Article:Oral contraceptives and condylar resorption in women

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cvn
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Article:Oral contraceptives and condylar resorption in women

#1 Post by cvn »

I thought I'd throw up a link here to the article published recently linking oral contraceptive use to condylar resorption in women, as one of my doctors just gave me a copy and I found it fascinating and explained a lot about my own case history. It's also come up a few times around here as myself and one other person my age-ish on this board (that I know of with the same surgeons) are on HRT, but we never really had anything to reference to about it as they hadn't published yet. The full article is pretty enlightening and, if you are a woman on birth control and with bite instability, is something you really should show to your surgeon because it's made a huge difference in success rates in women for these surgeons.

Here is the abstract from the American Journal of Orthodontics and Dentofacial Orthopedics, Volume 136, Issue 6, December 2009, Pages 772-779:
Oral contraceptive pill use and abnormal menstrual cycles in women with severe condylar resorption: A case for low serum 17β-estradiol as a major factor in progressive condylar resorption

References and further reading may be available for this article. To view references and further reading you must purchase this article.

Michael J. Gunsonnext a, G. William Arnett a, Bent Formby b, Charles Falzone c, Ruchi Mathur d and Carolyn Alexander d

aPrivate practice, Center for Corrective Jaw Surgery, Santa Barbara, Calif

bResearcher, Rasmus Institute for Medical Research, Santa Barbara, Calif

cPrivate practice, Santa Barbara, Calif

dAttending physician, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, Calif
Received 1 April 2009;
revised 1 July 2009;
accepted 1 July 2009.
Available online 3 December 2009.

Introduction
Progressive condylar resorption has been described for many years. Because condylar resorption favors women over men, many have thought that a prominent systemic factor for the pathogenesis of this disease might be related to sex hormones.

Methods
Over a 3-year period, 27 women without autoimmune disease came to our office for orthognathic surgical correction of their skeletal deformity secondary to severe condylar resorption. They all showed radiographic evidence of severe condylar resorption. Sex hormone dysfunction was evaluated, and midcycle serum levels of 17β-estradiol were measured. Use of exogenous hormones was also documented.

Results
Twenty-six of the 27 women with severe condylar resorption had either laboratory findings of low 17β-estradiol or a history of extremely irregular menstrual cycles. Of the 27 women, 25 showed abnormally low levels of serum 17β-estradiol at midcycle. Two subsets were identified in the group with low 17β-estradiol. The first did not produce estrogen naturally (8 of 27), and the second had low 17β-estradiol levels secondary to oral contraceptive pill (OCP) use (19 of 27). Of the 19 OCP users, all 19 reported that chin regression and open bite changes occurred after starting OCP use. Nine of the 19 reported these condylar resorption symptoms within the first 6 months of starting the OCP.

Conclusions
Whether induced by ethinyl estradiol birth control or by premature ovarian failure, low circulating 17β-estradiol makes it impossible for the natural reparative capacity of the condyle to take place in the face of local inflammatory factors. This leads to cortical and medullary condylar lysis.
The full article can be purchased at (I think this link should work): http://dx.doi.org/10.1016/j.ajodo.2009.07.011 or if you have access through school you can probably get it through that.

asmileconnectsus
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#2 Post by asmileconnectsus »

Thanks for posting this!!! Dr. Gunson just took me off of Hormone Therapy, but still am advised not to use oral contraceptive.

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