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Modified Condylotomy for Temporomandibular Joint Dysfunction

      The modified condylotomy is an extra-articular surgical procedure used to manage patients with temporomandibular joint dysfunction. The primary purpose of the procedure is to increase joint space by allowing the mandibular condyle to move inferiorly with respect to both the articular disc and eminence (Figs 1 and 2). An additional goal in some patients is to establish a more normal condyle/disc relationship, particularly for Wilkes I, II, and III (early) internal derangements. This disc relationship can be achieved in many patients by allowing the condyle to move anteriorly in addition to inferiorly (Fig. 3).
      Figure thumbnail gr1
      Fig. 1Proposed osteotomy site behind the inferior alveolar neurovascular bundle.
      Figure thumbnail gr2
      Fig. 2Inferior movement of the proximal segment to increase joint space.
      Figure thumbnail gr3
      Fig. 3Inferior and anterior movement of the proximal segment to increase joint space and reestablish a more normal relationship between the disc and condyle.
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      Further readings

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        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997; 84: 234-240
        • Bell W.H.
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        • Poor M.R.
        Treatment of temporomandibular joint dysfunction by intraoral vertical ramus osteotomy.
        Int J Adult Orthodont Orthognath Surg. 1990; 5: 9-27
        • Hall H.D.
        • Werther J.R.
        Results of reoperation after failed modified condylotomy.
        J Oral Maxillofac Surg. 1997; 55 ([discussion: 3–4]): 1250-1253
        • Hall H.D.
        • Nickerson Jr., J.W.
        • McKenna S.J.
        Modified condylotomy for treatment of the painful temporomandibular joint with a reducing disc.
        J Oral Maxillofac Surg. 1993; 51 ([discussion 43–4]): 133-142
        • Hall H.D.
        • Navarro E.Z.
        • Gibbs S.J.
        One- and three-year prospective outcome study of modified condylotomy for treatment of reducing disc displacement.
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        • Hall H.D.
        • Navarro E.Z.
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