Morphological and degenerative changes in a suspected post-traumatic bifid mandibular condyle

Abstract

Bifid mandibular condyle is a rare anatomical anomaly with uncertain aetiology and pathogenesis. Theories for the developmentof this condition include bony alterations post-trauma, however little evidence exists to support this theory. Furthermore, the likely alterations to joint morphology over time as a result of this condition - including possible degenerative changes - have notbeen highlighted. We describe a case of bifid mandibular condyle attributed to a post-traumatic aetiology with associated degenerative changes in a male Sri Lankan skull of approximately 40 to 50 years of age. Fractures of the left parietal bone, zygomatic bone and damage to the orbit were observed in addition to a bifid left mandibular condyle that had anteromedial and posterolateral condyles and remodeling of the mandible consistent with a fracture of the mandibular neck. Two fossae were notedin the squamous part of the temporal bone that corresponded to the two condyles. Degenerative alterations to both joint surfaces included damage to the articular surface and osteophyte formation around the articular margins. This case provides circumstantial evidence to support the development of bifid mandibular condyles post-trauma with observations including longterm modifications to temporomandibular joint morphology leading to subsequent alterations in masticatory muscle activity, andthe first evidence of degenerative change associated with this condition. Both outcomes will potentially result in a loss in temporomandibular joint function and are clinically relevant consequences of bifid mandibular condyle