Condylography
Condylography is a state-of-the-art, digitalized, non-invasive and painless technique for accurate diagnosis of temporomandibular joint (TMJ) dysfunctions, lasting approximately 20-30 minutes.
This diagnostic method is part of the dental branch known as Occlusology, recommended in specific cases such as comprehensive rehabilitation involving natural teeth or even dental implants, as well as in orthodontic cases.
With the help of condylography, the dentist can assess and record the condition of all temporomandibular joint elements in the form of charts and digital values and can program the articulator based on the received parameters.
The electronic condylograph is the device that aids in diagnosis and includes both a mechanical part – the tool placed on the patient’s head – and an electronic part that connects to a laptop/computer with specialized software that records mandibular dynamics.
There are scientific rules, established and confirmed by experts in the field, about how the masticatory system should function and how it should be structured to be functional. Functional analysis of the masticatory system is a dental method for evaluating the individual characteristics of the patient’s jaw. This procedure analyzes the masticatory muscles, the jaw, the teeth, and the periodontium. Chewing processes and movements of the upper and lower jaw are recorded, observing the functionality of the masticatory muscle.
Functional analysis is part of the dental branch called Occlusology. It is the pathway to diagnose a cranio-mandibular dysfunction and is specifically applied in cases involving superior aesthetics, such as dental veneers. It is considered the first step in performing prosthetic or aesthetic treatments.
When is condylography necessary?
Condylography is mandatory in complex cases, such as total rehabilitation of the stomatognathic system, combined interventions with dental implants and natural teeth, symptoms and pathologies of the temporomandibular joint, total maxillary or bimaxillary edentulism. Additionally, it is a valuable test prior to determining the need for orthodontic appliances and in detecting cranio-mandibular disorders, such as arthritic joints and joints with dislocated articular discs.
How is condylography performed?
Condylography is not the initial diagnostic step. The dentist conducts a preliminary consultation. If the dentist notices sensitivity in the muscles of the cranio-mandibular system, pain in the temporomandibular ligament, or pain in the temporomandibular joints during rotation or even in a static position, it indicates imbalances. These imbalances can be most easily, quickly and efficiently discovered through condylography.
Once the dentist and the patient have agreed to perform condylography, the process itself is much simpler than it seems, as it is digitized.
The mechanical part of the condylograph is placed in the patient’s mouth, with the external support points being the two auditory tracts (the ends of the mandible), and the electronic part, connected to specialized software, records all jaw movements through 4 ultrasound sensors that transmit the movements to the software. With the high-precision information received from the sensors, the software creates a virtual scheme of these movements and the disposition of the bones. The movements are recorded in real-time by the software, allowing the dentist and the patient to see the exact trajectory of the mandible during movements. This helps the doctor immediately understand the problem the patient is facing.
Following condylography, the dentist has all the information about the two cranial joints, thus being able to establish the most efficient treatment. Additionally, the patient will receive all the information to keep for the future, which can be used for any dental treatment involving the laboratory.
Dentists use this technique as a fundamental investigation for various imbalances to determine the most effective and predictable treatment for each patient.
Moreover, sending the information to the laboratory helps create a model of ceramic teeth that the dentist works on and shows the patient the final result of the treatment, without affecting the real teeth. This provides the patient with the opportunity to make an informed decision.
The benfits of condylography
- It represents a non-invasive and painless process.
- Accurate diagnosis ensures efficient and predictable treatment.
- The information transmitted to the dental technical laboratory following the diagnosis is precise, aiding in setting up the ARCON articulator for the treatment of each patient.
- It helps balance prosthetic, aesthetic and functional works from an articular perspective.
- It minimizes the risk of cranio-mandibular system imbalance after prosthetic works.
- Various symptoms can be more easily correlated with the medical issue through this type of diagnosis.
- It assists the patient in making informed decisions based on a ceramic model of the teeth used by the dentist as a “draft” for the recommended procedure.
- It helps customize the treatment for each patient.
- Precise measurements reduce visits to the dentist for size checks and adjustment of various orthodontic or prosthetic appliances.
- It reduces the risk of patient discomfort due to mathematical errors.
Functions of the cranio-mandibular system
In order to comprehend why condylography is necessary, it is essential to understand how the cranio-mandibular system functions.
It has three vital functions, namely breathing, chewing, and swallowing, a functional aspect – speaking, and an aesthetic function. All these are performed with the help of the cranio-mandibular system, which is why it is crucial for it to be healthy.
The movements of this system are complex rotations and translations, unique to each patient, carried out with the assistance of the muscles in the system. Through condylography, irregularities in mandibular dynamics can be identified for subsequent efficient treatment.
An individual with irregularities in the cranio-mandibular system may exhibit various symptoms, such as pain in the neck, head, or even the ears during chewing or opening the mouth widely. Headaches and migraines are commonly encountered symptoms, or even a restriction of movements that can be performed. In severe cases, the temporomandibular joint can be locked.
What is the treatment for mandibular repositioning?
If, following condylography, the dentist concludes that the mandible needs to be repositioned, the treatment takes between 6 and 8 months. This intervention can be done either by moving natural teeth through orthodontic appliances or by performing prosthetic work.
In most cases of mandibular repositioning, the result is lifelong, but there are situations where the patient is closely monitored by the dentist for a certain period to ensure that the body has adapted, and the treatment has been successful.
Condylography for prosthodontic and orthodontic appliances
During condylography, the dentist observes the positioning of the two articular discs for each patient and can more easily identify the issue. Additionally, specialized software records various precise angles and mathematical data, streamlining prosthodontic and orthodontic treatments. For these treatments, the processes are conducted extra-orally, in a laboratory. With precise and comprehensive measurements from condylography, the laboratory technician can create functional works for each patient, eliminating the need for adjustments by the dentist in the office, thereby reducing the risk of discomfort for the patient due to an inaccurate matrix.