A case of idiopathic condylar resorption

Abstract

Background: Idiopathic condylar resorption (ICR) is a well-documented but poorly understood condition, characterised by the progressive degeneration of the temporomandibular joint without an identifiable cause. ICR most commonly presents as a spontaneous, self-limiting episode of bilateral condylar resorption in the absence of pathology, injury or systemic disease. The condition most commonly affects physically active adolescent females, and has a strong predilection for individuals with a Class II skeletal relationship. Some ICR patients exhibit symptoms such as discomfort and/or functional limitations during the active phase of resorption, though some may be completely asymptomatic. Aim: This case report describes the ICR management of a 20-year-old female with asymptomatic bilateral condylar resorption, resulting in a rapid development of mandibular retrognathia. The retrognathic appearance was of concern to the patient and treatment was desired for this reason. Methods and results: Combined orthodontic-orthognathic treatment was undertaken. Pre-surgical orthodontics was completed following ICR stabilisation, and surgical correction consisted of a mandibular advancement plus a genioplasty. The resorbed condyles were accepted given the temporomandibular joints remained asymptomatic and there were no functional limitations. Following treatment, the patient remained asymptomatic, functioning without restrictions, and satisfied with the aesthetic outcome. Conclusion: The combined orthodontic-orthognathic approach addressed the aesthetic and functional concerns of the patient. The condyles were not reconstructed with prostheses and were left in their resorbed anatomical form and relationship. This illustrates the adaptive capabilities of the mandible and associated musculature, and that more complex condylar restorative procedures are not always required.