Orthognathic surgery in “older” adults with Hemi-Mandibular Elongation: Long-term occlusion outcomes

Orthodontic-surgical Management of the Horizontal Unilateral Condylar Hyperplasia

“…12,14,15,22,26 The mean age of the first consultation is in agreement with many studies which stated that UCH typically onsets in the second decade, when patients start to notice the asymmetric mandibular growth. 7,18,22 As expected, all patients of our sample had a clinically asymmetric lower third, with chin and lower midline deviated toward the healthy side, that are the characteristic features of the horizontal type. All patients but 2 did not have an involvement of the maxillary occlusal plane, confirming that the occlusal plane is preserved in the "pure" horizontal hyperdevelopment.…”

“…18 This approach is preferred by many Authors in patients at the end of growth, because it preserves the temporo-mandibular joint and achieves favorable and stable long-term occlusion over time. 2,6,7,19 Condylectomy may be useful when the difference of length of the condylar head leads to severe functional imbalances.…”

“…12,14,15,22,26 The mean age of the first consultation is in agreement with many studies which stated that UCH typically onsets in the second decade, when patients start to notice the asymmetric mandibular growth. 7,18,22…”

“…1 The extra-and intra-oral clinical features of the malocclusion resulting from UCH are not homogenous for all the patients at first consultation, mainly for the progressive nature of the disease and for the direction of condylar overgrowth (vertical, horizontal or hybrid, which has the clinical characteristics of both), that could determine different clinical and radiographic characteristics. 5 The horizontal pattern is characterized by a complex clinical picture related with the time elapsed from the onset of the hyperplasia, but the constant clinical feature is the "asymmetrical prognathism" with asymmetry of the facial lower third, deviation of chin and mandibular midline toward the healthy side without involvement of the maxillary occlusal plane, that not do not show canting, and class III relationships on the affected side [6][7][8] (Figure 1A-C); the condylar hyperdevelopment could lead to elongation of both ramus and body on the affected side 9 (Table 1).…”

Common Patterns of Developmental Dentofacial Deformities: A Biologic Classification System

“…Once the individual's jaw growth pattern is recognized, the natural progression of their deformity, the functional consequences (ie, effects on speech, chewing, swallowing, breathing), and the locations of skeletal dysmorphology that require surgical intervention fall into place. 13,[17][18][19][20][21][22] This biologic classification system assists the clinician towards an accurate and comprehensive diagnosis which takes into account the patients: upper airway, facial aesthetic, and long-term dental health needs. The 6 common jaw growth patterns include:…”