Condylar hyperplasia, diagnosis and clinical management: a clinical case report
Keywords:Condyle, Facial asymmetry, Segemental mandibulectomy, High condylectomu, High condylectomy
Condylar hyperplasia is a disorder characterized by excessive and progressive growth affecting the condyle, neck, body, and mandibular ramus. Under this condition, mandibular growth occurs in all three planes of space, but more predominantly in one of them. Its etiology is controversial in its own. Some of its suggested causes include: trauma, hypervascularity, infections, and hereditary/intrauterine factors. Treatment protocols are varied, but one of the best treatment choices is high condylectomy. Following is the case of a 16-year old female patient with this anomaly. The physical exam showed free facial asymmetry with mandibular deviation. Treatment consisted of TMJ surgery and high condylectomy plus a second orthodontic stage. The clinical outcomes at two-year follow-up suggest that a second intervention won´t be necessary. Patient was very satisfied with the results.
Sora C, Jaramillo PM. Diagnóstico de las asimetrías faciales y dentales. Rev Fac Odontol Univ Antioq 2005; 16 (1 y 2): 15-25.
Olate S, De Moraes M. Deformidad facial asimétrica. Papel de la hiperplasia condilar. Int J Odontostomat 2012; 6(3): 337-347.
Pirttiniemi P, Peltomäki T, Müller L, Luder HU. Abnormal mandibular growth and the condylar cartilage. Eur J Orthod 2009; 31(1): 1-11.
Gorlin RJ, Cohen MM, Hennekam RCM. Syndromes of the head and neck. 4th ed. New York: Oxford University Press; 2001.
Petty RE, Southwood TR, Baum J, Bhettay E, Glass DN, Manners P et al. Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol 1998; 25(10): 1991-1994.
Palmisani E, Solari N, Magni-Manzoni S, Pistorio A, Labò E, Panigada S et al. Correlation between juvenile idiopathic arthritis activity and damage measures in early, advanced, and longstanding disease. Arthritis Rheum 2006; 55(6): 843-849.
Rönning O, Väliaho ML, Laaksonen AL. The involvement of the temporomandibular joint in juvenile rheumatoid arthritis. Scand J Rheumatol 1974; 3(2): 89-96.
Björk A, Skieller V. Contrasting mandibular growth and facial development in long face syndrome, juvenile rheumatoid polyarthritis, and mandibulofacial dysostosis. J Craniofac Genet Dev Biol 1985; 1(Suppl): 127-138.
Hanna VE, Rider SF, Moore TL, Wilson VK, Osborn TG, Rotskoff KS et al. Effects of systemic onset juvenile rheumatoid arthritis on facial morphology and temporomandibular joint form and function. J Rheumatol 1996; 23(1): 155-158.
Mericle PM, Wilson VK, Moore TL, Hanna VE, Osborn TG, Rotskoff KS et al. Effects of polyarticular and pauciarticular onset juvenile rheumatoid arthritis on facial and mandibular growth. J Rheumatol 1996; 23(1): 159-165.
Kjellberg H. Craniofacial growth in juvenile chronic arthritis. Acta Odontol Scand 1998; 56(6): 360-365.
Legrell PE, Reibel J, Nylander K, Hörstedt P, Isberg A. Temporomandibular joint condyle changes after surgically induced non-reducing disk displacement in rabbits: a macroscopic and microscopic study. Acta Odontol Scand 1999; 57(5): 290-300.
Baumann A, Troulis MJ, Kaban LB. Facial trauma II: dentoalveolar injuries and mandibular fractures. En: Kaban LB, Troulis MJ. Pediatric oral maxillofacial surgery. USA: Elsevier Science; 2004. p. 441-460.
Rémi M, Christine MC, Gael P, Soizick P, Joseph-André J. Mandibular fractures in children: long term results. Int J Pediatr Otorhinolaryngol 2003; 67(1): 25-30.
Dorrit-Nitzan D. Mandibular asymmetry secondary to TMJ active condylar hyperplasia (ACH). Br J Oral Maxillofac Surg 2009; 47(6): 502-504.
Rushton MA. Unilateral hyperplasia of the mandibular condyle. Proc R Soc Med 1946; 39(7): 431-438.
Obwegeser HL, Makek MS. Hemimandibular hyperplasia-hemimandibular elongation. J Maxillofac Surg 1986; 14(4): 183-208.
Betts NJ, Vanarsdall RL, Barber HD, Higgins-Barber K, Fonseca RJ. Diagnosis and treatment of transverse maxillary deficiency. Int J Adult Orthodon Orthognath Surg 1995; 10(2): 75-96.
Ferreira S, da Silva Fabris AL, Ferreira GR, Faverani LP, Francisconi GB, Souza FA et al. Unilateral condylar hyperplasia: a treatment strategy. J Craniofac Surg 2014; 25(3): e256-258.
Avelar RL, Becker OE, Dolzan-Ado N, Göelzer JG, Haas OL Jr, de Oliveira RB. Correction of facial asymmetry resulting from hemimandibular hyperplasia: surgical steps to the esthetic result. J Craniofac Surg 2012; 23(6): 1898-1900.
Pereira-Santos D, De Melo WM, Souza FA, de Moura WL, Cravinhos JC. High condylectomy procedure: a valuable resource for surgical management of the mandibular condylar hyperplasia. J Craniofac Surg 2013; 24(4): 1451-1453.
Lippold C, Kruse-Losler B, Danesh G, Joos U, Meyer U. Treatment of hemimandibular hyperplasia: the biological basis of condylectomy. Br J Oral Maxillofac Surg 2007; 45(5): 353-360.
Wolford LM, Mehra P, Reiche-Fischel O, Morales-Ryan CA, García-Morales P. Efficacy of high condylectomy for management of condylar hyperplasia. Am J Orthod Dentofacial Orthop 2002; 121(2): 136-151.
Saridin CP, Raijmakers P, Becking AG. Quantitative analysis of planar bone scintigraphy in patients with unilateral condylar hyperplasia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104(2): 259-263.
Poswillo D. Experimental reconstruction of the mandibular joint. Int j Oral Surg 1974; 3(6): 400-411.
Oliveira-Júnior PA, Faber PA. Hiperplasia condilar: tratamento ortodôntico cirúrgico. Relato de caso. BCI 2001; 8: 42-45.
García A, Somoza C, Gándara J, Albertos J. Hiperplasia condilar. Tratamiento mediante condilectomía y prótesis de Christensen. Rev Esp Cirug Oral y Maxilofac 1999; 21(1): 22-27.
Ochandiano S, Salmerón JI, Soler FA, Acero J, Cuesta M, Concejo C. La hiperplasia condílea, tratamiento mediante condilectomía alta y meniscopexia. Rev Esp Cirug Oral y Maxilofac 2000; 22(1): 31-37.
Villegas C, Janakiraman N, Nanda R, Uribe F. Management of unilateral condylar hyperplasia with a high condylectomy, skeletal anchorage, and a CAD/CAM alloplast. J Clin Orthod 2013; 47(6): 365-374.
Chiarini L, Albanese M, Anesi A, Galzignato PF, Mortellaro C, Nocini P et al. Surgical treatment of unilateral condylar hyperplasia with piezosurgery. J Craniofac Surg 2014; 25(3): 808-810.
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