Bifid Mandibular Condyle as the Hidden Cause for Temporomandibular Joint Disorder

Bifid mandibular condyle is a rare occurrence, more frequently unilateral. The etiology of this condition is controversial. Bifid mandibular condyles of developmental origin are mostly asymptomatic and discovered incidentally through imaging. Here, we report a 38-year-old male patient, previously in good health, presented with progressive pain in his right temporomandibular joint and restricted joint movements. MRI of the bilateral temporomandibular joints revealed mild degenerative disc on the right side and bifid mandibular condyle on the left side. Conservative treatment comprising a series of soft, medium, and hard splint therapy in combination with analgesics showed symptomatic improvement initially but did not improve the condition in the long term. He subsequently underwent arthrocentesis of the right temporomandibular joint and perceived a good clinical improvement until he developed progressive pain in the left temporomandibular joint and radiating to the left side of the face. He underwent partial condylectomy and discopexy following which all of his symptoms improved; which drives us to question if bifid mandibular condyle is the hidden cause for bilateral temporomandibular joint pain.