Continuous intermaxillary elastic traction as first-line treatment for early idiopathic condylar resorption: A case report

• Published in: Journal of oral and maxillofacial surgery, medicine, and pathology Vol. 36; no. 5; pp. 708 - 715
• Main Authors: Oguma, Tetsushi, Abe, Atsushi, Kurita, Kenichi, Ogi, Nobumi, Aida, Eiichi, Nakayama, Atsushi
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.09.2024
• Subjects: Anterior open bite; Idiopathic condylar resorption; Indirect bonded splint; Intermaxillary elastic traction; Temporomandibular joint; TMJ; Idiopathic condylar resorption; Indirect bonded splint; Temporomandibular joint; ICR; IBS; Anterior open bite; Intermaxillary elastic traction
• ISSN: 2212-5558; 2212-5566
• DOI: 10.1016/j.ajoms.2024.01.008

Idiopathic condylar resorption (ICR) is characterized by resorption of the entire mandibular condyle, resulting in a reduced mandibular ramus and skeletal anterior open bite. We applied intermaxillary elastic traction to a patient with early ICR and obtained a stable long-term outcome. The patient was a 16-year-old girl who had noticed an anterior open bite after orthodontic treatment. The anterior open bite was observed with an overbite of − 2 mm and an overjet of + 4 mm. Computed tomography (CT) and magnetic resonance imaging (MRI) showed bilateral mandibular condylar resorption, and clinical diagnosis indicated ICR. An indirect bonded splint (IBS) was placed on the dental arches, and intermaxillary traction with elastic bands was applied continuously except during eating and oral cleaning. After 1 month of traction, complete contact of the upper and lower teeth was confirmed, indicating improvement of occlusion. CT images taken after 1 year of traction showed bone remodeling and cortical bone formation bilaterally in the part of condylar heads. This treatment was applied continuously for 1 more year and intermittently at night for another year to prevent relapse. After 3 years of traction, CT images taken showed a stable morphology of the mandibular condyle with stable occlusion, prompting the termination of the intermaxillary traction and removal of the IBS. Furthermore, 3 years after ending traction, CT and MRI showed no evidence of ICR recurrence, and occlusion was stable. This treatment method could be a useful first-line treatment for early ICR.