Alsabban Lena, Amarista Felix Jose, Mercuri Louis G, Perez Daniel
Assistant Professor, Department of Oral and Maxillofacial Surgery, New York University College of Dentistry, New York, NY.
Oral and Maxillofacial Surgery Intern, Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX.
J Oral Maxillofac Surg. 2018 Nov;76(11):2316.e1-2316.e13. doi: 10.1016/j.joms.2018.07.008. Epub 2018 Jul 19.
Idiopathic condylar resorption (ICR) is a relatively uncommon condition. Its diagnosis, etiology, and management options are controversial. Furthermore, it is difficult for 1 provider to collect a large cohort of ICR patients to develop a statistically significant study of these concerns. Therefore, the purpose of this study was to survey experienced temporomandibular joint (TMJ) surgeons who have managed ICR cases relative to these concerns, as well as review the management outcome literature.
SurveyMonkey (Palo Alto, CA) was used to canvas the 88 international TMJ surgeons on the TMJ Concepts (Ventura, CA) InterNetwork. This network connects a group of surgeons across the world who consistently perform TMJ surgery. The intent was to provide a global snapshot of the demographic, epidemiologic, diagnostic workup, and outcome data related to the management of ICR cases.
The surveys from surgeons who did not respond to all 12 questions were not included in the results. After application of the exclusion criteria, complete data on a cohort of 100 patients were obtained and used for the study. A history of hormonal imbalance was reported in only 10% of patients; however, 42 of 94 women were reportedly taking birth control pills presumably affecting their menstrual cycles. The most common reason for consultation was Class II malocclusion (98% of patients). Treatment modalities varied and included orthodontics, orthotics, TMJ total joint replacement, orthognathic surgery, and disc repositioning.
ICR management proved to be controversial among the surveyed surgeons. Multiple treatment options have been described in the literature, including medical management, orthognathic surgery only, TMJ and orthognathic surgery, and total joint prosthesis reconstruction. Long-term, controlled, multicenter clinical studies should be developed to evaluate outcomes of all nonsurgical and surgical management options for the ICR patient.
特发性髁突吸收（ICR）是一种相对罕见的病症。其诊断、病因及治疗方案存在争议。此外，单个医疗提供者难以收集大量ICR患者以开展针对这些问题的具有统计学意义的研究。因此，本研究的目的是调查处理过ICR病例的经验丰富的颞下颌关节（TMJ）外科医生对这些问题的看法，并回顾治疗结果的相关文献。
使用SurveyMonkey（加利福尼亚州帕洛阿尔托）对TMJ Concepts（加利福尼亚州文图拉）网络中的88位国际TMJ外科医生进行问卷调查。该网络连接了全球一组持续进行TMJ手术的外科医生。目的是提供与ICR病例管理相关的人口统计学、流行病学、诊断检查及结果数据的全球概况。
未对全部12个问题做出回复的外科医生的调查结果未纳入研究结果。应用排除标准后，获得了100例患者的完整数据并用于研究。仅10%的患者报告有激素失衡史；然而，据报道94名女性中有42人正在服用可能影响其月经周期的避孕药。最常见的咨询原因是安氏II类错牙合（98%的患者）。治疗方式多样，包括正畸、矫治器、TMJ全关节置换、正颌手术和盘复位。
在接受调查的外科医生中，ICR的治疗存在争议。文献中描述了多种治疗选择，包括药物治疗、仅正颌手术、TMJ和正颌手术以及全关节假体重建。应开展长期、对照、多中心临床研究，以评估ICR患者所有非手术和手术治疗方案的结果。
