Bifid Condyle: Review of the Literature of the Last 10 Years and Report of Two Cases

Abstract

Bifid mandibular condyle is a rare anomaly; there are several theories about its etiology, and it has been studied in both prehistoric and historic skulls, as well as in living human beings. It is a frequent, although unexpected, finding in asymptomatic individuals during radiological treatment. Presented here is a review of the literature over the past 10 years and two new cases of unilateral bifid condyle. Computerized tomography is usually considered the test of choice for establishing the differential diagnosis, although in certain cases, its use seems questionable. The distinction between bifid condyle and condylar notch or cleft has been described in the literature, it is proposed a criteria for defining bifid condyle depending on the level of the two heads. It is suggested that further testing such as MRI or CT be carried out only in cases where the therapeutic approach involves an active treatment. It is proposed that bifid condyle is described as that which presents two condylar heads emerging from the neck of the condyle or further down.

Bilateral bifid mandibular condyles diagnosed with three-dimensional reconstruction

“…This case report of bilateral BMC is consistent with the most contemporaneous description of the entity as reported by Lopez-Lopez et al, 10 in which the secondary condylar heads arise from the respective necks of the mandible. However, with the recent upsurge in reporting of BMC, a wide variety of other presentations have been noted and so the exact definition of BMC remains controversial.…”

“…This appearance is consistent with the most contemporaneous description of the entity, as provided by Lopez-Lopez et al, 10 and we are the first research group to substantiate their thesis using three-dimensional (3D) CT colour-enhanced images which specifically delineate the exact anatomical landmarks that must be assessed in order to arrive at this diagnosis.…”

Prevalence of bifid mandibular condyle in a Turkish population

“…The exact etiology is unknown, but circumstances such as trauma, teratogenic drug use, genetic tendency, infection and exposure to radiation have been identified as possible causes for these variations (9,10). Others reported that BMC could be an embryological malformation (8,11,12).…”

“…A review of the literature revealed 112 cases of BMC in living subjects (2,(4)(5)(6)(7)(8). BMC is usually diagnosed as an incidental finding during routine radiographic examination and typically has no distinct clinical symptoms (1)(2)(3).…”

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

“…[1][2][3] BMC is asymptomatic in many patients, often being detected on routine dental radiography, [3][4][5] however some individuals with BMC deformity suffer difficulties with occlusion and mastication that may require surgical intervention to allow restoration of temporomandibular function. [6,7] Bilateral BMC, although rare, has been reported, [7][8][9][10][11][12] and several cases of BMC associated with temporomandibular joint ankylosis have been published.…”