Idiopathic condylar resorption: A systematic review of etiology and management

Abstract

Objective: The aim of this study was to evaluate the level of evidence in the literature on etiology and management of idiopathic condylar resorption (ICR) of the mandible.

Study design: A systematic search of articles published from 1982 to 2019 was conducted via PubMed, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. English language reports of human studies that addressed the etiology or management of ICR were included. Case reports, opinion or perspective articles, and nonhuman or non-English language articles were excluded. The quality of the included studies was assessed by using the Oxford Center for Evidence-Based Medicine criteria.

Results: The search yielded 230 studies, and 40 met the criteria for inclusion. The etiology of ICR was the focus of 33 studies; the remaining 8 assessed its management. The total number of patients in the included studies was 1399. The level of evidence assessing the etiology of ICR averaged 3.16 (range 2b-to 3b). Proposed etiologies and contributing factors included female gender, 17β-estradiol levels, condylar anatomy, and history of orthognathic surgery. The level of evidence of studies assessing the management of ICR was 3.7 (range 2b-4). Treatment strategies included disk repositioning, autologous condylar reconstruction (costochondral graft), and alloplastic total joint reconstruction. Average follow-up was 46.8 ± 38.2 months.

Conclusions: The proposed etiology and management of ICR, as reported in the literature, vary considerably. Condylectomy with autogenous or alloplastic reconstruction appears to be the most stable management strategy. The levels of evidence regarding the etiology and management of ICR are low.