Abstract

Recognition Of Idiopathic Condylar Resorption As A Diagnostic Possibility In An Academic Orthodontic Clinic

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. Methods This retrospective study evaluated the electronic patient record database from 2010 to 2014. The database search inclusion criteria were: a) anterior open bite, b) Class II malocclusion and c) ages 10 to 40 years. The corresponding panoramic and cephalometric radiographs were evaluated for condylar resorption or condylar degenerative changes. The history and diagnostics portion of the electronic patient record was reviewed for patients identified with condylar changes/resorption and evaluated for diagnostic accuracy. Results Data collection revealed 122 (n=122) patients, ranging from 10 to 40 years of age, who presented with anterior open bite and Class II malocclusion. Of these 122 patients, a total of 23 showed radiographic condylar changes, consistent with adaptive changes, 1 had changes consistent with bilateral congenital condylar malformations and 3 (2.45%) were consistent with idiopathic condylar resorption but this was not considered as a diagnosis or investigated further in 2 of these patients. Conclusion Our data demonstrate poor diagnostic recognition and accuracy of ICR even in a major academic Orthodontic Department, where only 1 of 3 cases of likely ICR were correctly identified and diagnosed. There is a need for increasing the awareness of ICR and incorporating guidelines for diagnostics and treatment protocols which exist in the current literature. It is critical for the orthodontist to recognize and properly diagnose ICR as timely as possible within their patient population.


Author(s):

Dina Stappert and Gary Warburton



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