Adolescent internal condylar resorption (AICR) of the temporomandibular joint, part 1: A review for diagnosis and treatment considerations

Cranio. 2019 Jan;37(1):35-44. doi: 10.1080/08869634.2017.1386752. Epub 2017 Nov 10.

Abstract

Background: Adolescent internal condylar resorption (AICR) is a temporomandibular joint (TMJ) pathology that develops predominately in teenage females during pubertal growth (onset between ages 11 and 15 years), with a distinct clinical, radiographic, and magnetic resonance imaging (MRI) presentation. Clinical and imaging presentation: The condition usually occurs bilaterally with: (1) Progressive retrusion of the mandible; (2) High occlusal plane angle facial morphology; (3) Worsening Class II occlusion; and (4) TMJ symptoms such as pain, headaches, noises, etc. MRI imaging demonstrates decreased condylar head size and anterior disc displacement. Treatment protocol: AICR can be successfully treated when the condyles and discs are salvageable with the following surgical protocol: (1) Removal of bilaminar tissue surrounding the condyle; (2) Reposition the disc with the Mitek anchor technique; and (3) Orthognathic surgery to advance the maxillo-mandibular complex in a counterclockwise direction.

Conclusion: AICR can be successfully treated using the specific protocol presented herein to provide stable and predictable outcomes.

Keywords: Adolescent internal condylar resorption (AICR); Mitek anchor; disc repositioning; high occlusal plane angle; mandibular condylar resorption; mandibular condyle; orthognathic surgery; temporomandibular joint (TMJ).

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Bone Resorption / diagnosis
  • Bone Resorption / etiology
  • Bone Resorption / surgery*
  • Child
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Mandibular Condyle / surgery*
  • Orthognathic Surgery / methods*
  • Radiography, Dental
  • Temporomandibular Joint / surgery*
  • Temporomandibular Joint Disc / surgery*
  • Temporomandibular Joint Disorders / diagnosis
  • Temporomandibular Joint Disorders / etiology
  • Temporomandibular Joint Disorders / surgery*