The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Application and effects of condylectomy in asymmetric patients with condylar hyperplasia

과두과증식을 동반한 안면비대칭 환자에서 과두절제술의 적용과 효과

  • Lim, Kyoung-Sub (Department of Orthodontics, School of Dentistry, Yonsei University) ;
  • Cha, Jung-Yul (Department of Orthodontics, School of Dentistry, Yonsei University) ;
  • Hwang, Chung-Ju (Department of Orthodontics, School of Dentistry, Yonsei University, Dental Science Research Institute)
  • 임경섭 (연세대학교 치과대학 교정학교실) ;
  • 차정열 (연세대학교 치과대학 교정학교실) ;
  • 황충주 (연세대학교 치과대학 교정학교실, 두개안면기형연구소, 구강과학연구소)
  • Published : 2008.12.30
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Abstract

Condylar hyperplasia is a pathologic condition showing 3-dimensional skeletal hyperplasia of the mandible. The reason for condylar hyperplasia is not yet known, but the effects of hormone, trauma, infection, genetics, fetal condition, and hypervascularity are known as possible reasons. When we diagnose a patient as having condylar hyperplasia, it is important to decide if it is in progress or not. Treatment for facial asymmetry due to condylar hyperplasia are decided accordingly, including condylectomy, that is removal of growth site of the affected condyle, and conventional orthognathic surgery only or condylectomy with orthognathic surgery after the completion of growth. Therefore, it is important to determine the growth state of condylar hyperplasia in treatment stability. This is verified through bone scan and regular check-ups with 3D CT or PA cephalogram. This case report introduces an improved case of facial asymmetry with condylectomy together with orthognathic surgery.

과두과증식은 하악의 3차원적인 골격적인 비대가 일어나는 병적인 상태이다. 이러한 과두과증식의 원인은 호르몬의 작용, 외상, 감염, 유전, 태아기 때의 요인, hypervascularity 등의 요인으로 알려져 있다. 과두과증식의 진단 시 가장 중요한 것은 과두과증식 상태가 아직도 활성화 상태인지 판단하는 것이다. 이러한 과두과증식의 상태에 따라서 안면비대칭 환자의 치료는 이환측 과두의 성장 부위를 제거하는 과두절제 술을 시행하는 방법, 성장이 완료될 때까지 기다렸다가 통상적인 악교정 수술만을 시행하거나 과두절제술을 병행하는 시술방법이 있다. 과두과증식의 활성화 상태를 판단하는 것은 치료 안정성에 매우 중요한 요인이며, bone scan이나 주기적인 3차원 컴퓨터 단층촬영이나 정모 두부방사선사진 등을 통하여 확인할 수 있다. 본 보고에서는 과두과증식을 동반한 안면비대칭 환자를 과두절제술를 이용하여 개선한 증례를 소개하고자 한다.

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