The presence of advancement devices seems to induce adaptive changes in the condylar cartilage (Liu, Kaneko, & Soma, 2007a; Sato, Muramoto, & Soma, 2006), glenoid fossa
and articular eminence (Liu, Kaneko, & Soma, 2007b; Tuominen, Kantomaa, Pirttiniemi, & Poikela, 1996; Woodside, Metaxas, & Altuna, 1987), but little has been described about the effects of PDT.
Manual reduction may be difficult to reduce after certain period because of fibrous tissue within glenoid fossa
Radiographic examination using OPG shows haphazardly placed condylar heads and glenoid fossa
and unidentifiable joint space bilaterally and presence of 4 holed mono cortical plate with screws on lateral boder of the left condyle (Figure 1).
The morphology of the articular eminence, glenoid fossa
and mandibular condyle depends on numerous factors, such as changes in dentition associated with aging (tooth loss, attrition and/or increased function), degenerative changes of the glenoid fossa
, masticatory stress, craniofacial growth, gender, ethnicity and the relationship between the fossa and the eminence in relation to the facial structures(4,6,10-13).
In this position, the humeral head is drawn cranially and posteriorly against the glenoid fossa
by contraction of the shoulder muscles.
Dislocation of the temporomandibular joint (TMJ) is the dislodgment of the head of condyle from the glenoid fossa
Deep notching of gonial angle, narrowing of glenoid fossa
, and presence of a supernumerary tooth in right maxillary third molar region were other findings (Figure 1(c)).
Therefore, as an adaptive response of mandible to changes during function, there may be modeling of condyle and glenoid fossa
as well as remodeling and modeling of mandibular bone.
It prevents posterior migration of humeral head, thus centering it in the glenoid fossa
allowing a normal arc of movement (6, 15).
Bony fusion and fibrous tissue were observed between the condyle and lateral glenoid fossa
[Figure 3]b and c.
The glenohumeral (GH) joint consists of the humeral head that articulates in the glenoid fossa
of the scapula, surrounded by several static and dynamic structures.
This alludes to the fact that the surface area of the glenoid is small in comparison to the surface area of the humeral head; the average glenoid fossa
is 6 to 7 [cm.