMJ surgery, except for single-stage procedures if combined with total joint reconstruction). Overall, the Delphi procedure resulted in an interdisciplinary guideline offering the best possible evidence- and consensus-based expertise to date in the diagnosis and treatment of ICR.
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Affiliation(s)
- Merle Riechmann
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Gießen and Marburg GmbH, University Hospital Marburg, and Faculty of Medicine, Philipps University, 35043 Marburg, Germany; (M.R.); (C.S.); (J.S.); (C.V.)
| | - Christopher Schmidt
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Gießen and Marburg GmbH, University Hospital Marburg, and Faculty of Medicine, Philipps University, 35043 Marburg, Germany; (M.R.); (C.S.); (J.S.); (C.V.)
- Department for Radiology and Nuclear Medicine, GPR Hospital Rüsselsheim, 65428 Rüsselsheim am Main, Germany
| | - M. Oliver Ahlers
- Medical Practice, CMD-Centrum Hamburg-Eppendorf, 20251 Hamburg, Germany;
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center, Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Ima Feurer
- Physiotherapeutic Practice & Orthopedic Manual Therapy, 78315 Radolfzell-Böhringen, Germany;
| | - Johannes Kleinheinz
- Department of Craniomaxillofacial Surgery, University Hospital Münster, Westfälische Wilhelms-University Münster, 48149 Münster, Germany;
| | - Andreas Kolk
- Department of Oral and Maxillofacial Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Christoph Pautke
- Medical Practice & Clinic for Oral and Craniomaxillofacial Surgery, 80333 München, Germany;
| | - Andreas Schön
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Bonn, Rheinische Friedrich-Wilhelms-University, 53127 Bonn, Germany;
| | - Marcus Teschke
- Medical Practice for Oral and Craniomaxillofacial Surgery, 28195 Bremen, Germany;
| | - Astrid Toferer
- Medical Practice for Oral and Craniomaxillofacial Surgery, 8301 Laßnitzhöhe, Austria;
| | - Christopher J. Lux
- Polyclinic for Orthodontics, University Hospital Heidelberg, 69120 Heidelberg, Germany;
| | - Christian Kirschneck
- Polyclinic for Orthodontics, University Hospital Regensburg, 93053 Regensburg, Germany;
| | - Gabriele A. Krombach
- Department of Diagnostic and Interventional Radiology, University Hospital Giessen, 35392 Giessen, Germany;
| | - Peter Ottl
- Department of Prosthodontics and Materials Sciences, Rostock University Medical Center, 18057 Rostock, Germany;
- Department of Life, Light and Matter, University of Rostock, 18059 Rostock, Germany
| | - Ulla Vieth
- Medical Practice for General Medicine, 36088 Hünfeld, Germany;
| | - Johanna Stengel
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Gießen and Marburg GmbH, University Hospital Marburg, and Faculty of Medicine, Philipps University, 35043 Marburg, Germany; (M.R.); (C.S.); (J.S.); (C.V.)
| | - Caroline Völker
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Gießen and Marburg GmbH, University Hospital Marburg, and Faculty of Medicine, Philipps University, 35043 Marburg, Germany; (M.R.); (C.S.); (J.S.); (C.V.)
| | - Andreas Neff
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Gießen and Marburg GmbH, University Hospital Marburg, and Faculty of Medicine, Philipps University, 35043 Marburg, Germany; (M.R.); (C.S.); (J.S.); (C.V.)
