Condylar Degeneration and Diseases—Local and Systemic Etiologies

Sarver, David M.; Janyavula, Sridhar; Cron, Randy Q.

doi:10.1053/j.sodo.2012.11.008

Cited by 22 publications

(10 citation statements)

References 39 publications

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“…In a child presenting with possible isolated TMJ arthritis, the first step is to distinguish JIA limited to the TMJs from its mimic, idiopathic condylar resorption, alternatively called internal condylar resorption (ICR) [ 93 ]. A discussion of the surgical treatment of ICR is beyond the scope of this review, but is available elsewhere [ 94 ].…”

Section: Methodsmentioning

confidence: 99%

Temporomandibular joint arthritis in juvenile idiopathic arthritis, now what?

et al. 2018

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BackgroundArthritis involving the temporomandibular joint (TMJ) complicates 40 - 96% of cases of juvenile idiopathic arthritis (JIA), potentially leading to devastating changes to form and function. Optimal evaluation and management of this joint remains a matter of ongoing discussion.MethodsWe performed a PubMed search for all articles with keywords “temporomandibular” and “arthritis”, covering the dates 2002 through February 28, 2018. A separate PubMed search was performed for all articles with keywords “temporomandibular joint”, “arthritis”, and “treatment” covering the same dates.FindingsThe TMJ is a particularly challenging joint to assess, both clinically and with imaging studies. Clinical assessment of the TMJ is hampered by the low sensitivity of joint pain as well as the absence of physical exam findings early in the disease process. As with all joints, plain radiography and computed tomography only detect arthritic sequelae. Additionally, there is mixed data on the sensitivity of ultrasound, leaving magnetic resonance imaging (MRI) as the optimal diagnostic modality. However, several recent studies have shown that non-arthritic children can have subtle findings on MRI consistent with TMJ arthritis, such as joint effusion and contrast enhancement. Consequently, there has been an intense effort to identify features that can be used to differentiate mild TMJ arthritis from normal TMJs, such as the ratio of the enhancement within the TMJ itself compared to the enhancement in surrounding musculature. With respect to treatment of TMJ arthritis, there is minimal prospective data on medical therapy of this complicated joint. Retrospective studies have suggested that the response to medical therapy of the TMJ may lag behind that of other joints, prompting use of intraarticular (IA) therapy. Although most studies have shown short-term effectiveness of corticosteroids, the long-term safety of this therapy on local growth as well as on the development of IA heterotopic bone have prompted recommendations to limit use of IA corticosteroids. Severe TMJ disease from JIA can also be managed non-operatively with splints in a growing child, as well as with surgery.ConclusionIn this review, we summarize literature on the diagnosis and management of TMJ arthritis in JIA and suggest a diagnostic and therapeutic algorithm for children with refractory TMJ arthritis.

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Section: Methodsmentioning

confidence: 99%

Temporomandibular joint arthritis in juvenile idiopathic arthritis, now what?

et al. 2018

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“…8,33 However, others classify ICR as an individual pathology, distinct from OA. 1,34 Some clinical findings of ICR overlap those of OA; crepitus and breaks in the cortical outline can occur with both OA and ICR. 26,35 However, diagnostic characteristics, such as osteophytes and effusion, or an increased amount of fluid in the synovial compartment of a joint, are usually found in OA.…”

Section: Discussionmentioning

confidence: 99%

Anterior open bite due to idiopathic condylar resorption during orthodontic retention of a Class II Division 1 malocclusion

Park

Papademetriou

et al. 2019

American Journal of Orthodontics and Dentofacial Orthopedics

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A common dilemma when treating anterior open bite is understanding its etiology. Idiopathic condylar resorption (ICR) can cause open bite in affected individuals. Although it is prudent to not treat patients with ICR until active resorption has ceased, orthodontists may begin treating them because anterior open bite from ICR may not appear before or during their orthodontic treatment. This article reports a 12-year-old female who was diagnosed with ICR 10 months after completion of her orthodontic treatment for a Class II Division 1 malocclusion. When a young patient with a high mandibular angle and previous skeletal or dental Class II malocclusion returns with an open bite during the retention phase, the patient's condyles must be carefully examined to determine whether any temporomandibular joint disorder, such as ICR, is present. Currently, the controversy over the cause and the cure for ICR is continuing to challenge orthodontists in diagnoses and treatments. Orthodontists should closely monitor and offer informed treatment options to patients with risk factors for ICR or signs of its pathology that might develop at any stage of orthodontic treatment, including the retention period.

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“…The local factors of ICR include TMJ osteoarthritis, ischemic necrosis, infection, and trauma to the head, neck, and jaws [3][4][5]. The systemic factors reported include autoimmune diseases, such as rheumatoid arthritis and Sjögren's syndrome, and female hormonal disorders [3][4][5].…”

Section: Etiology Of Icrmentioning

confidence: 99%

“…Idiopathic condylar resorption (ICR), on the other hand, is defined as a condition in which the mandibular condyle is specifically and progressively resorbed, accompanied by a marked reduction in mandibular ramus height; this reduction is affected by mandibular retraction and, subsequently, an anterior open bite, resulting in an imbalance between the occlusal and musculoskeletal systems [3]. Since ICR is reported to occur most commonly in teenage girls, growing ICR patients are likely to be diagnosed as suffering from a simple maxillary protrusion or mandibular retrusion and thus receive inappropriate orthodontic treatment, which may induce an exacerbation of mandibular condylar resorption [3][4][5]. Therefore, it is extremely important to diagnose ICR as early and accurately as possible; however, the diagnostic criteria for ICR are still unclear.…”

Section: Introductionmentioning

confidence: 99%