Efficacy of proportional versus high condylectomy in active condylar hyperplasia — A systematic review

Niño-Sandoval, Tania Camila; Maia, Francisco Paulo Araújo; Vasconcelos, Belmiro Cavalcanti do Egito

doi:10.1016/j.jcms.2019.03.024

Cited by 25 publications

(24 citation statements)

References 54 publications

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“…Kim et al still needed adjunctive OS in 33.3% of their patients after a proportional condylectomy 34 . Nevertheless, the superiority of a proportional condylectomy over a HC was not conclusively confirmed in a recent systematic review 30,35 .…”

Section: Discussionmentioning

confidence: 95%

“…The HC is performed routinely by some authors, while others avoid it due to possible functional problems afterwards 25 . The HC allows early intervention with minimal patient morbidity and may prevent supplementary surgery [26][27][28][29][30] . It provided a surprising simplification of the treatment in four (16%) of the present study patients, who were scheduled for supplementary OS in their initial treatment plan.…”

Section: Discussionmentioning

confidence: 99%

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The need for secondary orthognathic surgery after high condylectomy in patients with active unilateral condylar hyperplasia

Aerden¹,

Verstraete²,

Politis³

2022

International Journal of Oral and Maxillofacial Surgery

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The need for secondary orthognathic surgery (OS) after a high condylectomy (HC) in patients with active unilateral condylar hyperplasia was assessed in 25 patients, reviewing patient characteristics and treatment planning. At 6-12 months after HC, 13 patients (52%) required secondary OS. The amount of mandibular dental midline shift before the HC (P = 0.037), and a dental crossbite that was present before the HC (P = 0.017) were significantly associated with the need for secondary OS. Overall, the mandibular dental midline coincided with the facial midline in eight patients (32%) at 2 weeks after HC. In 16% of the patients, no additional OS was needed despite this being the initial treatment plan. Additionally, the initially planned type of secondary OS was modified in six other patients. Early HC in skeletally immature patients provided very good results, both aesthetic and functional, with only two of them needing supplementary OS at 6-12 months after HC. The HC remains a valuable treatment in patients with active unilateral condylar hyperplasia, as it can eliminate the need for secondary OS and is very well tolerated by most patients.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

The need for secondary orthognathic surgery after high condylectomy in patients with active unilateral condylar hyperplasia

Aerden¹,

Verstraete²,

Politis³

2022

International Journal of Oral and Maxillofacial Surgery

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“…Values equal to or greater than 15% (the new suggested limit) are considered pathological and must be treated with condylectomy independent of the severity of the asymmetry. The surgical approach can be condylar shaving, high condylectomy or low/proportional condylectomy, depending on the severity of the asymmetry, age of the patient, skeletal discrepancy and the clinician's preferences for post‐surgical interventions 4,28‐30 …”

Section: Discussionmentioning

confidence: 99%

Reference values of mandibular condyles metabolic activity: A study using ^99mTc‐MDP single‐photon emission computed tomography

López

Castro

Muñoz

et al. 2020

Orthod Craniofacial Res

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Objective: To assess the condylar bone metabolic activity in patients with temporomandibular joint health by measuring 99m Tc-MDP uptake using a single-photon emission computed tomography (SPECT) to establish reference values of the uptake difference between condyles and the ratio with respect to the clivus.Setting and sample population: Eighty consecutive patients of both sexes who were admitted to a Nuclear Medicine Centre between 2017 and 2019 were included in the study. Method:This was an observational cross-sectional study in patients with SPECT indications to evaluate pathologies other than those of the temporomandibular joint.The values of the total and normalized counts in a fixed region of interest of five trans-axial slides were obtained to assess the percentage difference between the sides and the uptake ratio. The reference values are expressed as median and 5th and 95th percentiles. Results:The sample included 53 women (66.25%) and 27 men (33.75%) aged 15-55 years. The percentage of uptake difference between condyles was 5.04% (0.46-14.78) for men and 5.17% (0.27-13.21) for women (difference not significant, P = .9). The uptake difference was below 10% in 85% of the subjects (n = 68). The ratio values for total counts in women (0.87, 0.46-1.33) were significantly different (P = .0030) from those in men (1.08, 0.61-2.09). No significant correlation with age was found.Conclusions: These new reference ranges are applicable to the diagnosis of unilateral and bilateral condylar hyperplasia.

