Evaluation Of Surgical Condylectomy Of Unilateral Condylar Hyperplasia With Or Without Orthodontic Treatment

This clinical research presents the unilateral condylar hyperplasia as a pathological condition about causes, classification, and treatment. We discussed the hyperactivity of condyle and effect on the dentofacial symmetry from different aspects. This study includes four sections as follow:Chapter 1.Introduction and clinical date of unilateral condylar hyperplasiaFacial asymmetry defined as difference in the size, shape or relationship of two sides of the face, has high correlation with facial harmony, attractiveness and beauty. Condylar hyperplasia is one of reason causing facial asymmetry. Obwegeser and Makek classified the condylar hyperplasia into 3 different types.Patients and MethodOne hundred twenty eight (128) patients were involved this study from2007 to 2014. The data including the age, gender, the side of abnormality, clinical signs and symptoms, the time of surgery and the duration between surgical and orthodontic treatments were collected. All the patients underwent standardized diagnostic procedures including, clinical examination, radiographic examination such as CBCT, bone scan and extra and intra oral photograph as well the study model. Clinical diagnostic tool has been performed.ResultBased on the result of this study, the number of female 81 and the males 47 included, there were right side affected 44 and left side affected 37 in female patients. While there were right side affected 30, left side affected 17 in male patients.ConclusionCondylar hyperplasia may occur in wide age range and more frequently in female. Our finding indicate that CH can be exist in younger or in older age stages.Chapter 2.Surgical correction of unilateral condylar hyperplasiaCondylar hyperplasia (CH) can be defined as pathological condition that is caused by a hyperactivity of the growth center of one condylar head over the contralateral side, causing an excessive growth of the bone mass of variable degree and leading to facial asymmetry and occlusal disturbances which lead to psychological problems. The treatment protocol in this study for condylar hyperactivity was perform the high condylectomy with disc repositioning during active phase period to cut-off the condylar hyper active portion. Furthermore, eliminate the orthognathic surgery for shorting the treatment time.ObjectiveThe purpose of this study is to clarifying the surgical method for treatment the unilateral condylar hyperplasia in growing phase, and show the treatment result with high condylectomy and disc repositioning.Patients and MethodOne hundred and Twenty eight (128) patients were involved this study from 2007 to 2014.81 of them were females and 47 males, the age ranged from 16 to 33 year old. The date of the side of abnormality, clinical signs and symptoms were collected. The surgical procedure has been performed in active phase of CH under general anesthesia through extra-oral approach and intra-oral approach.ResultBased on the panoramic x-ray and the CBCT, there is a significant change in the condylar height between pre surgery and post-surgery. There is no significant change between post-surgery and the follow-up phase.ConclusionFrom the result of the treatment out come and follow-up, we conclude that the patients with unilateral condylar hyperplasia to perform high condylectomy during the active phase period can get good result.Chapter 3.Orthodontic treatment for the condylar hyperplasia patients with the open bite resulted from condylectomyObjectiveThe purpose of this study is to show the orthodontic treatment methods for managing the openbite resulted from condylectomy.Patients and MethodThis clinical study involved 21 patients,13 females and 8 males, who were diagnosed with active condylar hyperplasia from 2005 to 2012. All the patients underwent surgical condylectomy, and then referred to the orthodontic department for further treatment of the facial and dental problem. MEAW technique and vertical elastic used for managing the openbite. All the patients underwent the standardized clinical and radiographic examinations at the following intervals:Pre-surgery (P1), Post-surgery (P2), and Post-orthodontic treatment (P3).ResultThe post-treatment records showed significant improvement of facial profile. An angle class Ⅰ or complete class Ⅱ molar relationship with ideal overbite and overjet were obtained. MEAW technique and vertical elastic was used to obtain best fit of the occlusion. Proper cant of occlusal planes was achieved and corrected the mesial inclination of the dentition. The occlusion showed good interdigitation and canine guidance. The dental midline was coincident with the facial midline. Post-treatment evaluation showed significant uprighting of the mandibular and maxillary molars. The post treatment radiograph showed the root parallel to each other and no obvious evidence root resorption or any pathological conditions.