• The Journal of the Korean dental association
• /
• v.24 no.5 s.204
• /
• pp.439-447
• /
• 1986

The occurrence of osteochondroma, osteoma in mandibular condlye is rare. Sign and symptoms of enlargement of condyle are open bite, cross bite, myofascial symptoms, facial asymmetry. They are treated via condylectomy, subcondylar ostetomy, etc. We treated osteochondroma with condylectomy, osteoma with condylectomy & arthroplasty with titanium mesh & resin ball. Followings are the results 1. Condylectomy of osteochondroma resulted in good function & esthetics except slight deviation of mandible to the operation side during mouth opening. 2. Condylectomy & arthroplasty with titanium mesh & resin ball resulted in good function & esthetics & no deviation of mandible.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.18 no.2
• /
• pp.200-207
• /
• 1996

In patients with unilateral condylar hyperplasia, increased length of the condylar neck causes deviation of the mandible to the opposite site, resulting in facial asymmetry, but the arch form and general contour of the displaced mandible is approximately symmetric. So, the unilateral condylectomy have been prefered surgical method among the surgeons. The purpose of this study is to analyze the postoperative results comparatively following two different surgical methods, condylectomy and ramus surgery, in unilateral condylar hyperplasia. Case of 6 patients with the unilateral condylar hyerplasia were analyzed in this study, 3 case of the condylectomy only, 3 cases of the ramus surgery, Clinical and radiographic evaluations were tried for comparison. In conclusion, comparative results between two groups did not show any significant difference, but we confirmed that unilateral condylectomy could be a excellent surgical methods in unilateral condylar hyperplasia thinking over the unique morphological characteristics of it.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.41 no.5
• /
• pp.259-264
• /
• 2015

We describe our experience with conservative condylectomy for the correction of facial asymmetry in five patients with osteochondroma of the mandibular condyle. All five patients presented with malocclusion and facial asymmetry, which are common clinical findings of osteochondroma involving the mandibular condyle. We performed conservative condylectomy without additional orthognathic surgery for all five patients, preserving the vertical height of the condylar process as much as possible. Following surgery, intermaxillary traction using a skeletal anchorage system with rubber elastics was performed on all patients to improve occlusion, and, when necessary, additional minimal orthodontic treatment was performed. The mean follow-up period was 42 months. At the last follow-up visit, all patients exhibited satisfactory facial symmetry and remodeling of the remaining condyle, with stable health and no signs of recurrence. In conclusion, conservative condylectomy alone, without subsequent orthognathic surgery, is adequate for the restoration of facial symmetry and the preservation of vertical condylar height in select patients with condylar osteochondroma.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.37
• /
• pp.23.1-23.8
• /
• 2015

Background: The purpose of this study was to investigate the functional effects of temporalis myofascial flap after condylectomy, with or without disc removal, in elderly patients with anterior disc displacement (ADD) without reduction and an erosive condylar surface of the temporomandibular joint (TMJ). Methods: A total of 15 joints from 11 elderly patients (71-78 years old) were included. The patients had pain, mandibular dysfunction symptoms, and unilateral or bilateral ADD as well as an erosive condylar surface of the TMJ. All patients underwent temporalis myofascial flap reconstruction after condylectomy, with or without disc removal. If the maximal mouth opening (MMO) remained <35 mm after condylectomy, coronoidotomy was also performed. Self-assessed pain and mandibular function, including MMO and protrusive and lateral movements, were evaluated. Results: No patient experienced serious complications. Most measurements improved significantly after surgery compared to preoperatively. Most patients achieved nearly-normal mouth opening at 4 weeks after surgery. Although most patients felt discomfort during active postoperative physiotherapy, no patient reported serious pain during the follow-up period. Conclusion: Although nonsurgical therapy is often the first treatment choice for ADD without reduction of the TMJ, surgical intervention involving condylectomy and temporalis myofascial flap reconstruction may be a reasonable first option for elderly patients with an erosive condylar surface of the TMJ.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.29 no.3
• /
• pp.233-240
• /
• 2007

Osteochondroma is a common benign tumor of the axial skeleton, especially the distal metaphysis of the femur and proximal metaphysis of the tibia. However, it occurred rarely on the facial skeleton. The coronoid and condylar processes have been considered to be the most common sites of occurrence for osteochondroma of the facial skeleton. The first treatment of osteochondroma is condylectomy, whereas extirpation was done by excision with condyle salvage. Condylectomy presents decrease of vertical dimension, jaw deviation, malocclusion. So, reconstruction is need. Methods of reconstruction are as follows: no reconstruction, condyloplasty, discectomy, costochondral graft, discplication or coronoidectomy, eminoplasty, alloplastic spacer placement, Le Fort I level maxillary osteotomy, extraoral and intraoral vertical ramus osteotomy. This is a case report of a 28-year old woman who had facial asymmetry, malocclusion and temporomandibular joint pain. We obtained moderate functional and cosmetic results with surgical removal of the osteochondroma by condylectomy and concomitant reconstruction of condyle by vertical ramus osteotomy with sliding technique.

