Progressive condylar resorption (PCR) is a pathological process that primarily afflicts early through late adolescent females, but can present in males as well.
Previously identified by the term idiopathic condylar resorption, it is a degenerative condition that strikes the condylar head with arthritic-like presentation and leads to pain and dysfunction.
It is crucial to identify this issue as early as possible in order to maintain bone volume in the condyle. Every discipline in dentistry has the potential to see a patient with this, and the presentation can involve pain with function, an altered occlusion that may or may not be progressive, articular disc displacement, an altered range of motion and accompanying myalgia. The crucial aspect of treatment is to avoid adverse loading of the condylar head which is the main perpetuating factor via the use of an orthotic to prevent full condylar seating. This therapy is transitional and can take up to a year or longer in many cases, at which point the degenerative process has typically ceased to be active and remodeling of the affected joint has begun. Residual defects in occlusion can at that point be predictably managed through a multidisciplinary effort among dental professionals.
The key to managing PCR is early identification, which has become much more predictable through the use of Cone beam computed tomography (CBCT) imaging. However, the most important aspect remains proper identification of these patients through clinical presentation in dental offices.