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Free Online Library: Hiperplasia condilar, diagnostico y manejo clinico a proposito de un caso clinico.(CASO CLINICO, Ensayo) by “Revista Facultad de. Case report. Facial asymmetry secondary to mandibular condylar hyperplasia. A case report. Alberto Wintergerst Fisch,* Carlos Iturralde Espinosa,§ Santiago. Title: Tratamento da assimetria facial causada por hiperplasia condilar: série de casos. (Portuguese); Alternate Title: Treatment of facial asymmetry caused by.

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Nevertheless a crossbite can appear on that same side. Under a Creative Commons license. To the knowledge of these authors, there is nothing in the anatomy, pathology or surgery literature regarding the use of magnetic resonance to study these ihperplasia or reports of follow-up with CBCT, so it is difficult to compare our results.

Facial asymmetry caused by mandibular deviation to the left, mandibular prognathism, condikar retrognathism, and anterior and posterior crossbite. The condylar growth patterns in these types of procedures could contribute to a better understanding of regenerative processes since if a similar macromorphology is obtained between a treated condyle and a normal condyle, it is possible that a similar micromorphology is also obtained, including the presence of layers known to be in the normal condylar head.

The diagnosis of CH can be made by a combination of clinical and radiological examinations. The etiology of condylar hyperplasia remains uncertain, although certain factors like arthritis and hormonal disorders have been associated to it. At the same time, the choice of vertical osteotomies in the mandible along with the posterior maxillary intrusion allowed the redirection of the mandible by counter-clockwise rotation Figure Mandibular condylar hyperplasia is a rare disease first described in as an condiilar of the mandibular condyle leading to facial asymmetry and occlusal alterations.

All the images were obtained using the same equipment, which was operated by two previously trained technicians. The condilarr force, articular disc and the age of coneilar are important factors in the condylar repair.

Tratamento da assimetria facial causada por hiperplasia condilar: série de casos.

Gammagraphy that shows the end of metabolism and active cell proliferation in the mandible. Condylar hyperplasia, facial asymmetry, orthognatic surgery, dentofacial deformity. You can change the settings or obtain more information by clicking here. For aesthetical purposes an advancement genioplasty was performed.

Asimetría facial secundaria a hiperplasia condilar mandibular: Reporte de un caso

In the present case, orthognathic surgery and TMJ surgery were performed concomitantly because the patient was an adult growth phase ceased and was unwilling to undergo two surgical procedures at different times. The growth process is self-limiting, but as long as it remains active, asymmetry will progress along with associated occlusal alterations. It is important to psychologically prepare the patient to accept the major changes that occur during and after the surgical-orthodontic treatment Figure Some CH classification systems have been proposed.


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Based on the information reported by the patient and clinical data, he was referred for imaging evaluation of the TMJs. C- Panoramic radiograph showing the arrangement and steady maintenance of anchoring devices in place. Along with the surgery of models, it was arrived to a consensus surgical treatment plan Figure 6. Posterior intrusion 3 mm. The risk of recurrence of benign tumors is low after surgical removal. The patient was hospitalized for 2 days and received antibiotics, anti-inflammatory drugs, and analgesics.

It is important to be cognizant with the type of surgery to be performed as well as all expected changes, to perform presurgical dental movements. Thus, the low condylectomy was performed carefully using an instrument to protect the posterior region of the condyle. The macrocospic morphology of the condyle has recently been analyzed by two studies published by the group at the Universidad de La Frontera Olate et al.

This case confirms the importance of performing a low condylectomy to eliminate the tumor.

Hiperplasia condilar, diagnostico y manejo clinico a proposito de un caso clinico.

After the initial period and edema reduction, the patient reported no TMJ pain, there was no limitation of mouth opening and mandibular growth ceased. If the maxillary plane does not follow the mandibular plane, on that side, an open bite will develop.

Thus, it was necessary to keep the jaw in a stable position to avoid postsurgical relapse. Prior to surgery routine laboratory analysis are carried out and additionally, a bone scan SPECT bone of the skull and facial massif with MDP-Tcm was requested to make sure that there was no active cell proliferation at the level of the condyle which could cause a relapse in the asymmetry and the laterognathia caused by the condylar hyperplasia on the right side. A year-old man presented with the esthetic chief complaints of facial asymmetry and difficulty chewing and speaking.

In conclusion, condylar repair and remodeling can be obtained in these types of surgeries and the morphology of resected condyles after 1 year is quite close to normal macroscopic anatomy. Alberto Wintergerst Fisch Escolta Num.


The surgery consisted of the partial resection of the condylar head using a high or proportional condylectomy. The images were analyzed with the EZ3D plus software by a single observer on three different occasions 15 days from the initial measurement in order to reduce analytical error. Nowadays, the combination of different parameters of nuclear medicine, clinical studies and imaging follow-up could determine the progressive and active nature of UCH.

Surgical prediction from the Department of Orthodontics. This disorder is self limiting, but as long as it remains active, asymmetry and occlusal changes will remain progressive.

Several studies have demonstrated the clinical relevance of this technique to patients with Hiprplasia, because this method is able to identify those with persistent unilateral condylar activity. Simple radiographic studies were carried out.

There should be no attempt to bring the teeth to the facial midline. Journal of Oral and Maxillofacial Surgery ; The treatment protocol includes performing a low condylectomy at the junction of the mandibular condyle and condylar neck to completely remove the tumor and preserve the condylar neck. Histopathologic comparison of normal and hyperplastic condyles.

The resected condyle, initially with low vascularization, could lead to a secondary repair, considering that the development of hypertrophic cartilage in its final stage determines bone growth by endochondral methods with low mechanical resistance Chen et al. During the first 10 days, the patient had trismus and difficulty chewing due to TMJ and orthognathic surgery and was therefore given a liquid and soft diet during this period. However, the Risdon submandibular approach was also mentioned as being used for excision of the lesion in the mandibular condyle.

Surgical solutions were represented by condilectomy, orthognathic surgery, and a combination of both. When this affects one of the mandibular condyles, it is called unilateral condylar hyperplasia UCH and is characterized as presenting alterations to both the condylar and facial morphology Olate et al.

Presurgical orthodontic treatment is of the utmost importance. Experiencie with 61 patients. One year after the surgery, imaging revealed a clear sign of regeneration likely due to bone apposition with cortical structure, which was partial in every case.