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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- "Limited studies report postoperative function in patients who have undergone a condylectomy . From the functional point of view, the mandibular dynamic is maintained with no significant changes when the high condylectomy is performed  . In a follow-up study of 15 patients undergoing a high condylectomy that presented no significant differences between the pre-and postoperative stages in either the objective or the subjective evaluations, Brusati  determined excellent function in 53.3%, "
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: Condylar hyperplasia is a rare non-neoplastic pathology associated with overgrowth of the mandibular condyle. Presentation of condylar hyperplasia with bifid mandibular condyle has never been reported in literature. Early management of the hyperplastic disorders of the mandibular condyle can prevent occlusal canting and developing asymmetric deformities. We report a case of ‘Bifid Hyperplastic Mandibular Condyle’ in a 14-year-old male with emphasis on early surgical intervention. To best of our knowledge, the present case is the first reported case of bifid mandibular condyle with condylar hyperplasia and 66th reported case of bifid mandibular condyle in living human population.Journal of Maxillofacial and Oral Surgery 12/2013; 12(4). DOI:10.1007/s12663-011-0257-2
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ABSTRACT: To study long-term changes in the mandibular asymmetry of patients with hemimandibular elongation (HE) treated with two-phase surgical orthodontic approach. Descriptive clinical study. Private practice setting. Seven (six females) out of 47 diagnosed and treated patients for severe mandibular asymmetry were included with the following criteria: diagnosis of HE based on clinical, radiological and single photon emission computed tomography bone scintigraphic studies, good quality orthopantomograms (OPT) available at six time-points, two-phase surgical treatment (high condylectomy, HC, and orthognathic surgery, OS) and measurements of maximal mouth opening (MMO) available. Mandibular ramus height and corpus length were measured on OPTs at six time-points. Ratios between the affected/non-affected sides were calculated. All patients had progression of mandibular asymmetry before any operation, which finding together with the scintigraphy resulted to the decision to perform HC. Thereafter ramus and corpus asymmetry decreased compared with the initial measurements. After OS, stable symmetry of corpuses and alignment of skeletal and dental midlines were obtained. MMO reduced on average 50% after HC, regained 20% after OS and recovered almost totally at the last follow-up. High condylectomy to stop excessive growth and OS to correct facial asymmetry is considered successful and necessary treatment for patients with HE. MMO can well recover after surgical traumas. Orthodontists should consider mandibular asymmetry as abnormal and need for surgical treatment if asymmetry is progressive and the ratio between affected/non-affected sides approaches 10%.Orthodontics and Craniofacial Research 09/2008; 11(3):172-9. DOI:10.1111/j.1601-6343.2008.00427.x · 1.29 Impact Factor