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Wang M, Qian Y, Zhao H, Zhu M, Yu H, Shen SG. Mandibular stability and condylar changes following orthognathic surgery in mandibular hypoplasia patients associated with preoperative condylar resorption. Clin Oral Investig 2022; 26:7083-7093. [PMID: 36151404 DOI: 10.1007/s00784-022-04668-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/08/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate postoperative mandibular stability and condylar changes in patients with mandibular hypoplasia and preoperative condylar resorption (CR) undergoing orthognathic surgery. MATERIALS AND METHODS Fifty-four patients were included in this retrospective study. Computed tomography (CT) scans were acquired preoperatively (T0), 2-7 days immediate postoperatively (T1), and at least 1 year postoperatively (T2). Three-dimensional (3D) cephalometric analysis and measurements of condylar angle, volume, and position (joint spaces) were performed. A 2-mm mandibular relapse was deemed clinically acceptable. We also analyzed the correlations between relapse and postoperative CR and susceptible factors using a multivariate logistic regression model. RESULTS The results showed one year after the surgery, the average mandibular relapse was 1.0 mm (p < 0.05), and the average reduction of condylar volume was 152.4 mm3 (12.7%). Condyle-fossa relationships were improved immediately after the surgery, with a tendency of returning to their original state in the follow-up (p < 0.05). Anteroposterior advancement at point B (B-CP advancement) at T1 and superior joint space (SJS) at T0 were significantly correlated with mandibular relapse, and postoperative CR was mainly associated with vertical increasement at point B (B-AP increasement) at T1. The optimal cut-off values were as follows: 1.6 mm for SJS, 4.2 mm for B-CP advancement, and 1.8 mm for B-AP increasement. Concomitant advancement Genioplasty showed no significant correlation with relapse and postoperative CR. CONCLUSIONS While patients with mandibular hypoplasia and preoperative CR were vulnerable to further condylar resorption after mandibular advancement, the treatment outcomes were generally clinically acceptable. Postoperative relapse was associated with a larger than 4.2 mm of mandibular advancement measured at B-CP and a larger than 1.6 mm of superior joint space measured at SJS, and postoperative CR was associated with a larger than 1.8 mm of mandibular vertical increasement measured at B-AP. CLINICAL RELEVANCE The findings of this study suggested that the mandibular advancement might be limited to 5 mm for patients with preoperative CR. A concomitant advancement genioplasty might also be considered to achieve a better facial profile in these patients.
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Affiliation(s)
- Minjiao Wang
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, 200011, Shanghai, China
| | - Yifeng Qian
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, 200011, Shanghai, China
| | - Hanjiang Zhao
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, 200011, Shanghai, China
| | - Min Zhu
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, 200011, Shanghai, China
| | - Hongbo Yu
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, 200011, Shanghai, China.
| | - Steve Gf Shen
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, 200011, Shanghai, China. .,Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China.
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Shen P, Zhang D, Luo Y, Abdelrehem A, Yang C. Characteristics of patients with temporomandibular joint idiopathic condylar resorption. Cranio 2022:1-7. [PMID: 35880737 DOI: 10.1080/08869634.2022.2100973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVE To investigate characteristics of temporomandibular joint (TMJ) idiopathic condylar resorption (ICR) and analyze the related factors. METHODS A total of 755 consecutive patients (150 with ICR and 605 with anterior disc displacement [ADD]) from July 2015 to December 2018 were recruited. A comprehensive questionnaire characterizing the multidimensional impact of the TMJ was designed. Clinical examination and radiological evaluation were also performed. The odds ratio for each variable in the ICR group versus the ADD group was computed using logistic regression analysis. RESULTS Multivariate logistic regression analysis showed significant correlations between mouth opening restriction, disease course, mandibular retrusion, mandibular retrusion progression, skeletal Class II profile, and overjet in ICR patients. CONCLUSION These results suggest that a longer ADD disease course might have a strong relationship with ICR.
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Affiliation(s)
- Pei Shen
- Department of Oral Surgery, Shanghai Ninth People's Hospital; Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Dahe Zhang
- Department of Oral Surgery, Shanghai Ninth People's Hospital; Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Yi Luo
- Department of Oral Surgery, Shanghai Ninth People's Hospital; Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Ahmed Abdelrehem
- Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Egypt
| | - Chi Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital; Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China
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