Orthodontic and surgical treatment of unilateral condylar hyperplasia during growth--a case report

A 9-year-old boy was diagnosed as having an unilateral cross-bite with mandibular deviation. This was later found to be due to unilateral hyperplasia of the right condyle. The increased growth activity subsequently led to an extreme facial asymmetry and a serious psychological condition began to develop. Consequently, surgery was performed at the age of 11 years 8 months when removal of the enlarged condyle and an oblique ramus osteotomy on the opposite side was performed. In this way the facial asymmetry was eliminated. No effort during the surgery was made, however, to restore normal occlusion. The post-operative orthodontic treatment was successful in allowing growth to bring about a normalization of the occlusal relationships. Two years after surgery, complete aesthetic and function rehabilitation has been achieved. This has also led to an improvement in the patient's psychological condition. The result was still stable 11 years post-operatively. The case illustrates the value of early treatment and co-operation between orthodontists and oral surgeons.