Progressive idiopathic condylar resorption or PCR
Condylar resorption is degenerative condition seen mostly in adolescent and young women. It is fortunately very rare, since it can be very damaging. Orthodontics typically encounter ICR at a rate of 1 care per 5000. The average office will likely see 0-2 cases in a career.
Causes of idiopathic condylar resorption or ICR
The exact cause can never be known for sure but we do know some risk factors. The following all have a correlation
- Hormonal imbalances like estrogen and 17β-estradiol.
- Nutritional issues like low Vitamin D and omega-3 fatty acids.
- Physical triggers like repetitive trauma, orthodontics, orthognathic surgery, and certain occlusal appliances.
What is PCR?
It is a noninflammatory degenerative disorder of the TMJ. PCR leads to loss of condylar mass, decrease of mandible ramus height, and most noticeable an anterior open bite. It often causes pain and limits opening of the mouth.
Treatment for progressive condylar resorption
To truly treat the condition requires surgery. Often orthodontics delay treatment of any kind until after active resorption is done. There are very few oral surgeons who treat this condition, primarily due to it’s rarity. Management is often the first step. This can be done by an orthodontist or dentist but will often be someone that has a keen interest in the condition.
Management of PCR.
Management goals are to decrease pain from the joint and muscles, increase joint function, and prevent further damage.
TNF-α inhibitors has the most promising future. Other medications include tetracyclines and NSAIDs. Doctors also use things like antioxidants and dietary modificatins