Treatment of hemimandibular hyperplasia: The biological basis of condylectomy
ABSTRACT Treatments to correct skeletal deformities in patients with hemimandibular hyperplasia differ, particularly about the age at which the operation is done and the operation itself. To some extent, the differences can be attributed to the unknown biological basis of disease. The aim of the present study was to evaluate clinically the outcome of a rationale for the operation based on condylectomy on the affected side. Histological, radiological, and nuclear methods were used to get a more detailed insight into the reason for the operation. Six patients with hemimandibular hyperplasia were treated by a combined orthodontic-maxillofacial protocol. All patients had the affected joint removed. The histological morphology of each condylar specimen was compared with the bone scintigraphy to try and find a correlation between the methods. The clinical evaluation showed morphological and functional rehabilitation of all six patients. During the 2-year follow-up, all patients had stable symmetrical mandibles with no disturbance of temporomandibular function. Remodelling of the joint and the destruction of the cartilaginous layer was accompanied by much bone scintigraphic activity. We conclude that condylectomy can correct hemimandibular hyperplasia, even in patients with active condylar growth, by removing the underlying disease.
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ABSTRACT: Condylar hyperplasia (CH) is a bone disease characterized by the increased development of one mandibular condyle. It regularly presents as an active growth with facial asymmetry generally without pain. Statistically it affects more women in adolescence, although it does not discriminate by age or gender. Its best-known consequence is asymmetric facial deformity (AFD), which combined with alteration of the dental occlusion with unilateral crossbite or open bite. It is not known when CH begins and how long it lasts; diagnostic examinations are described and are efficient in some research about diagnosis. Protocol treatment is not well studie and depends on the criteria described in this paper. The aim of this research is to provide up-to-date information about the diagnosis of this disease and to analyze the treatment protocol, visualizing the CH and AFD presented.International Journal of Clinical and Experimental Medicine 01/2013; 6(9):727-737. · 1.42 Impact Factor
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ABSTRACT: This case report demonstrates the successful treatment of facial asymmetry with condylar hyperplasia with limited surgical and orthodontic treatment. A high condylectomy was performed to shorten the elongated condyle and to remove its active growth site. The maxillary molars on the affected side were then orthodontically intruded using temporary anchorage devices to improve the occlusal cant and posterior open bite of the unaffected side. This combined surgical-orthodontic treatment provided a satisfactory outcome without additional orthognathic surgery. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 04/2015; 147(4 Suppl). DOI:10.1016/j.ajodo.2014.04.025 · 1.44 Impact Factor
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ABSTRACT: The purpose of this study was to measure the changes in facial, occlusal, and skeletal relationships in patients with active unilateral condylar hyperplasia whose sole treatment was a low condylectomy. A retrospective observational descriptive study was conducted. All patients had undergone a low condylectomy as the sole or initial surgical treatment. The size of the condylar segment removed was decided by matching the affected side with the healthy side, leaving them both like the healthy one. The length of the ramus was measured using panoramic X-ray (distance from the highest part of the condyle to the mandibular angle). Facial, occlusal, and skeletal changes were evaluated using clinical, photographic, and radiological records before and after surgery. Condylectomy as the sole treatment for patients with active condylar hyperplasia allowed improvements to the alterations produced by this pathology, such as chin deviation, tilted lip commissure plane, tilted occlusal plane, angle of facial convexity, unevenness of the mandibular angles, and length of the mandibular ramus. The occlusal relationship also improved with orthodontic and elastic therapy. To conclude, low condylectomy as a sole and aetiological treatment for patients with active condylar hyperplasia allowed improvements to alterations produced by this pathology.International Journal of Oral and Maxillofacial Surgery 11/2014; 44(2). DOI:10.1016/j.ijom.2014.10.013 · 1.36 Impact Factor