• The korean journal of orthodontics
• /
• v.38 no.6
• /
• pp.437-455
• /
• 2008

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.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.13 no.2
• /
• pp.191-198
• /
• 1991

This is a case report and review of literature of the facial asymmetry corrected by various surgical methods. In case 1, facial asymmetry resulted from osteochondroma of condyle and corrected via condylectomy only. In case 2, unilateral condylar hyperplasia with compensatory maxillary growth resulted in severe facial asymmetry. Procedures used in case 2 are vertical ramus osteotomy, condylectomy, genioplasty, mandibular inferior border ostectomy and Le Fort I osteotomy.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.37
• /
• pp.4.1-4.6
• /
• 2015

Osteochondroma is rarely reported in the maxillofacial region; however, it is prevalent in the mandibular condyle. This slowly growing tumor may lead to malocclusion and facial asymmetry. A 39-year-old woman complained of gradual development of anterior and posterior unilateral crossbite, which resulted in facial asymmetry. A radiological study disclosed a large tumor mass on the top of the left mandibular condyle. This bony tumor was surgically removed through condylectomy and the remaining condyle head was secured. Subsequently, bimaxillary orthognathic surgery was performed to correct facial asymmetry and malocclusion. Pathological diagnosis was osteochondroma; immunohistochemistry showed that the tumor exhibited a conspicuous expression of BMP-4 and BMP-2 but rarely expression of PCNA. There was no recurrence at least for 1 year after the operation. Patient's functional and esthetic rehabilitation was uneventful.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.38 no.5
• /
• pp.305-309
• /
• 2012

Temporomandibular joint (TMJ) subluxation and dislocation are uncommon but very unpleasant and distressing conditions to patients. Subluxation of the TMJ is an excessively abnormal condylar excursion secondary to flaccidity and laxity of the capsule. When the condyle head excurses anterior to the eminence upon wide opening, it can return to the fossa by self-manipulation or non-surgical conservative reduction. Surgery is recommended if a complete dislocation, so-called open lock, occurs as a chronic or recurrent protracted condition that cannot be reduced voluntarily. A range of surgical procedures can be performed to limit condylar hypermobility inclusing soft tissue tethering, creation of articular obstacles, removal of mechanical blockade and augmentation of articular eminence using different kinds of grafts. In the present case, a 74-year-old woman was diagnosed with a chronic TMJ dislocation that had lasted for 6 months. Bilateral condylectomy was performed and the post-operative results were good without functional limitations or recurrence.

• Archives of Plastic Surgery
• /
• v.42 no.6
• /
• pp.716-720
• /
• 2015

Background This study has been conducted with the aim of evaluating modified T-plate interpositional arthroplasty. Methods A prospective comparative study in patients admitted with temporomandibular joint ankylosis. Ankylotic temporomandibular joint arthroplasty included condylectomy gap arthroplasty in 7, temporalis muscle flap interpositional arthroplasty in 8, and modified T-plate interpositional arthroplasty in 13 cases. The patients were followed for three years. Collected data were tabulated and subjected to Fisher's exact test, chi-square test and probability estimation. Results A significant increase in interincisal distance of 32 mm was seen in 12 (92.31%) patients in the T-plate interposition group, in 2 (25%) cases of the temporalis muscle flap interposition group, and in 1 case (14.28%) of the condylectomy group at 12, 24, and 36 months. Re-ankylosis was observed in 1 case (9.69%) of the T-plate interposition group, while as it was observed in 4 (50%) cases in the temporalis muscle flap interposition group and 4 (57.14%) cases in the condylectomy group, and these differences were statistically significant. Conclusions Our clinical experience with the use of the T-plate over the past 5 years has been encouraging, and our physiotherapy technique is quite simple. Even illiterate parents can assess it easily. Hence, we recommend this easy technique that does not damage the temporalis muscle for the management of temporomandibular joint ankylosis.