2019 Volume 31 Issue 1 Pages 24-31
Progressive condylar resorption (PCR) or idiopathic condylar resorption is a disease that manifests as a rapid resorption of the condyles and condylar processes leading to posterior dislocation of the mandibula or anterior tooth opening without injury or fraction. In this paper, we report the treatment and progression of an PCR case that emerged after treatment for temporomandibular disorder (TMD) with disc displacement without reduction. The PCR patient was a 43-year-old woman who visited the TMD & Bruxism clinic in our hospital, complaining of open bite of an anterior tooth and masticatory disturbance. The patient had been treated for TMD 3 years earlier in our clinic for mouth-opening limitations, with manipulation and a stabilization splint. Magnetic resonance imaging (MRI) showed a distinct resorption on both condyles with erosion, which we diagnosed as PCR because of the short period and remarkable resorption. We planned splint therapy for occlusal stabilization, exercise therapy of the mandible and habit control to improve jaw function as the primary treatment in this case. Secondary treatment using orthognathic surgery with full arch prosthodontic treatment was to be implemented after occlusal stabilization had been obtained to acquire an ideal occlusion. However, we canceled the secondary treatment, because the patient achieved acceptable development for occlusion after the primary treatment. As there are no reports in the literature regarding the predictable progression of PCR, there are no clear treatment guidelines. If functional and aesthetic development can be achieved without orthognathic surgery, priority on conservative treatment should be considered.
