S M Balaji1. 1. Balaji Dental and Craniofacial Hospital, Teynampet, Chennai, India. smbalaji@gmail.com
Abstract
BACKGROUND AND OBJECTIVES: Bifid mandibular condyle (BMC) with associated temporomandibular joint ankylosis (TMJA) is extremely rare with only sixteen cases reported worldwide. This article presents the largest case series with 12 patients of BMC with TMJA with treatment results in an attempt to elucidate the morphological pattern in this rare condition. MATERIALS AND METHOD: Retrospective examination of Computed Tomograms (CT) over a period of 9 years revealed that 12 cases had BMC with TMJA. Demographical, Clinical, CT features and treatment results of these were analyzed. Patients were grouped according to sides of involvement and orientation of condyles. Data of 12 Indian cases were noted and pooled from existing literature from India and analysis performed using statistical software. Descriptive statistics and one way anova were used to find association. RESULTS: The male: female ratio was 1:1. Twenty three cases were post-traumatic and one postinfectious. The etiology was sustained in childhood in all patients. The mean presenting age was 16.92 +/- 11.05 years. Of all the cases 66.7% presented with ipsilateral chin deviation. The mean mouth opening was 3.89 +/- 5.4 mm. Bilateral BMC was observed in 29% of cases and 87.5% of all cases had mesiolateral orientation. In general, ankylosed heads were mushroom shaped compared with non-ankylosed heads. The result of 1 year postoperative mouth opening was compared with treatment modalities used in this center. CONCLUSIONS: This series attempts to elucidate patterns of ankylosis and CT morphology in BMC with associated TMJA. Also included are treatment results of BMC with TMJA. This case series is the largest presented and includes youngest case of TMJA with BMC reported so far in English literature.
BACKGROUND AND OBJECTIVES: Bifid mandibular condyle (BMC) with associated temporomandibular joint ankylosis (TMJA) is extremely rare with only sixteen cases reported worldwide. This article presents the largest case series with 12 patients of BMC with TMJA with treatment results in an attempt to elucidate the morphological pattern in this rare condition. MATERIALS AND METHOD: Retrospective examination of Computed Tomograms (CT) over a period of 9 years revealed that 12 cases had BMC with TMJA. Demographical, Clinical, CT features and treatment results of these were analyzed. Patients were grouped according to sides of involvement and orientation of condyles. Data of 12 Indian cases were noted and pooled from existing literature from India and analysis performed using statistical software. Descriptive statistics and one way anova were used to find association. RESULTS: The male: female ratio was 1:1. Twenty three cases were post-traumatic and one postinfectious. The etiology was sustained in childhood in all patients. The mean presenting age was 16.92 +/- 11.05 years. Of all the cases 66.7% presented with ipsilateral chin deviation. The mean mouth opening was 3.89 +/- 5.4 mm. Bilateral BMC was observed in 29% of cases and 87.5% of all cases had mesiolateral orientation. In general, ankylosed heads were mushroom shaped compared with non-ankylosed heads. The result of 1 year postoperative mouth opening was compared with treatment modalities used in this center. CONCLUSIONS: This series attempts to elucidate patterns of ankylosis and CT morphology in BMC with associated TMJA. Also included are treatment results of BMC with TMJA. This case series is the largest presented and includes youngest case of TMJA with BMC reported so far in English literature.