Idiopathic Condylar Resorption Diagnosis, Risks and Treatment
In some cases condylar resorption may be asymptomatic, but in others it may be painful and uncomfortable and may even change a person’s physical appearance. As a result, condylar resorption can significantly affect a person’s quality of life. Thankfully, modern dentistry, orthodontics, and medicine offer multi-faceted approaches to treating condylar resorption and restoring the full form and function of the temporomandibular joints as much as possible.
What Is Condylar Resorption?
Also called idiopathic condylar resorption (ICR), condylar resorption is a type of temporomandibular joint disorder marked by the degeneration of one or both of the mandibular condyles (the upper-most parts of the mandible or lower jawbone).
Signs and Symptoms of Condylar Resorption
Unfortunately, we have found that many cases of condylar resorption tend to go undiagnosed for years or even decades.
Signs and symptoms of condylar resorption include:
- Receding chin
- Open anterior bite – (which can occur even after orthodontics or jaw surgery has been completed)
- Imbalanced facial appearance
- Malocclusion, especially class II (overbite), and open bite
- Posterior tooth wear
- Shortened ramus (lower jawbone)
- Smaller airway, snoring, and sleep apnea
- Limited jaw mobility
- Popping or clicking when opening or closing the jaw
- Pain when moving the jaw
- Facial muscle pain and tired feeling
A condylar resorption diagnosis is typically made based on symptoms, a physical examination of the patient, and diagnostic imaging such as an MRI (Magnetic Resonance Imaging) or CBCT cone-beam computer tomography to verify and assess the level of degeneration of the mandibular condyles. The current activity of the condylar resorption bone loss is often assessed via a test called SPECT or Tech99.
What Causes Condylar Resorption/Idiopathic Condylar Resorption? Condylar Resorption Risk Factors:
The exact cause of idiopathic condylar resorption is not known, but ICR seems to occur when the mandibular condyles change due to inflammation in the temporomandibular joints and/or excessive pressure from trauma placed on the joints.
It is a well-documented but poorly understood disease process that occurs predominantly in females (with a 9:1 female:male ratio.) There is no single, specific cause of condylar resorption. Rather, the condition tends to develop as a result of the combination of several different systemic factors, including:
- General inflammation and any systemic condition which might worsen inflammation such as rheumatoid arthritis/juvenile rheumatoid arthritis; osteoarthritis; lupus; infections; and others.
- Hormonal imbalances are often a factor, which may be why there tends to be a higher frequency of condylar resorption/ICR in women during the teenage years, during pregnancy, and in menopause. In men, there is often a finding of low testosterone levels that may be related to ICR.
- Trauma/injury to the joint may be related, though this is not well understood or documented.
How Is Condylar Resorption Treated?
Treatment for condylar resorption depends on the condition’s underlying causes and how far the degeneration has progressed at the time of diagnosis.
Treatments typically include a combination of approaches designed to reduce inflammation in the body (such as in cases when the patient has rheumatoid arthritis) while addressing the underlying causes. Many patients with condylar resorption/ICR often need surgical intervention in the form of a total TMJ joint replacement.
Diagnosing condylar resorption/ICR is very important, because if a patient has ICR and that patient receives orthodontic treatment or surgical orthognathic corrections without addressing or diagnosing the underlying condylar resorption, it is likely that the resulting corrected occlusion (or bite) will not be stable as the condylar resorption advances in the future.
Comprehensive Orthodontics and Oral Surgery at Oakwood Dental
Dr. Attila Nagy at Oakwood Dental is highly experienced and well-trained in diagnosing and treating even the most complex orthodontic issues, including helping patients with condylar resorption. Through his company, Nagy Orthodontic Academy, he has given numerous lectures and seminars on this topic throughout the United States and in Europe in an attempt to educate other practitioners, as this condition often goes undiagnosed or misdiagnosed. Dr Nagy has helped many patients obtain a definitive diagnosis for idiopathic condylar resorption and has aided in recommending the appropriate treatment and/or proper referral to a medical specialist for surgical treatment when appropriate.
Dr. Nagy feels passionate about helping patients with idiopathic condylar resorption, and he focuses on early detection and diagnosis.
To learn more about idiopathic condylar resorption or to schedule a consultation with Dr. Attila Nagy, we welcome you to contact our dental office in Bucyrus today.