Mar 15, 2017 introduction idiopathic condylar resorption icr, also known as condylar lysis and condylar atrophy is a condition affecting the size and morphology of the mandibular condyles papadaki, tayebaty et al. Idiopathic condylar resorption icr, also known as idiopathic condylysis or condylar atrophy, is multifactorial pathology leading to severe mandibular retrognathism. Idiopathic condylar resorption icr, which is alternatively called progressive condylar resorption pcr, is an uncommon aggressive form of degenerative disease of the temporomandibular joint tmj. Idiopathic condylar resorption of the temporomandibular. Mehra is among a handful of surgeons who can do it in a onestep, 10hour operation. Idiopathic condylar resorption icr is a welldocumented but poorly understood progressive disease that affects the temporomandibular joint tmj. Idiopathic condylar resorption of the temporomandibular joint. Another common name for this condition is cheerleader syndrome because it frequently affects female athletes and cheerleaders who receive jaw injuries. The cause of one form of this condition, known as idiopathic condylar resorption icr, is not well understood. Meanwhile, she has been instructed to perform manual therapy and clenching exercises to. Idiopathic condylar resorption international journal of applied. Idiopathic condylar resorption in teenage girls most common tmd in adolescent 9f. Idiopathic condylar resorption icr continues to present a major diagnostic and therapeutic challenge to practitioners for many reasons including rarity of the condition, progressive nature of the deformity, and its simultaneous involvement of skeletal, occlusal and articular disorders. Apos trends in orthodontics orthodontic camouflage via.
It is not fully understood why one form of the condition, known as idiopathic condylar resorption icr, develops. B the same condyle 1 year after treatment with orthodontics and surgical mandibular advancement. Progressive condylar resorption, idiopathic condylar resorption, total joint replacement, juvenile idopathic arthritis, jia, created date. Idiopathic condylar resorption is a poorly understood progressive disease that affects the tmj and that can result in malocclusion, facial disfigurement, tmj dysfunction, and pain. Condylar resorption case report aao 2019 ehandout update. Adolescent internal condylar resorption aicr larry m.
A surgeon proposed a condylar shave designed to reshape the eroded condyle. Remodeling of the condyle and temporal fossa with destruction of condylar cartilage and subchondral bone leads to postsurgical condylar resorption, with arthralgia and functional limitations. Definitive treatment received by patients with idiopathic. Idiopathic condylar resorption and arthrosis of the joints. Clinically this presents as mandibular retrusion with clockwise rotation high angle, angle class ii anterior open bite aob with excess overjet, malocclusion and loss of overall posterior facial height 3. Condylar degeneration and diseaseslocal and systemic. Upon orthognathic mandibular advancement surgery the adjacent soft tissues can displace the distal bone segment and increase the load on the temporomandibular joint causing loss of its integrity. Idiopathic condylar resorption begins during treatment if a patient develops icr during orthodontic treatment, it may remain undetected until an anterior open bite forms after orthodontics is complete. Surgical management of idiopathic condylar resorption oral and. Anterior open bite due to idiopathic condylar resorption. The only sign may be some pain and a longer than expected orthodontic treatment time. Recognition of idiopathic condylar resorption as a.
The term idiopathic is used to describe it because, in idiopathic diseases, the cause is unknown. Pdf idiopathic condylar resorption icr, alternatively called progressive condylar. Osseous condylar resorption that occurs without obvious cause is termed idiopathic condylar resorption icr. The condition most often occurs in teenage girls, but can occur at any age, although rarely over the age of 40 years. Progressive condylar resorption pcr, which is alternatively called idiopathic condylar resorption icr, is an uncommon degenerative disease of the temporomandibular joint tmj of an aggressive nature that is seen mostly in female adolescents and young women. Facial imbalance receding chin, smaller airway snoring, apnea and bite disturb. Condylar resorption also known as condylysis is an event rarely seen in normal orthodontic practice, but when it occurs, it is a very unhappy occurrence and.
The condyles undergo resorption and the bone loss results in facial, bite and airway changes. Anterior open bite due to idiopathic condylar resorption during. Oct 29, 2019 the cause of one form of this condition, known as idiopathic condylar resorption icr, is not well understood. American journal of orthodontics and dentofacial orthopedics, december 2009. Idiopathic condylar resorption dr sylvain chamberland. Orthodontic treatment protocols for patients with idiopathic. Condylar resorption is degenerative condition seen mostly in adolescent and young women.
Treatment of orthodontic patients with idiopathic condylar resorption icr is challenging for clinicians due to the continuous change of occlusion caused by the unstable condylar position and symptoms in the temporomandibular joint tmj. In patients with the condition of uncertain etiology that is commonly referred to as idiopathic condylar resorption, the condyles of the mandible partially resorb, thereby causing a loss of condylar height with secondary alterations of the maxillofacial morphology, occlusion, and head and neck function. Idiopathic condylar resorption icr, alternatively called progressive condylar. A meaningless medical mouthful to most people, icr is all too real for holly anderson. This hormonally mediated condition is initiated as the adolescent enters the pubertal growth phase age of onset between 11 to 15 years. This article will focus on issues related to the etiology of these conditions. The etiology has been shown to be multifactorial, such as avascular necrosis, traumatic injuries, hormone and autoimmune disease and it is largely difficult to distinguish the.
Methods this retrospective study evaluated the electronic patient record database from 2010 to 2014. Oral contraceptive pill use and abnormal menstrual cycles in women with severe condylar resorption. Idiopathic condylar resorption icr is a temporomandibular joint tmj condition characterized by condylar deformation leading to idiopathic loss of condylar height. Idiopathic condylar resorption public group facebook.
