Idiopathic Condylar Resorption: A Survey and Review of the Literature

Purpose: Idiopathic condylar resorption (ICR) is a relatively uncommon condition. Its diagnosis, etiology, and management options are controversial. Furthermore, it is difficult for 1 provider to collect a large cohort of ICR patients to develop a statistically significant study of these concerns. Therefore, the purpose of this study was to survey experienced temporomandibular joint (TMJ) surgeons who have managed ICR cases relative to these concerns, as well as review the management outcome literature. Materials and Methods: SurveyMonkey (Palo Alto, CA) was used to canvas the 88 international TMJ surgeons on the TMJ Concepts (Ventura, CA) InterNetwork. This network connects a group of surgeons across the world who consistently perform TMJ surgery. The intent was to provide a global snapshot of the demographic, epidemiologic, diagnostic workup, and outcome data related to the management of ICR cases. Results: The surveys from surgeons who did not respond to all 12 questions were not included in the results. After application of the exclusion criteria, complete data on a cohort of 100 patients were obtained and used for the study. A history of hormonal imbalance was reported in only 10% of patients; however, 42 of 94 women were reportedly taking birth control pills presumably affecting their menstrual cycles. The most common reason for consultation was Class II malocclusion (98% of patients). Treatment modalities varied and included orthodontics, orthotics, TMJ total joint replacement, orthognathic surgery, and disc repositioning. Conclusions: ICR management proved to be controversial among the surveyed surgeons. Multiple treatment options have been described in the literature, including medical management, orthognathic surgery only, TMJ and orthognathic surgery, and total joint prosthesis reconstruction. Long-term, controlled, multicenter clinical studies should be developed to evaluate outcomes of all nonsurgical and surgical management options for the ICR patient. (C) 2018 American Association of Oral and Maxillofacial Surgeons