Bilateral condylar anomaly: A case report and review

Management of bilateral condylar agenesis by distraction osteogenesis: a rare case report

Condylar agenesis is a rare case involving developmental disturbances related to growth of mandible, facial aesthetics, dentition development, muscle deformation, and occlusal problems. As such, this is a rare condition, and there is no internationally accepted protocol for the same. Underdevelopment or defective formation of condyle may be congenital or acquired. Condylar agenesis is congenital non formation of condyle, while hypoplasia is poor development. We report a case of bilateral condylar agenesis in a 30-year-old female patient.

Trifid Mandibular Condyle: Case Report and Current Review of the Literature

Trifid mandibular condyle (TMC) is a rare anatomical variation characterized by the duplication of the mandibular condyle. The aim of this study is to report a new case of a 26-year-old female patient with a left TMC and to review the current existing literature on TMC, the relevant cases, etiology, symptoms and different treatment modalities. The database engines PubMed, EMBASE, Scopus, Web of science, Scientific Electronic Library Online, Cochrane and CINAHL were searched for TMC cases from inception until April of 2022. Only 13 previous cases of TMC were found. Although it is a rare anatomical entity, TMC is increasingly being detected due to more advanced imaging techniques, especially computed tomography (CT), cone beam CT (CBCT) and magnetic resonance imaging (MRI) emerging in the field of dentistry. The etiology and pathogenesis of TMC and its relationship with TMD are still unclear. Further studies and follow-up may help to better understand this anatomic variant and possible interactions with local pathologies.

Trifid mandibular condyle: A case report and literature review

Trifid mandibular condyle is a rare anatomical malformation characterized by a division of the mandibular condylar head. The two articulating surfaces of the bifid condyle are divided by a groove that can be oriented mediolaterally or anteroposteriorly. This anomaly of the mandibular condyle has been described as a condition of unknown ætiology and uncertain pathogenesis. Some authors see it as a result of accidental trauma or forceps delivery, with the two heads occurring one behind the other in the sagittal plane. Reported cases are mostly unilateral and usually asymptomatic. The diagnosis is made after radiographic exploration and precised by advanced imaging techniques such as three-dimensional computerized tomography.

Bifid mandibular condyles: A systematic review

Background

Bifid mandibular condyle (BMC) constitutes an extremely rare disorder characterized by a duplication of the head of the mandibular condyle. Its prevalence ranges from 0.31% to 1.82% in the published literature.

Objectives

The primary objective was to describe the main etiological, clinical and radiological characteristics of patients with BMCs and the existent treatment options. The secondary objective was to simultaneously include the characteristics of two new cases of BMC.

Material and Methods

An electronic search in Pubmed (MEDLINE), Scopus and The Cochrane Library was carried out by two independent reviewers until April 2018. Prospective or retrospective cohort studies, case series and case reports describing clinical and/or radiological characteristics of patients with BMC were included. Registered variables were demographic, etiological factors, diagnostic exam, clinical characteristics and treatment options. The results from the articles selected were organized in a Table along with the characteristics of two new cases of BMC provided by the authors.

Results

From a total of 431 articles found in the initial search, 68 articles were finally included. This systematic review included 216 patients and 270 BMC with an average age of 30.6 (SD=14.7) years and a women:men ratio of 1.4:1. Mediolateral condylar orientation was the most prevalent position (80.1%). Among cases with known etiology, 40.8% of cases had a history of traumatism, while 55.9% did not present any relevant medical background. Half of the symptomatic cases had history of trauma. The most common symptoms were hypomobility (22.7%), arthralgia (18.1%), articular noise (17.2%) and ankylosis (17.6%). Active monitoring and manufacturing an occlusal splint were the most frequent treatment options.

Conclusions

BMC may have congenital or traumatic etiology. Hypomobility and arthralgia are the most frequent symptoms and treatment options are often conservative.

Key words:Bifid mandibular condyle, trifid condyle, tetrafid condyle, condylar orientation, ankyloses.

A study on etiopathogenesis and clinical features of multi-headed (bifid and trifid) mandibular condyles and review of the literature

PURPOSE

The formations of second or more condylar heads are considered as rare anomalies. Fourteen multi-headed condyles (MHC) were presented; 13 of these were bifid mandibular condyles (BMC), whereas one exceptionally rare case was a trifid mandibular condyle (TMC). The TMC presented in this paper is the eighth case reported in the literature. In this paper, etiopathogenesis, types, and treatments are discussed.

MATERIALS AND METHODS

Patients were classified according to their status, etiologies, gender, functions of the mandible, interocclusal distances, pathological conditions, types, and treatment received.

RESULTS

BMCs were classified into two groups: type I BMCs were nontraumatic, nonsymptomatic, mediolateral, presumably developmental, and characterized by shallow grooves. Type II BMCs were traumatic and may have two subgroups. The first group of type II BMCs were mediolateral and Y-shaped. The second group of type II BMCs were characterized by two separate and anteroposteriorly located condyles.

CONCLUSION

Treatment depended on patients' complaints. In this study, asymptomatic patients did not receive therapy, whereas patients with temporomandibular join internal derangement received medical treatment, and patients with ankylosis had surgical treatment.