Patient Spotlight: Madison Rondinone

My name is Madison Rondinone. I am 22 years old and I’ve been diagnosed with idiopathic condylar resorption for approximately 8 years now. When you live with a chronic medical condition, the physically obvious factors are often at the forefront of what is acknowledged and discussed. The mental effects of chronic illness are not as commonly talked about, but they are just as important. Any disease that impacts the appearance of the face, such as degenerative joint disease of the TMJs, is known to have broad psychological impacts [1]. I found this to be true of my experience, too — I have slowly watched the structure of my jaw and face shift, and with every additional change I recognize myself less and less, leading to increased mental and emotional distress.

When I was 10 years old, I had my first round of braces installed. These were strictly for the orthodontic correction of my teeth alignment and severe overbite. I wore these for about 2.5 years and during that time my orthodontist was having trouble getting my overall bite to line up and remain stable.
In my final x-rays he noticed I had a problem with the alignment of my jaws and this was identified as the cause of my bite issues, not my teeth. I shuffled between a few oral surgeons, all of which came up with different theories regarding my treatment-resistant bite, until finally a diagnosis was reached – idiopathic condylar resorption.
Unfortunately, the oral surgeon I was working with at the time had moved on and I ended up needing to find someone new. That stressful situation became a blessing as I ended up meeting the oral surgeon I have been working with for about 6 years now. He hand-made an oral splint for me that I wear every night to manage my pain.

Orthodontic records from when I was 12 years old in 2013.

CBCT scan taken right after my first round of braces.

For a while my condition was not progressing. There was little to no change in my x-rays and bone structure as the years went by. However, in early 2021, I started noticing an increase in my pain levels. The pain began radiating through the muscles on the left side of my face from my lower jaw to my temples. I brought this up to my oral surgeon and they determined it was likely due to the growth of my upper wisdom teeth. My lower two wisdom teeth had been previously extracted, but due to the anatomy of my jaw they felt it was best to wait until a later time to remove my upper wisdom teeth. Since my upper teeth were starting to surface, they were pushing on the splint, causing a shift in my bite and alignment at night.
He was able to adjust and reshape the splint, which helped to relieve most of my pain. After this obstacle was overcome, my local oral surgeon recommended I reach out to a specialist for further evaluation. Due to the rarity of this condition, he wanted to have additional opinions regarding the long-term treatment options for my case. I was sent to Tufts School of Dentistry in Boston, MA, where I initially met with my surgeon.

He explained that, due to the severity of my condition and progression, surgery was my only viable option moving forward.

Orthodontic records taken more recently — in 2021 at 21 years old.

We wanted to ensure there would be no development of other resorption-associated long-term medical problems, or a significant increase in my pain levels. He emphasized that this condition was not going to heal itself or get better, therefore my best option was to start planning for surgical intervention while I am still young. We made a plan to have me consult with my local orthodontist and oral surgeon, and begin making preparations for having TMJ total joint replacement (TJR) surgery.
I just passed the one-year mark in my second round of braces. Unfortunately, it is very common for braces to accelerate resorption, and with the additional degeneration of my left condyle has come new challenges. I now have a slipped disk on my right condyle from the overcompensation, which will require surgical repair.

ICR is a rare and extremely intrusive disease and it can greatly affect the physical and mental health of those suffering. I am still pre-op and expecting surgery around December 2022 or January 2023. I will be undergoing a unilateral temporomandibular joint replacement with Le Fort 1, genioplasty, and unilateral sagittal split osteotomy.