• Title/Summary/Keyword: Condylar area

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FUNCTIONAL RECOVERY OF MANDIBULAR HIGH CONDYLAR FRACTURE PATIENT WITH IMMEDIATE PROVISIONAL IMPLANT: CASE REPORT (Immediate provisional implant를 이용한 하악골 high condylar fracture환자의 기능회복: 증례보고)

  • Jang, Bo-Young;Ahn, Mi-Ra;Ahn, Kyung-Mi;Lee, Won-Hyuk;Shon, Dong-Seok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.1
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    • pp.82-88
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    • 2005
  • Treatment methods of mandibular condylar fracture were conservative and surgical method. Surgical method of mandibular high condylar fracture was very difficult because approach and internal fixation of small size fracture fragment were difficult. So there is a tendency to select conservative method over surgical method for guiding a stable occlusion and avoiding TMJ disorder and growth disturbance, minimizing pain and deviation during function. But, in case of mandibular high condylar fracture patient who has no biting teeth on posterior teeth area, guiding a stable occlusion and conservative functional treatment were very difficult. In this case, patient was 62years old male. He had fracture of mandibular symphysis, right mandibular body, left mandibular high condyle. We treated the patient for mandibular symphysis and right mandibular body fracture area with surgical method. But left mandibular high condylar fracture area was difficult to treat with surgical method. So we selected a conservative functional method on left mandibular high condylar fracture area. We intended recovery of vertical dimension and stable occlusion with implantation of immediate provisional implant on maxillar and mandibular posterior teeth area, and temporary crown. And then patient did mandibular functional movement and his mandibular function was recoverd.

CONDYLAR ANKYLOSIS : UNILATERAL POSTTRAUMATIC CONDYLAR PSEUDOANKYLOSIS (악관절 과두강직 : 편측성 과두강직을 동반한 안모비대칭 치료 증례)

  • Hong, Sung-Gyu;Hong, Sung-Joon
    • The korean journal of orthodontics
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    • v.23 no.3 s.42
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    • pp.427-445
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    • 1993
  • The ankylosis of temporomandibular joint occured by several causes directly developes TM joint disfunction, In cases with prolonged condylar ankylosis, especially at growing age the condylar ankylosis evokes malfunction of growth center area, and then developes the abnormal facial morphology and malocclusion. Therefore it must be cured. Almost authors have agreed to the necessity of surgical correction of the TMJ anylosis. but they did not decide the one surgical method to get the best result. The Tx. method suggested by many authors are the using interposition after resection of condyle to remain a lever of 3rd class in Mn. kinetics, the autogenous condylar graft and the alloplastic condylar graft. Some authors have got the satisfied results only with the condylectomy of the involved TMJ. This study also operated only the detachment of fibrous adhesion on ankylosed condylar side and then established occlusion in the case with the unilateral TMJ ankylosis and fibrous joint adhesion and facial asymmetry evoked after the fracture of condylar head at early age. This study got a improved mouth opening and a stable postsurgical result after 1 year. Also, this study reviewed many author's study about the chanracteristics, etiology, diagnosis and Tx. method for the ankylosis of TMJ.

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Modified high-submandibular appraoch for open reduction and internal fixation of condylar fracture: case series report

  • Lee, Sung-Jae;Chun, Young-Joon;Lee, Seung-Jun;Jun, Sang-Ho;Song, In-Seok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.5
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    • pp.267-276
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    • 2022
  • Objectives: Recently a modified high-submandibular approach (HSMA) has been introduced for treatment of condylar fracture. This approach involves an incision line close to the mandibular angle and transmasseteric transection, leading to a low incidence of facial palsy and allowing good visualization of the condyle area, especially the condylar neck and subcondyle positions. This study reports several cases managed with this modified HSMA technique for treating condylar fractures. Materials and Methods: Six cases of condylar fractures treated with modified HSMA technique were reviewed. Results: Three unilateral subcondylar fracture, 1 bilateral subcondylar fracture, 1 unilateral condylar neck fracture, 1 unlateral simultaneous condylar neck and subcondylar fracture cases were reviewed. All the cases were successfully treated without any major complication. Conclusion: Reduction, fixation, and osteosynthesis of condylar fractures via the modified HSMA technique enabled effective and stable treatment outcomes. Therefore, the described approach can be used especially for subcondylar and condylar neck fractures with minimal complications.

