Bifid Mandibular Condyle as the Hidden Cause for Temporomandibular Joint Disorder

Abstract

Bifid mandibular condyle is a rare occurrence, more frequently unilateral. The etiology of this condition is controversial. Bifid mandibular condyles of developmental origin are mostly asymptomatic and discovered incidentally through imaging. Here, we report a 38-year-old male patient, previously in good health, presented with progressive pain in his right temporomandibular joint and restricted joint movements. MRI of the bilateral temporomandibular joints revealed mild degenerative disc on the right side and bifid mandibular condyle on the left side. Conservative treatment comprising a series of soft, medium, and hard splint therapy in combination with analgesics showed symptomatic improvement initially but did not improve the condition in the long term. He subsequently underwent arthrocentesis of the right temporomandibular joint and perceived a good clinical improvement until he developed progressive pain in the left temporomandibular joint and radiating to the left side of the face. He underwent partial condylectomy and discopexy following which all of his symptoms improved; which drives us to question if bifid mandibular condyle is the hidden cause for bilateral temporomandibular joint pain.

Bilateral bifid condyle mandibula features in panoramic radiography: a case report

“…Several cases were found incidentally through routine panoramic radiograph examinations. 3,8,11 The incidence of BMC has increased in the last 10 years due to the increasing use of radiology in patient care procedures. 10 BMC is a rare anatomical disorder and until now the etiology cannot be known with certainty.…”

“…Nonetheless, several cases associated with ankylosis and the temporomandibular joint have been reported. 6,8,9,10,11 In most cases, BMC is asymptomatic and is more often found incidentally on radiographic examinations in the form of panoramic, CT, MRI, ultrasonography, and CBCT. 3,6 With the increasing use of radiography, especially in dentistry, the findings for this case are also increasing.…”

“…Therefore, clinicians need to radiographically recognize the bifid mandibular condyle to determine the diagnosis and appropriate treatment plan for the patient. 11,12 This article reports on a symptomatic case of bifid condylar discovered during a routine radiographic examination. In this article, we will describe the clinical features on panoramic radiograph and accompanying clinical symptoms in bifid condyles cases.…”