Condylar fractures of the mandible. II. a radiographic study of remodeling processes in the temporomandibular joint.

Remodeling processes in 76 temporomandibular joints were studied on radiographs from 67 individuals sustaining condylar fractures. The indivuduals were ranged into four age groups: 3-11, 12-15, 16-19, and larger than or equal to 20 years of age at the time of fracture. The radiographic examinations were to be performed at the time of the trauma and 3, 6, 12, 24 and 36-48 months after the injury. In the age group 3-11 there was a complete return to normal skeletal relations in 20 of the 27 joints. Joints in teenagers (12-19) did not become normal to the same extent and in adults only minor remodeling was observed. In children the remodeling of the condylar process was extensive but indistinctly outlined. With increasing age there was a shift towards a more distinct apposition of bone on the posterior part of the condylar head visualized as a double contour. This contour first appeared in the late teens. In adults the remodeling processes seemed only to be part of the functional adjustment. Thus, the remodeling processes of the condylar process in a clinical sense may be looked upon as restitutional in children and adjusting or functional in adults. As regards the articular fossa, in children the remodeling processes were first observed as a double contour, of which the new one became more and more distinct, while the original roof gradually disappeared. The final results was a flattened fossa. In adults, a sclerosis of the roof of the fossa was found.