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Mandibular antegonial notching is a concavity of the undersurface of the body just anterior
to the angular process (gonion) seen in congenital and acquired disorders. The notch tends
to be longer in the congenital than in the acquired state, and the ascending ramus is at a more
obtuse angle to the body.
INDEX TERMS: Jaws, diseases. (Mandible, anatomic detail, 2 [43].920). (Mandible, hy-
poplastic congenital abnormality, 2 [43] .142)
congenita I
normal
Fig. 1. The mandibular shape in normal, acquired, and a congenital antegonial notching. Note the directions of muscle pull. C = condyle; CO
= coronoid; g =gonion; m = menton.
1 From the Departments of Radiology (M.H.B., P.J.C.) and Surgery (J.M.C.), New York University Medical Center, New York, N. Y. Presented
at the Pediatric Radiology Section of the Sixty-First Scientific Assembly and Annual Meeting of the Radiological Society of North America, Chicago,
111., Nov. 30-Dec. 5, 1975.
This work was supported by grants from the Billy Rose Foundation and the Reader's Digest Training Fund, and N.I.H. grant DEO 3568. S5
149
150 MELVIN H. BECKER AND OTHERS October 1976
DISCUSSION
Juvenile rheumatoid arthritis has been recognized as Fig. 4. A. and B. Juvenile rheumatoid arthritis (Still's dis-
an underlying factor in this mandibular deformity (4). The ease): the condyle is short and flattened. The antegonial notch
is a shorter curve than that seen in the congenital disorders, and
temporomandibular joint may be the first symptomatic there is a build-up of bone on the angular process.
area, and may be the only joint involved. The condylar area,
an important growth site, is injured by the inflammatory and a muscular imbalance, which leads to the growth
reaction. This results in decreased growth of the mandible changes that produce the antegonial notching.
Fig. 3. A. and B. Familial congenital condyle abnormality: father and son with flattened short mandibular condyles
and antegonial notching.
Pediatric
Vol. 121 ANTEGONIAL NOTCHING OF THE MANDIBLE 151 Radiology