A 57 years old female complained of severe pain on the right temporomandibular joint (TMJ) area. Her right condyle had been partly resected under surgical operation 13 years ago due to condyle hypertrophy, thereafter she felt dull pain on TMJ area and recently the lesion became severely swelled and painful leading to cancer phobia. The present radiological views showed slightly enlarged and sclerosed condyle with increased radiopacity, but its articular sliding function was almost disable during mouth opening. The patient’s TMJ lesion was carefully managed with conservative physiotherapy and pain treatment. The microsection of condyle head obtained from the previous operation was re-evaluated histologically, and it was finally diagnosed as osteochondrosis dissecans (OCD), exhibiting hyperplastic proliferation of cartilage in condyle head and marked vascular dilatation in epiphyseal zone. This abnormal cartilage tissue was distinguishable from normal cartilage tissue found in the peripheral cartilaginous cap of the same microsection. The involved cartilage cap showed thick hypertrophic chondrocyte zone with horizontal and vertical clefts accompanying diffuse hyaline degeneration. The superficial fibrous zone of cartilage cap was thickened and frequently peeled off, while lower hypertrophic zone of cartilage cap was highly cellular and proliferative. Consequently, the endochondral ossification became aberrant and resulted pre-mature apoptosis of many hypertrophic chondrocytes, followed by diffuse and mild inflammatory reaction in the underlying marrow tissue. Therefore, it was suggested that this hypertrophic condyle lesion, OCD, be differentiated depending on radiological and histological features from ordinary condyle hyperplasia, osteochondroma, and osteoarthritis, and that the pathological confirmation of OCD may provide a reliable modality for dental and medical treatment of chronic and painful TMJ lesion.

Osteochondroma is one of the most common benign tumors of the bone. Although osteochondroma is rarely seen in the facial region, it was reported that the cases occured in the mandibular region, especially around the condyle. Patients complain about malocclusion, temporomandibular disorders and facial asymmetry. The treatments of these cases include total condylectomy or local resection of the lesion. A 48-year-old man visited our hospital. His chief complaints were pain in the left temporomandibular joint (TMJ) and deviation of mandible during mouth opening. Panoramic radiograph showed an enlarged left condyle. A bony proliferation with benign sign was also observed in the computed tomography. Surgical treatment was done by removing the bony mass. Histologically, biopsy result was an osteochondroma. After surgery, there was reduced pain and normal mouth opening. Deviation of the mandible was also observed. We report a case of osteochondroma on the mandibular condyle and a review of literature about the surgical treatment.

The aim of this study is to find out histomorphologic change and cellular activity of condyle resulted from unilateral mastication by comparison of cell proliferation and apoptosis activity. 30 adult rats were dived to 15 experimental group and 15 control group randomly. Right upper and l ower molars were gently extracted in experimental group, to make unilateral mastication environment. All subjects were sacrificed at 1 week, 2 weeks and 4 weeks by chloroform, and their tissues were prepare to observation. Streptovidin-biotin system for BrdU stanning, was used to determine cellular proliferative activity. TUNEL method was used to determine apoptotic activity. The result for cellular activity was recorded at both of anterior portion and posterior portion of condyle. Hematoxylin and Eosin stanning was used for histiomorphological change. The results were as follows. There were more change in superficial layer than deep layer of condyle in cellular activity. In anterior portion of condyle cartilage, cellular proliferative activity of experimental group was lower than control group and apoptotic activity of experimental group was higher than control group. And apoptotic activity of extracted side in experimental group is the most. In posterior portion of condyle cartilage, cellular proliferative activity of extracted side in experimental group was higher than non-extracted side and control group, And apoptotic activity of extracted side in experimental group was the low. As a result of histomorphological change, there was hyperplasia in posterior region o f extracted side c ondyle i n experimental g roup, but t here was n o change i n unextracted side i n experimental group. There was histomorphological hyperplasia in posterior condyle of experimental group as results of high cellular proliferative activity. There was mainly apoptotic change of anterior portion condyle in experimental group. But there was no histomorphologic change. In other words, there was hyperplasia by increasing of cellular proliferative activity in posterior portion of nonfunctional side condyle. In functional side condyle, there was no histomorphological change in functional condyle, but there was change in cellular activity.