Treatment of hemimandibular hyperplasia: The biological basis of condylectomy

Bifid Hyperplastic Mandibular Condyle

“…The etiology of condylar hyperplasia is controversial. Hormonal influences, hypervascularity, heredity, infection, or trauma has been suggested by various authors as triggering factors, although no such history was elicited in the presented case [6]. It has been suggested that the clinical picture varies depending upon the age of onset of the condition or the stage of the disorder [4].…”

“…To compensate for the complex geometrical misalignment during growth of the lower jaw, the maxillary plane is tilted. The operations are usually therefore intended to correct the dental and skeletal asymmetry and to remove the growth centre by the bimaxillary operation [6]. But if this condition is recognized early before the maxillary plane is tilted, high condylectomy should be the preferred surgical option in cases of scintigraphically proven actively growing condyles and the abnormally growing condyle should be removed at the earliest to prevent further deformity and thereby preventing the maxillary canting.…”

“…But if this condition is recognized early before the maxillary plane is tilted, high condylectomy should be the preferred surgical option in cases of scintigraphically proven actively growing condyles and the abnormally growing condyle should be removed at the earliest to prevent further deformity and thereby preventing the maxillary canting. It has been reported in literature that the treatment of hemimandibular hyperplasia with combined orthodontic-maxillofacial treatment including condylectomy produces good aesthetic and functional results [6]. Condylectomy should be performed as early as possible.…”

Deformidad Facial Asimétrica: Papel de la Hiperplasia Condilar

“…Lippold et al (2007), en una interesante investigación, relataron una relación directa entre los hallazgos histológicos con amplios signos de artrosis y la mayor marcación en el cintigrama, lo cual asentaría las bases de una osteotomía condilar del segmento superior del cóndilo para limitar su crecimiento anómalo.…”

“…Del punto de vista funcional, la dinámica mandibular se mantiene sin cambios significativos cuando se realiza la condilectomia alta (Wolford et al, 2002;Lippold et al). Brusati et al (2010) determinaron en un estudio de seguimiento de 15 pacientes sometidos a condilectomia alta que no se presentaron diferencias significativas entre la etapa preoperatoria y postoperatoria en las evaluaciones tanto objetivas como subjetivas, señalando que en el 53,3% existió una función excelente, en el 40% fue solamente buena debido a la reducción parcial de la lateralidad del lado afectado, mientras que en un paciente (6,7%) se observó una función caracterizada como suficiente ya que este paciente abandono el tratamiento kinésico protocolar para los pacientes en la etapa postoperatoria.…”