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Surgical management of mandibular condylar hyperplasia type 1
Larry M Wolford1, Carlos A Morales-Ryan, Patricia García-Morales
1Department of Oral and Maxillofacial Surgery, Texas A & M University Health Science Center Baylor College of Dentistry and Baylor University Medical Center, Dallas, Texas (Wolford, Morales-Ryan, Perez), and the Department of Biomedical Sciences, Texas A & M University Health Science Center Baylor College of Dentistry (García-Morales). Dr. Morales-Ryan and Dr. García-Morales are now in private practice in Laredo, Texas.
Abstract:
This study compared outcomes of two surgical methods for patients diagnosed with active condylar hyperplasia type 1. Group 1 (n = 12) was treated with orthognathic surgery only, while group 2 (n = 42) was treated with high condylectomies, articular disc repositioning, and orthognathic surgery. There was no statistically significant difference between the two groups for maximum incisal opening, lateral excursions, and subjective jaw function before surgery. Group 2 showed more active presurgical mandibular growth (P < 0.05). At long-term follow up, no differences were found in lateral excursions and subjective jaw function. Group 2 showed a greater increase in maximum incisal opening (P < 0.01) and stability (P < 0.05) at long-term follow-up. All of the patients in group 1 grew back into skeletal and occlusal Class III relationships requiring secondary intervention, whereas all patients in group 2 remained stable in a Class I skeletal and occlusal relationship. Thus, patients with active condylar hyperplasia treated with high condylectomy, articular disc repositioning, and orthognathic surgery had stable, predictable outcomes compared with those treated with orthognathic surgery only. The high condylectomy effectively arrests disproportionate mandibular growth while maintaining normal jaw function.
