DEVELOPMENTAL DISTURBANCES Aplasia of the manibular condyle Hypoplasia of mandibular condyle Hyperplasia of manidbular condyle

1. DISORDERS OF
TEMPEROMANDIBULAR
JOINT - 1
D R A M I T H A G , B D S , M D S
O R A L A N D M A X I L L O F A C I A L
P A T H O L O G Y

2. ARTICULAR DISORDERS
DEVELOPMENTAL DISTURBANCES
Aplasia of the manibular condyle
Hypoplasia of mandibular condyle
Hyperplasia of manidbular condyle

3. TRAUMATIC DISTURBANCES
Internal disc derangements
Anterior disc displacement
Posterior disc displacement
Dislocations
Luxation (Complete dislocation)
Subluxation (Incomplete dislocation)
Ankylosis (hypomobility)
Injuries of Articular disck (Meniscus)
Fracture of condyle

4. INFLAMMATORY DISTURBANCES
Arthiritis
Infectious arthritis (bacterial, viral and fungal)
Rheumatoid arthiritis
Osteoarthiritis or degenerative joint disease
NEOPLASTIC DISTURBANCES
Benign : osteoma, chondroma
Malignant : primary, metastatic

5. NON ARTICULAR DISORDERS
MUSCULAR DISORDERS
1. Muscle spasm
2. Myofacial pain dysfunction syndrome
3. Myotonic dystrophies
4. Myositis ossificans progressiva
5. Fibromyalgia
SYNDROME ASSOCIATED
Costen’s syndrome
Temperomandibular joint syndrome

6. DEVELOPMENTAL DISTURBANCES OF TMJ
APLASIA OF THE MANDIBULAR CONDYLE
Is the failure of development of the mandibular condyle
Synonym
Condylar Aplasia

7. Clinical features
• It is a rare condition
• It can be
• Unilateral
• Bilateral
• It is usually associated with other anatomically related defects , such as
• Defective or absent external ear
• Underdeveloped mandibular ramus
• Macrostomia
Presentation
• Unilateral condylar aplasia – obvious facial asymmetry, and both occlusion and
mastication is altered.
A shift of the mandible toward the affected side occurs during the opening.
• Bilateral condylar aplasia – this shift is not present

8. Treatment
If derangement is severe - Osteoplasty and correction of the malocclusion by
orthodontic appliances

9. HYPOPLASIA OF THE MANDIBULAR CONDYLE
- Underdevelopment or defective formation of the mandibular condyle.
- May be
 Congenital
 Acquired

10. Congenital
- Underdevelopment of the condyle beginning early in life.
- Idiopathic origin
- This could be
 Unilateral
 Bilateral
Acquired
- Could be due to any agent which interferes with the normal development of the
condyle.

11. Etiology
• Forceps deliveries that cause traumatic birth injury
• External trauma to the condylar area
• Children following X ray radiation over the TMJ area for local treatment
of Skin lesions such as the hemangioma, or birthmark.
• Infection may involve the joint and interfere with condylar growth and
result in hypoplasia. Infection could be
 Spreading locally from dental area
 Or by hematogenous route from a distant site
• Endocrine and vitamin derangements

12. Clinical features
- Unilateral
- Most common clinical type
- Facial asymmetry
- Often accompanied by limitation of lateral excursion on one side and
exaggeration of the antegonial notch of the mandible on the involved side.
- Mandibular midline shift during opening and closing.
- The distortion of the mandible in this pathognomonic pattern results from lack of
downward and forward growth of the body of the mandible due to arrest of the
chief growth center of the mandible, the condyle.

13. - Some growth continues at the outer periosteal border of the angle of the
mandible, resulting in thickening of the bone in this area.
- The older the patient at the time of growth disturbance – less severe will be the
facial deformity.
- But even tehn deformity is observed because, the growth of the mandible
continues till the age of 20 years.

14. HYPERPLASIA OF THE MANDIBULAR CONDYLE
- Rare unilateral enlargement of the condyle.
- Since it clinically resembles osteoma or chondroma, it should not be confused
with a neoplasm of this structure.
Etiology
- Unilateral occurrence strongly suggests a local phenomenon.
- Mild chronic inflammation like OM (proliferative) which stimulates the growth of
the condyle or adjacent tissues.

15. Clinical features
- Unilateral, slowly progressive elongation of the face with deviation of the chin
away from the affected side.
- The enlarged condyle may be clinically evident or at least palpated.
- Affected joint may or may not be painful.
- Severe malocclusion is a usual sequel of the condition.

16. Radiographic presentation
- Anteroposterior and lateral view
- Condylar films
Treatment
- Resection of the condyle

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