Bifid mandibular condyle: investigating the association with temporomandibular joint disorders on three-dimensional T2-weighted SPACE sequences performed for brain magnetic resonance radiological scanning techniques

Background: Bifid mandibular condyle (BMC) is a rare anatomical variation whose cause has not been fully understood. It has been hypothesized that BMC may be associated with an increased frequency of temporomandibular joint (TMJ) abnormalities. The aim of the study was to comparatively review the magnetic resonance imaging (MRI) archives of the hospital focusing on patients with BMC who underwent brain MRI using the T2-weighted 3D sampling perfection with application-optimised contrast using different flip angle evolutions (SPACE) radiological scanning techniques. Methods: The TMJ was thoroughly evaluated in patients diagnosed with BMC. Pathological findings were categorized into six classes: disc degeneration, disc displacement, disc deformation, degenerative osteoarthritis, effusion, and subluxation. Results: A total of 29 patients with BMC were identified, including 9 males (31%) and 20 females (69%). BMC was located on the right side in 10 patients (34.5%), on the left side in 7 patients (24.1%), and bilaterally in 12 patients (41.4%). Only 5 patients (17.2%) showed no pathological findings on MRI, while 24 patients (82.8%) exhibited at least one TMJ-related abnormality. Among these, 22 patients (75.9%) had disc degeneration, 8 (27.6%) had disc displacement, 10 (34.5%) had disc deformation, 2 (6.9%) had degenerative osteoarthritis, 12 (41.4%) had effusion, and 5 (17.2%) had subluxation. Conclusions: TMJ disc pathology is the most frequently observed abnormality in BMC, although it remains uncertain whether this relationship is causal or coincidental. BMC may contribute to the development of TMJ disorders; however, further research with larger sample sizes is needed to clarify its role.

Bifid mandibular condyle; Temporomandibular joint; T2-weighted SPACE sequence

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