The current understanding in diagnosis and treatment. The bilateral anterior open bite starts to develop when the idiopathic condylar resorption is bilateral. Orthodontics typically encounter icr at a rate of 1 care per 5000. Im a little nervous about the recovery process from jaw surgery so any tips would be useful, even though i still dont have a date for my surgery so please do share. The early symptoms and signs of condylar resorption are subtle. It is also referred to as idiopathic condylysis, 1,2 condylar atrophy,2 aggressive condylar. Pdf on jul 15, 2019, claudio cabralromero and others published idiopathic condylar resorption diagnosis, pathophysiology, treatment and orthodontic considerations find, read and cite all.
Idiopathic condylar resorption icr is a progressive condition that affects the jaw joints. This kind of condylar resorption is known to affect women much more frequently than men, and it affects teenage girls most often, leading to dental disorders and musculoskeletal disorders. Pushkar mehras pioneering surgery to repair idiopathic. Despite the favorable treatment result of class ii division 1 malocclusion and the absence of symptoms during the treatment, the patient returned with pain and. Idiopathic condylar resorption icr is characterized by a loss of condylar height, changes in condylar volume and shape, facial changes, and occlusal changes that occur regardless of the patients history of injury or history of disorders associated with the temporomandibular joint tmj. Anyone else diagnosed with idiopathic condylar resorption. It sometimes has been referred to as cheerleaders syndrome, because it frequently occurs in teenage girls participating in sports activities which, through minor or major. Condylar changes in patients with idiopathic condylar. Adolescent internal condylar resorption acir cases 3 and 4 aicr is one of the most common tmj conditions seen in teenage females 8. Orthodontic treatment may coincide with idiopathic condylar resorption. Condylar resorption, also called idiopathic condylar resorption, icr, and condylysis, is a temporomandibular joint disorder in which one or both of the mandibular condyles are broken down in a bone resorption process. There are many known causes of condylar resorption, including infections, accidental injury and arthritis. It is usually encountered in adolescent and young females, although it has also been observed in males. Dugoni school of dentistry, san francisco, ca 94103, usa.
Idiopathic condylar resorption jaw surgery youtube. Idiopathic condylar resorption icr of the temporomandibular joint tmj is a condition that is often esthetically and functionally altering, characterized by progressive resorption of the tmj condylar heads, without a known cause. This disorder is nine times more likely to be present in females than males, and is more common among teenagers. The temporomandibular joint condyle is susceptible to developing a variety of problems, ranging from simple osteoarthrosis to severe condylar resorption. Condylar resorption causes and treatment bauer smiles. Purpose this study evaluated the efficacy of orthodontic diagnostics in condylar resorption and specifically idiopathic condylar resorption icr in patients who presented with the cardinal signs of anterior open bite and class ii malocclusion prior to orthodontic treatment. Feb 17, 2017 idiopathic condylar resorption icr is a welldocumented but poorly understood progressive disease that affects the temporomandibular joint tmj.
The current understanding in diagnosis and treatment andrew young department of diagnostic sciences, university of the pacific, arthur a. If the idiopathic condylar resorption is less rapid, the anterior disclusion will proceed slowly. Im just looking to discuss diagnosis with people, treatment experiences, etc. With a dramatic change in function, there was a resulting change in the condylar anatomy. The etiology has been shown to be multifactorial, such as avascular necrosis, traumatic injuries, hormone and autoimmune disease and it is largely difficult to distinguish the exact cause in each individual. Idiopathic condylar resorption and its impact on orthodontic.
There are a number of icrpcr patients who present with one of the following problems, who are best treated with synthetic total joint replacement. It affects females almost exclusively between ages 1535 yrs with a peak around the pubertal growth spurt huang, pogrel et al. The average office will likely see 02 cases in a career. Idiopathic condylar resorption is a condition in which the mandibular condyles undergo resorption, leading to loss of condylar height. Icr affects more females than males, and largely affects teenage girls. Correct diagnosis and determination of whether the icr is active or inactive are essential when orthodontic or prosthodontic treatment is. Orthognathic surgery for patients with idiopathic condylar. She is currently being monitored for burnout of the condylar resorption. Kerstens and colleagues 4 reported on 12 of 206 patients with highangle mandibular retrognathia and open bite who developed condylar resorption after bimaxillary surgical treatment.
The condylar resorption is shown by the green arrow and the resorption of the eminence is shown by the blue arrow. Icr may result in malocclusion, facial disfigurement, tmj dysfunction, and pain. If condylar resorption is still active, replacement of the joint with an autologous costochondral graft or total alloplastic temporomandibular joint replacement prosthesis is possible 25, 4045. Baylor university medical center 3409 worth street, suite 400 dallas, tx 75246 2148289115.
Idiopathic condylar resorption icr is a specific condition that affects the jaw joints temporomandibular joints or tmjs and most commonly occurs in teenage girls. Condylar resorption can be aggressive months or slow years. Oct 14, 2012 idiopathic condylar resorption in teenage girls most common tmd in adolescent 9f. This article presents the diagnostic criteria for idiopathic condylar resorption and a new treatment protocol for management of this pathologic condition. Diagnosis, treatment protocol, and outcomes idiopathic condylar resorption is a poorly understood progressive disease that affects the tmj and that. Idiopathic condylar resorption is a condition in which the mandibular condyles undergo resorption, leading to loss of condylar height 2. Introduction idiopathic condylar resorption icr, also known as condylar lysis and condylar atrophy is a condition affecting the size and morphology of the mandibular condyles papadaki, tayebaty et al. Mar 30, 2020 the term idiopathic is used to describe it because, in idiopathic diseases, the cause is unknown. Recognition of idiopathic condylar resorption as a diagnostic. Idiopathic condylar resorption oral and maxillofacial surgery. It often results in a posterior, rotational growth pattern of the mandible, deficient vertical posterior mandibular development, and retrognathic profiles often requiring.