青少年特发性髁突吸收或系发育期异常咬合所致软骨退变相关的病理性改建OA

Juvenile idiopathic condylar resorption (JICR) is a rare temporomandibular joint problem characterized by the progressive resorption of condylar tissues,leading to mandibular ramus height reduction,mandibular retrognathia,and anterior open bite. Emerging evidence from recent animal studies in the laboratory indicated that different from conven-tional pathological resorption observed in developed condyles,JICR could be condylar cartilage degradation associated with pathological remodeling at growth and developmental stage initiated by aberrant occlusion. At present,however,there is an argument which is evidenced with publications in the etiology,pathogenesis,diagnosis,differential diagnosis and treatment of JICR. The etiology and pathogenesis of JICR remain obscure. Traumatic loading,including that from ab-errant occlusion,plays a role in JICR. The diagnosis and differential diagnosis of JICR are challenging. They mostly rely on imaging signs of the condyle deformity,which are not significant at early stages. Making a definite diagno-sis of JICR at the early stage is difficult. Retrognathia re-lated maxillofacial deformity is often taken as an early sign of JICR. Many researchers opposed the application of orthodontic and orthognathic treatment during the active phase of JICR because of risks of exacerbating condylar re-sorption. However,given that traumatic occlusion is etiological to JICR,delayed intervention may compromise conserva-tive management efficacy and progression of the condylar and orofacial deformities. Here,the author advocates for the prompt diagnosis and correction of underlying traumatic occlusion to prevent deformity progression. Effective diagnosis and management of malocclusion constitute the cornerstone for addressing this clinical conundrum.