Three-dimensional assessment of condylar surface changes and remodeling after orthognathic surgery

  • Lee, Jung-Hye;Lee, Woo-Jin;Shin, Jae-Myung;Huh, Kyung-Hoe;Yi, Won-Jin;Heo, Min-Suk;Lee, Sam-Sun;Choi, Soon-Chul
    • Imaging Science in Dentistry
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    • v.46 no.1
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    • pp.25-31
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    • 2016
  • Purpose: This study was performed to evaluate condylar surface changes and remodeling after orthognathic surgery using three-dimensional computed tomography (3D CT) imaging, including comparisons between the right and left sides and between the sexes. Materials and Methods: Forty patients (20 males and 20 females) who underwent multi-detector CT examinations before and after surgery were selected. Three-dimensional images comprising thousands of points on the condylar surface were obtained before and after surgery. For the quantitative assessment of condylar surface changes, point-to-point (preoperative-to-postoperative) distances were calculated using 3D processing software. These point-to-point distances were converted to a color map. In order to evaluate the types of condylar remodeling, the condylar head was divided into six areas (anteromedial, anteromiddle, anterolateral, posteromedial, posteromiddle, and posterolateral areas) and each area was classified into three types of condylar remodeling (bone formation, no change, and bone resorption) based on the color map. Additionally, comparative analyses were performed between the right and left sides and according to sex. Results: The mean of the average point-to-point distances on condylar surface was $0.11{\pm}0.03mm$. Bone resorption occurred more frequently than other types of condylar remodeling, especially in the lateral areas. However, bone formation in the anteromedial area was particularly prominent. No significant difference was found between the right and left condyles, but condylar surface changes in males were significantly larger than in females. Conclusion: This study revealed that condylar remodeling exhibited a tendency towards bone resorption, especially in the lateral areas. Condylar surface changes occurred, but were small.

The Effect of Fuctional Lateral Shift of Mandible on the Growth of Mandible in Growing Rats (백서 하악골의 기능적 측방편위가 하악골 성장에 미치는영향)

  • PARK, Kwan-Sik;KYUNG, Hee Moon;SUNG, Jae Hyun
    • The korean journal of orthodontics
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    • v.27 no.1
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    • pp.105-117
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    • 1997
  • This investigation examined the effect of lateral shift of mandible from functional occlusal interference on the growth of mandible and the growth pattern of mandible shown after the removal of occlusal interference. The followings were performed with the results below : the changes in mandible and condylar cartilage were studied in the experimental group with upper right, lower left incisors cut for 2 and 4 weeks- an 4-week-old rats and the experimental group which had cut for 4 weeks and suspended for 2 weeks. 1. In the 2-week experimental group, the left mandibular length, condylar length, mandibular height and condylar area seemed smaller than those on the right and the normal group ; the right mandibular length and condylar area were smaller than the normal group. 2. In the 4-week experimental group, left condylar area was smaller than the right, but due to the quick changes in adaptability of left mandible, right and left mandibular lengths were similar. compared with the normal group, however, mandibular length and condylar area still remained small. 3. In the 6-week experimental group, the left and the right appeared similar with the mandibular length remaining still shorter than the normal group. 4. In the sagittal plane, the proliferation of the cartilage layers of the left condylar cartilage of the 2-week group appeared to have general repression compared with the right and the normal group. The right side also showed repressed growth compared with the normal group. In the 4 and 6-week groups, however, it was similar to the normal group. 5. In condylar cartilage volume, no significant difference was noted in the comparisions of left and right of the experimental group, nor in the comparison of the same sides of experimental wand normal groups. Based on the above, in case of contralateral incisal cutting in rats, it was observed that the growth of mandible and condyle of the cutting side was repressed, at the same time, the quick adaptability led to similar changes of growth in left and right mandibles. But judging from the similar phenomena throughout the whole experimental period in the changes of condylar cartilage volume in the experimental, right and left, and normal groups, the general overall growth of condylar cartilage was found unrepressed. It was also recognized that the growth of condylar cartilage can take in various directions.