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“…Os procedimentos de tratamento da HC ainda não foram padronizados, sendo possível encontrar vários protocolos e algoritmos de manejo cirúrgico na literatura. Os métodos mais comuns relatados na literatura são: a realização apenas da cirurgia ortognática, o tratamento cirúrgico exclusivo da ATM (condilectomia alta ou condilectomia proporcional) e uma Research, Society and Development, v. 9, n. 10, e29108688, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i10.8688 10 combinação de cirurgia da ATM e cirurgia ortognática realizadas em um ou dois momentos cirúrgicos (Niño-Sandoval, Maia & Vasconcelos, 2019).…”

Section: Discussionunclassified

“…A varredura óssea (cintilografia) demonstra bom desempenho nessa avaliação, fornecendo informações anatômicas detalhadas associadas à atividade de crescimento que em conjunto com um exame clínico detalhado contribui significativamente no estabelecimento do diagnóstico (Muñoz et al, 1999). O tratamento da HC ainda não é um consenso na literatura, sendo possível encontrar diversos protocolos de manejo cirúrgico como a realização apenas da cirurgia ortognática, o tratamento cirúrgico exclusivo da ATM (condilectomia alta ou condilectomia proporcional) e uma combinação de cirurgia da ATM e cirurgia ortognática realizadas em um ou dois momentos cirúrgicos (Niño-Sandoval, Maia & Vasconcelos, 2019). Diante disso, esse estudo tem o objetivo de relatar o caso de tratamento cirúrgico precoce da HC por meio da condilectomia alta.…”

Section: Introductionunclassified

Tratamento precoce da hiperplasia condilar com condilectomia alta

Rocha

Silva

Santana

et al. 2020

RSD

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A hiperplasia condilar (HC) é caracterizada por um crescimento excessivo do côndilo mandibular provocando problemas estéticos e funcionais. O tratamento da HC ainda não é um consenso na literatura, sendo possível encontrar diversos protocolos de manejo cirúrgico. Diante disso, esse estudo tem o objetivo de relatar o tratamento cirúrgico precoce da HC por meio de um estudo descritivo, qualitativo, do tipo relato de caso. Paciente sexo masculino, 13 anos de idade, com histórico de severa assimetria facial. Ao exame físico apresentava assimetria em terço inferior de face, desvio contralateral do mento, inclinação do plano oclusal e maloclusão. O exame tomográfico evidenciou uma hiperplasia em região condilar esquerda, com alongamento do processo condilar, aumento do corpo mandibular ipsilateral e desvio contralateral do mento. O procedimento cirúrgico de condilectomia alta por acesso pré auricular foi realizado com a ressecção de 7 mm do processo condilar esquerdo. Paciente em acompanhamento ambulatorial, há mais de dois anos do procedimento, apresentava simetria facial, boa abertura bucal, oclusão estável e ausência de queixa álgica. Dessa forma, a condilectomia alta pode ser considerada uma alternativa racional de tratamento precoce nos casos de HC ativa no inicio da puberdade, diminuindo o estimulo de crescimento do côndilo afetado e reduzindo a necessidade de cirurgia ortognática posterior.

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Efficacy of proportional versus high condylectomy in active condylar hyperplasia — A systematic review

Cited by 25 publications

References 54 publications

The need for secondary orthognathic surgery after high condylectomy in patients with active unilateral condylar hyperplasia

The need for secondary orthognathic surgery after high condylectomy in patients with active unilateral condylar hyperplasia

Reference values of mandibular condyles metabolic activity: A study using ^99mTc‐MDP single‐photon emission computed tomography

Tratamento precoce da hiperplasia condilar com condilectomia alta

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Efficacy of proportional versus high condylectomy in active condylar hyperplasia — A systematic review

Cited by 25 publications

References 54 publications

The need for secondary orthognathic surgery after high condylectomy in patients with active unilateral condylar hyperplasia

The need for secondary orthognathic surgery after high condylectomy in patients with active unilateral condylar hyperplasia

Reference values of mandibular condyles metabolic activity: A study using 99mTc‐MDP single‐photon emission computed tomography

Tratamento precoce da hiperplasia condilar com condilectomia alta

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Reference values of mandibular condyles metabolic activity: A study using ^99mTc‐MDP single‐photon emission computed tomography