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Facial Plastic Surgery Clinics of North... Feb 2022Mandibular condyle fractures can result in short-term and long-term morbidity. As a weak area of the mandible, the condyle is vulnerable to injury by a direct impact or... (Review)
Review
Mandibular condyle fractures can result in short-term and long-term morbidity. As a weak area of the mandible, the condyle is vulnerable to injury by a direct impact or an indirect force. Current treatment recommendations aim to better match the severity of the fracture with the choice of closed or open approach. Long-term follow-up of patients provides the best opportunity to monitor the degree of functional restoration after treatment. There is a growing consensus regarding the use of standardized fracture classification methods and outcomes measures that will allow better assessment of treatment results and strengthen the quality of outcomes research.
Topics: Fracture Fixation, Internal; Humans; Mandible; Mandibular Condyle; Mandibular Fractures; Treatment Outcome
PubMed: 34809889
DOI: 10.1016/j.fsc.2021.08.007 -
Facial Plastic Surgery : FPS Dec 2021The mandibular condyle is an integral structure in the temporomandibular joint (TMJ) serving not only as the hinge point for mandibular opening, but also facilitating... (Review)
Review
The mandibular condyle is an integral structure in the temporomandibular joint (TMJ) serving not only as the hinge point for mandibular opening, but also facilitating mandibular growth and contributing to facial aesthetics. Significant compromise of the TMJ can be debilitating functionally, psychologically, and aesthetically. Reconstruction of the mandibular condyle is rarely straightforward. Multiple considerations must be accounted for when preparing for condylar reconstruction such as ensuring eradication of all chronically diseased or infected bone, proving clear oncologic margins following tumor resection, or achieving stability of the surrounding architecture in the setting of a traumatic injury. Today, there is not one single gold-standard reconstructive method or material; ongoing investigation and innovation continue to improve and transform condylar reconstruction. Herein, we review methods of condylar reconstruction focusing on autologous and alloplastic materials, surgical techniques, and recent technological advances.
Topics: Humans; Mandible; Mandibular Condyle; Temporomandibular Joint
PubMed: 33878796
DOI: 10.1055/s-0041-1726444 -
Facial Plastic Surgery : FPS Dec 2019There exists no consensus "gold standard" treatment for condylar fractures, and there is continued debate on whether condylar fractures should undergo surgical or... (Review)
Review
There exists no consensus "gold standard" treatment for condylar fractures, and there is continued debate on whether condylar fractures should undergo surgical or conservative management. Herein, we review various techniques of conservative, closed, and open surgical treatments of condylar fractures. Also, we review complications associated with each treatment modality and compare and contrast closed and open management. Standardization of fracture classification schemes and treatment modalities is needed to elucidate the best course of action for each patient and each fracture.
Topics: Conservative Treatment; Humans; Mandibular Condyle; Mandibular Fractures
PubMed: 31783418
DOI: 10.1055/s-0039-1700888 -
Scientific Reports Oct 2022We compared mandibular condyle positions as determined by magnetic resonance imaging (MRI) and a mechanical device, the condylar position indicator (CPI). Both methods...
We compared mandibular condyle positions as determined by magnetic resonance imaging (MRI) and a mechanical device, the condylar position indicator (CPI). Both methods assessed 3 mandibular positions in 10 asymptomatic males and 10 asymptomatic females, aged 23 to 37 years, free from temporomandibular disorders: maximum intercuspation, bimanually manipulated centric relation, and the unguided neuromuscular position. Bite registrations were obtained for bimanual operator guidance and neuromuscular position. 3 T MRI scans of both temporomandibular joints produced 3D data of the most superior condylar points in all 3 mandibular positions. Using mounted plaster casts and the same bite registrations, an electronic CPI displayed 3D data of its condylar spheres in these positions. The results showed interclass correlation coefficients ranging from 0.03 to 0.66 (95% confidence intervals from 0 to 0.8) and significantly different condyle positions between both methods (p = 0.0012, p < 0.001). The implications of the study emphasize that condyle position is unpredictable and variable. Its exact knowledge requires radiological imaging and should not rely on CPI assessments.
Topics: Female; Humans; Male; Centric Relation; Magnetic Resonance Imaging; Mandibular Condyle; Temporomandibular Joint
PubMed: 36284175
DOI: 10.1038/s41598-022-22745-5 -
Nederlands Tijdschrift Voor... May 2024A fracture of the mandibular condyle is a common fracture of the mandible. After the diagnosis has been made, there are various treatment options: wait and see,... (Review)
Review
A fracture of the mandibular condyle is a common fracture of the mandible. After the diagnosis has been made, there are various treatment options: wait and see, conservative or surgical. Which of these treatment options is best depends on several different factors and is often the subject of debate. A common complication of a fracture of the mandibular condyle is malocclusion. Malocclusion can cause problems - even in the long term - for which the patient often requires secondary treatment.
Topics: Humans; Mandibular Condyle; Mandibular Fractures; Malocclusion
PubMed: 38715533
DOI: 10.5177/ntvt.2024.05.23107 -
British Dental Journal Apr 2022
Topics: Mandibular Condyle
PubMed: 35396399
DOI: 10.1038/s41415-022-4146-5 -
Stomatologiia 2022The overview of the current literature in the research of mandibular condyle displacement after orthognathic surgeries was done. The correct postoperative mandibular... (Review)
Review
The overview of the current literature in the research of mandibular condyle displacement after orthognathic surgeries was done. The correct postoperative mandibular condyle position is considered as one of the determinants of the stability of treatment results.
