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Mousoulea S, Kloukos D, Sampaziotis D, Vogiatzi T, Eliades T Condylar resorption in orthognathic patients after mandibular bilateral sagittal split osteotomy: a systematic review. Eur J Orthod. 2017; 39:294-309
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Catherine Z, Breton P, Bouletreau P Condylar resorption after orthognathic surgery: a systematic review. Rev Stomatol Chir Maxillofac Chir Orale. 2016; 117:3-10
Handelman CS, Green CS Progressive/idiopathic condylar resorption: an orthodontic perspective. Semin Orthod. 2013; 19:55-70
Chigurupati R, Mehra P Surgical management of idiopathic condylar resorption: orthognathic surgery versus temporomandibular total joint replacement. Oral Maxillofac Surg Clin North Am. 2018; 30:355-367
Gunson MJ, Arnett GW, Formby B Oral contraceptive pill use and abnormal menstrual cycles in women with severe condylar resorption: a case for low serum 17 beta-estradiol as a major factor in progressive condylar resorption. Am J Orthod Dentofacial Orthop. 2009; 136:772-779
Mercuri LG, Edibam NR A fourteen year follow up of a patient fitted total temporomandibular joint reconstruction system. J Oral Maxillofac Surg. 2007; 65:1140-1148
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Kobayashi T, Izumi N, Kojima T Progressive condylar resorption after mandibular advancement. Br J Oral Maxillofac Surg. 2012; 50:176-180
Young A Idiopathic condylar resorption: the current understanding in diagnosis and treatment. J Indian Prosthodont Soc. 2017; 17:128-135
Wolford LM Idiopathic condylar resorption of the temporomandibular joint in teenage girls (cheerleaders syndrome). Proc (Bayl Univ Med Cent). 2001; 14:246-252
Kim JH, Kim YK, Kim SG Effectiveness of bone scans in the diagnosis of osteoarthritis of the temporomandibular joint. Dentomaxillofac Radiol. 2012; 41:224-229
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Larheim TA, Abrahamsson AK, Kristensen M, Arvidsson LZ Temporomandibular joint diagnostics using CBCT. Dentomaxillofac Radiol. 2015; 44
Wolford LM, Gonçalves JR Condylar resorption of the temporomandibular joint: how do we treat it?. Oral Maxillofac Surg Clin North Am. 2015; 27:47-67
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Idiopathic condylar resorption in orthodontics

From Volume 14, Issue 2, April 2021 | Pages 82-88


Salwa El-Habbash


Orthodontic Registrar, Birmingham Dental Hospital

Articles by Salwa El-Habbash

Email Salwa El-Habbash

Timothy McSwiney

BDS(Hons), MFDS RCS, DClinDent(Orth), MOrth RCS, FDS(Orth) RCS

Locum Consultant Orthodontist, Dublin Dental University Hospital, 2 Lincoln Place, Dublin, Ireland

Articles by Timothy McSwiney

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Condylar resorption (CR) can be categorized into functional and dysfunctional remodelling of the temporomandibular joint (TMJ). The literature describes dysfunctional remodelling of the TMJ as idiopathic condylar resorption (ICR). Idiopathic condylar resorption (ICR) is a well-documented but poorly understood pathological entity that can occur spontaneously or post-orthognathic surgery. It predominantly affects young women, with other risk factors including Class 2 malocclusion with steep mandibular plane angles. It is distinguished by a decreased condylar head volume and ramus height, progressive mandibular retrusion and an anterior open bite. Its aetiology can be categorized into surgical and non-surgical risk factors. These include hormones, systemic disease, trauma, mechanical load and surgical risk factors, such as magnitude and direction of mandibular movement, type of surgical fixation and length of post-operative maxilla-mandibular fixation. ICR is a diagnosis of exclusion, and identified by a combination of clinical, radiographic and haematological findings. Multiple treatment options have been described in the literature, including medical management, orthodontics, orthognathic surgery, TMJ surgery, TMJ and orthognathic surgery combined, and total joint prosthesis reconstruction. Further research is required to better understand the aetiology of ICR and more long-term, controlled, multicentre clinical studies are needed to evaluate the outcomes of surgical and non-surgical management of CR patients.

CPD/Clinical Relevance: Idiopathic condylar resorption has many presentations and potential causes that can greatly impact the decisions and outcomes for orthodontic/orthognathic treatment.


Condylar resorption (CR) can be categorized into functional and dysfunctional remodelling of the temporomandibular joint (TMJ).1 Functional remodelling is an ongoing process involving morphological changes of the articular structures of the joint that are not associated with significant alterations in the occlusion, whereas remodelling is dysfunctional if it adversely affects the joints and the occlusion.1 The literature describes dysfunctional remodelling of the TMJ as idiopathic condylar resorption (ICR).2 ICR has also been described in the literature as condylysis, condylar atrophy, osteoarthrosis, condylar resorption, progressive condylar resorption and avascular necrosis.1,3

ICR can be progressive, resulting in alteration of the shape and volume of the mandibular condyle, but may also go into remission.4 In remission cases, excessive joint loading, for example trauma, parafunction, orthodontics and orthognathic surgery can reinitiate the resorptive process.5 It is distinguished by a decreased condylar head volume and ramus height, progressive mandibular retrusion and an anterior open bite (AOB).1,4,5 It is a well-known, but rare, occurrence most commonly seen in young females following surgery to correct an AOB, mandibular retrognathia or long anterior face height.5 It has a reported prevalence of 1 in 5000 individuals presenting for orthodontic treatment and is reported to occur as a complication in 2–5% of post-orthognathic surgery patients, with the incidence increasing to 19–31% within a subset of patients with Class 2 malocclusion with steep mandibular plane angles.6

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