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

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)
• mandibular condylar resorption
• mandibular condyle
• temporomandibular joint (TMJ)
• orthognathic surgery
• disc repositioning
• Mitek anchor
• high occlusal plane angle