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AN EXPERIMENTAL STUDY OF THE EFFECT OF THE UNILATERAL TOOTH LOSS ON THE TEMPOROMANDIBULAR JOINT (편측치아결손(片側齒牙缺損)이 악관절(顎關節)에 미치는 영향(影響)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Lim, Yong-Joon
    • The Journal of Korean Academy of Prosthodontics
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    • v.17 no.1
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    • pp.35-46
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    • 1979
  • A number of experimental studies have been carried out in order to clarify the question as to how temporomandibular joint adapt to the changes of mandibular movement and occlusal equilibration. Recently, the studies on the interrelations between anatomical structure of temporomandibular joint and the state of occlusion have been actively performed in dentistry particularly in prosthodontic field. Author performed extraction of unilateral mandibular molars in 30 mature male rats, and observed histological changes of temporomandibular joint through the light microscope. Following results were obtained. 1. The loss of unilateral teeth gave rise to the changes in the location of condylar head, that is, interior displacement of condylar head in the extraction side and upper displacement in the non-extraction side. 2. Articular disk was compressed by the interior surface of condylar head, resulting in its extension below the condylar neck in the extraction side, and the histological arrangement of the compressed area showed irregular feature. 3. The extension of articular disk below the condylar neck was accompanied with the contraction of muscle fibers which were originated from the articular disk. 4. The cartilage layer of articular fossa to the exterior of the extraction side showed hypertropy. 5. Early in the experiment, the inernal extremity of condylar head of extract ion side showed bone resorption, and cartilage layer of condylar head showed hypertropy. At 12 weeks after experiment, the condylar surface showed flattened, and the cartilage layer of condylar head was replaced by the compact bone. 6. The articular disk showed the formation of pannus in the extraction side as well as in the non-extraction side. 7. The occlusal disturbance due to unilateral missing teeth has brought about the non-inflammatory retrogressive change and osteoarthrotic change late in the experiment.

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Three-dimensional cone beam computed tomography analysis of temporomandibular joint response to the Twin-block functional appliance

  • Jiang, Yuan-yuan;Sun, Lian;Wang, Hua;Zhao, Chun-yang;Zhang, Wei-Bing
    • The korean journal of orthodontics
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    • v.50 no.2
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    • pp.86-97
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    • 2020
  • Objective: To propose a three-dimensional (3D) method for evaluating temporomandibular joint (TMJ) changes during Twin-block treatment. Methods: Seventeen patients with Class II division 1 malocclusion treated using Twin-block and nine untreated patients with a similar malocclusion were included in this research. We collected their cone beam computed tomography (CBCT) data from before and 8 months after treatment. Segmentations were constructed using ITK-SNAP. Condylar volume and superficial area were measured using 3D Slicer. The 3D landmarks were identified on CBCT images by using Dolphin software to assess the condylar positional relationship. 3D models of the mandible and glenoid fossa of the patients were constructed and registered via voxel-based superimposition using 3D Slicer. Thereafter, skeletal changes could be visualized using 3DMeshMetric in any direction of the superimposition on a color-coded map. All the superimpositions were measured using the same scale on the distance color-coded map, in which red color represents overgrowth and blue color represents resorption. Results: Significant differences were observed in condylar volume, superficial area, and condylar position in both groups after 8 months. Compared with the control group (CG), the Twin-block group exhibited more obvious condyle-fossa modifications and joint positional changes. Moreover, on the color-coded map, more obvious condyle-fossa modifications could be observed in the posterior and superior directions in the Twin-block group than in the CG. Conclusions: We successfully established a 3D method for measuring and evaluating TMJ changes caused by Twin-block treatment. The treatment produced a larger condylar size and caused condylar positional changes.

