Total Bilateral Temporomandibular Joint Reconstruction for Idiopathic Condylar Resorption

Idiopathic condylar resorption (ICR) is a rare, progressive condition characterized by the resorption of the mandibular condyle leading to significant jaw dysfunction, facial asymmetry, and occlusal abnormalities with an unknown etiology. The condition predominantly affects adolescent females and has a strong predilection for individuals with a class II skeletal relationship that can result in chronic pain, restricted jaw movements, and profound aesthetic and functional consequences like reduced airway space and breathing difficulties. Temporomandibular joint reconstruction with custom-made prosthesis has emerged as a viable treatment option for patients with advanced ICR who do not respond to conservative treatment.

The authors report a case of a 30-year-old female patient diagnosed with ICR who presented with loss of mandibular movement and occlusal collapse. Radiographic imaging and clinical examination confirmed extensive bilateral condylar resorption, contributing to functional impairment and aesthetic concerns. The case was treated surgically with bilateral temporomandibular joint (TMJ) full reconstruction with alloplastic custom-made TMJ prosthesis. The main objective of the reconstruction of the TMJ was the complete restoration of form and function.

Combined orthodontic-surgical treatment was undertaken. Pre-surgical orthodontic treatment was completed and after ICR stabilization, the surgical treatment consisted of bilateral custom alloplastic total joint replacement through an established protocol.

Advanced ICR can be successfully treated with alloplastic total bilateral joint prosthesis as an alternative where conservative management fails to alleviate the symptoms of this condition. The personalized prosthesis and virtual surgical planning are useful in providing the best functional and aesthetic results.