Condylar resorption can be challenging to orthodontist when encountered during treatment. The clinical characteristics and cephalometric findings of a patient who experienced postoperative skeletal relapse caused by progressive condylar resorption (CR) are presented in this case report. The predisposing factors and treatment protocols of condylar resorption are also discussed. A 17-year-old female patient came to our hospital with chief complaint of no contact of anterior teeth. Cephalometric analysis shows that she is a patient with skeletal Class II hyper-divergent pattern caused by mandibular retrognathism. Flattened left condylar head was found on panoramic film suggesting possible condylar erosion in the past. Before starting her treatment, the superimposition of serial cephalometric films was done, and no active resorption of condyles were found. After four months of pre-surgical orthodontic treatment, a two-jaw surgery was performed. However, an increase in overjet was noticed nine months after that. Cephalometric superimposition revealed a decrease in ramus height indicating a skeletal relapse due to CR. Inter-arch elastics was stopped to eliminate the loading on temporomandibular joint (TMJ), and vitamin D plus calcium supplementation was prescribed. Condyle remained stable throughout the rest of the treatment. Total treatment time is 36 months, and satisfactory facial profile and occlusion have been achieved. CR is attributable to young female, Class II hyperdivergent skeletal pattern, posteriorly inclined condylar neck, estrogen deficiency, and pre-existing TMJ disorder. Mandibular advancement over 10 mm, posteriorly displaced condyles, and counterclockwise rotation of the proximal and distal segment are high-risk surgical factors. Impact of CR can be minimized by making the correct diagnosis, optimal orthodontic or orthodontic-surgical planning, and periodic check up on condylar condition.
Lin, In-Ru; Chen, Meng-Yen; Wong, Tung-Yiu; and Chang, Chen-Jung
"Treatment of a Class II Hyperdivergent Case with Progressive Condylar Resorption,"
Taiwanese Journal of Orthodontics: Vol. 33
, Article 5.
Available at: https://www.tjo.org.tw/tjo/vol33/iss4/5
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