Condylar jugular diverticulum: A report of 3 cases

  • Jagtap, Rohan;Wazzan, Taggreed;Hansen, Matthew;Kashtwari, Deeba
    • Imaging Science in Dentistry
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    • v.49 no.3
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    • pp.251-256
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    • 2019
  • Jugular bulb diverticulum is an irregular extension of the jugular bulb into the temporal bone that may be symptomatic or asymptomatic. The jugular bulb has rarely been reported to extend into the occipital condyle; such extension is termed a condylar jugular diverticulum and is characterized as a defect in the occipital condyle contiguous with the jugular bulb. This report details 3 cases of condylar jugular diverticulum. Extension of the jugular bulb into the ipsilateral occipital condyle was noted as an incidental finding on cone-beam computed tomographic (CBCT) images of 3 patients. All 3 patients were asymptomatic, and this finding was unrelated to the initial area of interest. CBCT use is becoming ubiquitous in dentistry, as it allows 3-dimensional evaluation, unlike conventional radiography. Proper interpretation of the entire CBCT is essential, and recognition of the indicators of condylar jugular diverticulum may prevent misdiagnosis of this rare entity.

A DIOGRAPHIC STUDY OF THE CONDYLAR HYPERPLASIA (하악 과두 과형성증에 관한 방사선학적 연구)

  • Kim Jin-Soo;Kim Young-Jin;Choi Eui-Hwan;Kim Jae-Duk
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.25 no.2
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    • pp.569-578
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    • 1995
  • Condylar hyperplasia is a self-limiting condition characterized by a slowly progressing, enlargement of the mandible that results in facial asymmetry and a crossbite malocclusion. The facial asymmetry, open bite or crossbite, and radiographic evidence of an enlarged condyle confirm the diagnosis of condylar hyperplasia. The etiology of the condition is unknown. This condition usually first becomes apparent during the second decade of life, when one condyle continues to grow while the other is no longer active. Radiographically, the condyle may appear enlarged or the neck of the condyle maybe elongated or both may occur, Sometimes, however, no radiographically demonstrable condylar abnormality will be noted. Surgical correction with subcondylar osteotomy is the treatment of choice. We have observed two cases of condylar hyperplasia occurred in the left mandibular condyle of 24-year-old and 35-year-old women. We obtained that two cases were shown the followed results; 1. Clinically, both cases was unilaterally developed on C/C area, with temporomandibular disorders and pain, facial asymetry and malocclusion. 2. Radiographically, hyperplastic mass confined to the condyle. 3. Histopathologically, these cases shown increased hypertrophic region in parts, and lamellated bone with irregular trabeculae.

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RADIOGRAPHIC ANALYSIS OF THE TEMPOROMANDIBULAR JOINT BY THE STANDARDIZED PROJECTION TECHNIQUE (악관절규격촬영법에 의한 과두위의 분석 연구)

  • Choe Han Up
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.13 no.1
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    • pp.7-15
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    • 1983
  • The purpose of this study was to investigate the radiographic images of the condylar head in clinically normal subjects and the TMJ patients using standardized projection technique. 45 subjects who have not clinical evidence of TMJ problems and 96 patients who have the clinical evidence of TMJ problems were evaluated, but the patients who had fracture, trauma and tumor on TMJ area were discluded in this study. For the evaluation of radiographic images, the author has observed the condylar head positions in closed mouth and 2.54㎝ open mouth position taken by the standardized transcranial oblique lateral projection technique. The results were as follows: 1. In closed mouth position, the crest of condylar head took relatively posterior position to the deepest point of the glenoid fossa in 8.9 % of the normals and in 26.6% of TMJ patients. 2. In 2.54㎝ open mouth position, condylar head took relatively posterior position to the articular eminence in 2.2% of TMJ patients and 39.6% of the normals. 3. In open mouth position, the horizontal distance from the deepest point of the glenoid fossa to the condyla head was 13.96㎜ in the normals and 10.68㎜ in TMJ patients. 4. The distance of true movement of condyalr head was 13.49㎜ in the normals and l0.27㎜ in TMJ patients. 5. The deviation of mandible in TMJ patients was slightly greater than that of the normals.

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