Topics: Humans; Mandibular Condyle; Orthognathic Surgery; Orthognathic Surgical Procedures; Postoperative Period
PubMed: 36268926
DOI: 10.17116/stomat202210105177 -
Journal of Dentistry May 2023Quantitative analysis of the volume and shape of the temporomandibular joint (TMJ) using cone-beam computed tomography (CBCT) requires accurate segmentation of the...
OBJECTIVE
Quantitative analysis of the volume and shape of the temporomandibular joint (TMJ) using cone-beam computed tomography (CBCT) requires accurate segmentation of the mandibular condyles and the glenoid fossae. This study aimed to develop and validate an automated segmentation tool based on a deep learning algorithm for accurate 3D reconstruction of the TMJ.
MATERIALS AND METHODS
A three-step deep-learning approach based on a 3D U-net was developed to segment the condyles and glenoid fossae on CBCT datasets. Three 3D U-Nets were utilized for region of interest (ROI) determination, bone segmentation, and TMJ classification. The AI-based algorithm was trained and validated on 154 manually segmented CBCT images. Two independent observers and the AI algorithm segmented the TMJs of a test set of 8 CBCTs. The time required for the segmentation and accuracy metrics (intersection of union, DICE, etc.) was calculated to quantify the degree of similarity between the manual segmentations (ground truth) and the performances of the AI models.
RESULTS
The AI segmentation achieved an intersection over union (IoU) of 0.955 and 0.935 for the condyles and glenoid fossa, respectively. The IoU of the two independent observers for manual condyle segmentation were 0.895 and 0.928, respectively (p<0.05). The mean time required for the AI segmentation was 3.6 s (SD 0.9), whereas the two observers needed 378.9 s (SD 204.9) and 571.6 s (SD 257.4), respectively (p<0.001).
CONCLUSION
The AI-based automated segmentation tool segmented the mandibular condyles and glenoid fossae with high accuracy, speed, and consistency. Potential limited robustness and generalizability are risks that cannot be ruled out, as the algorithms were trained on scans from orthognathic surgery patients derived from just one type of CBCT scanner.
CLINICAL SIGNIFICANCE
The incorporation of the AI-based segmentation tool into diagnostic software could facilitate 3D qualitative and quantitative analysis of TMJs in a clinical setting, particularly for the diagnosis of TMJ disorders and longitudinal follow-up.
Topics: Humans; Deep Learning; Temporomandibular Joint; Mandibular Condyle; Temporomandibular Joint Disorders; Cone-Beam Computed Tomography; Image Processing, Computer-Assisted
PubMed: 36870441
DOI: 10.1016/j.jdent.2023.104475 -
Cranio : the Journal of... Jan 2023To correlate the volume of the mandibular condyle (MC) and the coronoid process (CP) with sex, age, and skeletal deformities.
OBJECTIVE
To correlate the volume of the mandibular condyle (MC) and the coronoid process (CP) with sex, age, and skeletal deformities.
METHODS
The structures were visualized through semi-automatic segmentation of the 3D model and complemented with manual segmentation, using the ITK-SNAP 3.0 software. Mann-Whitney, Kruskal-Wallis, and the Dunn test were performed ( < 0.05).
RESULTS
The MC volume showed statistical differences between sex and skeletal deformities. Men and Class III patients showed higher values. CP volume was not influenced by age or skeletal deformities. However, statistical differences were found between sex, with higher values for men.
CONCLUSION
MC volume was influenced by sex and skeletal deformities, while CP was influenced only by sex. Women have smaller volumes for these structures. Age is not correlated with the volume of MC and CP. The highest and lowest values of condylar volume were found for Class III and II individuals, respectively.
Topics: Male; Humans; Female; Mandibular Condyle; Mandible; Cone-Beam Computed Tomography; Imaging, Three-Dimensional
PubMed: 32741267
DOI: 10.1080/08869634.2020.1800323 -
Journal of Cranio-maxillo-facial... Apr 2021The merits of surgical treatment of fractures of the mandibular condyle versus non-surgical management remains highly controversial, despite a large volume of literature... (Review)
Review
The merits of surgical treatment of fractures of the mandibular condyle versus non-surgical management remains highly controversial, despite a large volume of literature dedicated to this topic. One reason the controversy remains, is because most of the outcomes in the literature are not directly comparable. The disparate range of condylar fracture classifications used is one of the reasons that studies are not comparable. We sought to review classification systems for condylar fractures used in the recent scientific literature. Review of the literature from 2016 to 2019, looking for papers relating to fractures of the mandibular condyle. Papers identified were assessed for type of study, focus of study, classification system used. 88 studies were identified, including prospective and retrospective cohort studies, randomised and non-randomised prospective studies, randomised controlled trials and case series. More studies focussed on epidemiological factors than surgical access, fixation or outcomes. 31 used no classification system, whilst 17 used unique classification systems and 40 used previously referenced classification systems. Classification systems are used to help separate clinical problems into distinguishable groups, where there is a difference in management or outcome depending on the distinguishing features. There is currently a wide diversity of classification systems used for condyle fractures, and as a result, comparisons of surgical access, fixation and outcomes are difficult to make. Having a single classification system across the published literature would allow easier comparison and the classification proposed by the AO group is recommended for future use.
Topics: Consensus; Fracture Fixation, Internal; Humans; Mandibular Condyle; Mandibular Fractures; Prospective Studies; Retrospective Studies; Treatment Outcome
PubMed: 33589333
DOI: 10.1016/j.jcms.2021.01.017